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Nan J, Chen M, Yuan H, Cai S, Piao W, Li F, Yang Y, Zhao L, Yu D. Prevalence and Influencing Factors of Central Obesity among Adults in China: China Nutrition and Health Surveillance (2015-2017). Nutrients 2024; 16:2623. [PMID: 39203759 PMCID: PMC11357308 DOI: 10.3390/nu16162623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 09/03/2024] Open
Abstract
The purpose of this study was to describe the prevalence of central obesity and its influencing factors among Chinese adults aged 18 or older. The data were from China Nutrition and Health Surveillance (2015-2017), which used a stratified, multistage, random sampling method. A total of 145,298 adults aged 18 years or older from 31 provinces were included in this study. The Criteria of Weight for Adults promulgated by China in 2013 were used to determine central obesity. Out of all the adults investigated, 48,342 were identified with central obesity, with a prevalence rate of 33.3%. A logistic analysis suggested that the following factors were associated with central obesity: female sex [odds ratio (OR) = 1.329, 95%CI = 1.277~1.384]; increasing age [OR (95%CI): 1.146 (1.061~1.238), 1.254 (1.167~1.348), 1.774 (1.651~1.907), 2.041 (1.894~2.198), 2.434 (2.239~2.647)]; being married [OR = 1.184, 95%CI = 1.077~1.302]; being divorced or widowed [OR = 1.132, 95%CI = 1.006~1.273]; an urban setting [OR = 1.096, 95%CI = 1.061~1.132]; BMI [OR (95%CI): 0.159 (0.095~0.266), 12.645 (11.388~14.042), 180.989 (153.025~214.064)]; drinking [OR = 1.069, 95%CI = 1.031~1.109]; and screen time > 5 h [OR = 1.088, 95%CI = 1.036~1.141] were risk factors for central obesity; while education above primary school [OR (95%CI): 0.905 (0.875~0.936), 0.857 (0.802~0.915)] and sufficient physical activity [OR = 0.819, 95%CI = 0.782~0.858] were protective factors for central obesity. This study revealed that the prevalence of central obesity, which differed by gender and age, is still high. Large differences between different groups and geographic regions exist persistently. Effective, sustainable, and culturally targeted interventions are needed.
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Affiliation(s)
- Jing Nan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
| | - Mulei Chen
- Chinese Center for Disease Control and Prevention, Beijing 102206, China;
| | - Hongtao Yuan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
| | - Shuya Cai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
| | - Wei Piao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
- NHC Key Laboratory of Public Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Fusheng Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
| | - Yuxiang Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
- NHC Key Laboratory of Public Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (J.N.); (H.Y.); (S.C.); (W.P.); (F.L.); (Y.Y.); (L.Z.)
- NHC Key Laboratory of Public Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Gonçalves C, Raimundo A, Abreu A, Pais J, Bravo J. Effects of High-Intensity Interval Training vs Moderate-Intensity Continuous Training on Body Composition and Blood Biomarkers in Coronary Artery Disease Patients: A Randomized Controlled Trial. Rev Cardiovasc Med 2024; 25:102. [PMID: 39076951 PMCID: PMC11263861 DOI: 10.31083/j.rcm2503102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 07/31/2024] Open
Abstract
Background Cardiac rehabilitation (CR) is essential in reducing cardiovascular mortality and morbidity. High-intensity interval training (HIIT) has emerged as a promising exercise intervention for enhancing clinical outcomes in cardiac patients. This study aimed to investigate the effects of two short-term exercise-based programs employing HIIT and moderate-intensity continuous training (MICT) in comparison to a control group concerning blood pressure, body composition, and blood biomarkers in patients diagnosed with coronary artery disease (CAD). Methods Seventy-two CAD patients (14% women) underwent randomization into three groups: HIIT, MICT, and control. The training programs encompassed six weeks of supervised treadmill exercises, conducted thrice weekly. MICT targeted ≈ 70-75% of peak heart rate (HRpeak), while HIIT was tailored to ≈ 85-95% of HRpeak. The control group received guidance on adopting healthy lifestyles. Outcome measurements included evaluations of blood pressure, body composition, and blood biomarkers. Results In contrast to MICT, the HIIT exhibited superior improvements in body fat mass ( Δ %HIIT: 4.5%, p < 0.001 vs. Δ %MICT: 3.2%, p < 0.001), waist circumference ( Δ %HIIT: 4.1%, p = 0.002 vs. Δ %MICT: 2.5%, p = 0.002), hemoglobin A1c (HbA1c) ( Δ %HIIT: 10.4%, p < 0.001 vs. Δ %MICT: 32.3%, p < 0.001) and thyrotropin (TSH) ( Δ %HIIT: 16.5%, p = 0.007 vs. Δ %MICT: 3.1%, p = 0.201). Both HIIT and MICT induced significant enhancements across all variables compared to the control group. Conclusions HIIT and MICT emerged as effective modalities for enhancing systolic and diastolic function, body composition, and blood biomarkers in CAD patients, with HIIT demonstrating incremental improvements over MICT. The absence of participation in exercise-based programs following cardiovascular events yielded less favorable outcomes. HIIT holds promise as an adjunct intervention in CR programs for CAD patients. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT03538119.
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Affiliation(s)
- Catarina Gonçalves
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre, 7002 - 554 Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre, 7002 - 554 Évora, Portugal
| | - Ana Abreu
- Department of Cardiology, Santa Maria Hospital, 1649-028 Lisbon, Portugal
| | - João Pais
- Department of Cardiology, Espírito Santo Hospital of Évora, 7000-811 Évora, Portugal
| | - Jorge Bravo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7000-727 Évora, Portugal
- Comprehensive Health Research Centre, 7002 - 554 Évora, Portugal
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Bober J, Wiśniewska K, Okręglicka K. Eating Behaviours of Polish and Portuguese Adults-Cross-Sectional Surveys. Nutrients 2023; 15:nu15081934. [PMID: 37111153 PMCID: PMC10143936 DOI: 10.3390/nu15081934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Eating behaviours affect energy intake through the types and amounts of foods chosen and decisions about the beginning and ending of the eating process. This study aims to determine and compare the eating behaviours of Polish and Portuguese adults and, in addition, to establish the correlations between daily behaviours, food-approaches and food-avoidance behaviours, and BMI in both populations. The study was conducted between January 2023 and March 2023. Participants from Poland and Portugal responded to the AEBQ questionnaire and questions on eating habits and body-image self-perception. The research tool was a website-based survey questionnaire with single-choice questions. No significant differences related to BMI levels were found between the Polish and Portuguese adults in terms of their eating behaviours. Both groups were characterised by the increased intensity of their food-approach behaviours, which was directly correlated with increases in BMI. Greater snacking intensity and binge drinking were associated with higher BMI. The study revealed an increased prevalence of binge drinking in the Polish sample. The study also confirmed a higher frequency of food-approach behaviours in overweight and/or obese individuals and uncontrolled calorie intake in participants imposing dietary restrictions for weight loss. Nutrition education is needed to improve eating habits and food choices, as well as to prevent overweight and obesity in adults.
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Affiliation(s)
- Julia Bober
- Student Scientific Association of Hygiene and Prevention, Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
| | - Klaudia Wiśniewska
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
| | - Katarzyna Okręglicka
- Department of Social Medicine and Public Health, Medical University of Warsaw, 02-007 Warsaw, Poland
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Goiana-da-Silva F, Cruz-e-Silva D, Rito A, Lopes C, Muc M, Darzi A, Araújo F, Miraldo M, Morais Nunes A, Allen LN. Modeling the health impact of legislation to limit the salt content of bread in Portugal: A macro simulation study. Front Public Health 2022; 10:876827. [PMID: 36176524 PMCID: PMC9513608 DOI: 10.3389/fpubh.2022.876827] [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] [Received: 02/15/2022] [Accepted: 07/20/2022] [Indexed: 01/21/2023] Open
Abstract
Background Excessive salt consumption-associated with a range of adverse health outcomes-is very high in Portugal, and bread is the second largest source. Current Portuguese legislation sets a maximum limit of 1.4 g salt per 100 g bread, but imported and traditional breads are exempted. In 2017 the Ministry of Health proposed reducing the salt threshold to 1.0/100 g by 2022, however the legislation was vetoed by the European Commission on free-trade grounds. Aims To estimate the health impact of subjecting imported and traditional breads to the current 1.4 g threshold, and to model the potential health impact of implementing the proposed 1.0 g threshold. Methods We gathered bread sales, salt consumption, and epidemiological data from robust publicly available data sources. We used the open source WHO PRIME modeling tool to estimate the number of salt-related deaths that would have been averted in 2016 (the latest year for which all data were available) from; (1) Extending the 1.4 g threshold to all types of bread, and (2) Applying the 1.0 g threshold to all bread sold in Portugal. We used Monte Carlo simulations to generate confidence intervals. Results Applying the current 1.4 g threshold to imported and traditional bread would have averted 107 deaths in 2016 (95% CI: 43-172). Lowering the current threshold from 1.4 to 1.0 g and applying it to all bread products would reduce daily salt consumption by 3.6 tons per day, saving an estimated 286 lives a year (95% CI: 123-454). Conclusions Salt is an important risk factor in Portugal and bread is a major source. Lowering maximum permissible levels and removing exemptions would save lives. The European Commission should revisit its decision on the basis of this new evidence.
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Affiliation(s)
- Francisco Goiana-da-Silva
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, United Kingdom,Faculdade de Ciências da Saúde, Universidade da Beira Interior, Covilhã, Portugal
| | - David Cruz-e-Silva
- Center for Innovation, Technology and Policy Research, IN+, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Ana Rito
- National Institute of Health, Porto, Portugal
| | - Carla Lopes
- Department of Public Health and Forensic Sciences, and Medical Education, University of Porto Medical School, Porto, Portugal,Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Magdalena Muc
- Appetite and Obesity Research Group, Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Ara Darzi
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Fernando Araújo
- Centro Hospitalar Universitário São João, Faculty of Medicine, Porto University, Porto, Portugal
| | - Marisa Miraldo
- Department of Management, Centre for Health Economics and Policy Innovation, Imperial College Business School, London, United Kingdom
| | - Alexandre Morais Nunes
- Centro de Administração e Políticas Públicas, Instituto Superior de Ciências Sociais e Políticas, Universidade de Lisboa, Lisboa, Portugal
| | - Luke N. Allen
- London School of Hygiene and Tropical Medicine, London, United Kingdom,*Correspondence: Luke N. Allen
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Yoo TK, Rhim HC, Lee YT, Yoon KJ, Park CH. Relationship between hyperhomocysteinemia and coexisting obesity with low skeletal muscle mass in asymptomatic adult population. Sci Rep 2022; 12:12439. [PMID: 35858996 PMCID: PMC9300668 DOI: 10.1038/s41598-022-16401-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/08/2022] [Indexed: 11/09/2022] Open
Abstract
The relationship between hyperhomocysteinemia (HHcy) and obesity with low skeletal muscle mass (LMM) has not been established. We aim to assess the association between HHcy and the coexistence of obesity and LMM in asymptomatic adult population. We conducted a population-based cross-sectional study among asymptomatic individuals who underwent measurements of plasma homocysteine and body composition analysis. HHcy was defined as > 15 umol/L, obesity as body mass index ≥ 25 (kg/m2), and LMM as skeletal muscle index less than 2 SD below the sex-specific mean of young adults. The participants were classified into ‘control’, ‘obesity alone’, ‘LMM alone’, and ‘obesity with LMM’. Among 113,805 participants, the prevalence of HHcy was 8.3% in control, 8.7% in obesity alone, 10.0% in LMM alone, and 13.0% in obesity with LMM (p for trend < 0.001). In a multivariable logistic regression analysis, the associations showed a positive trend for HHcy along the groups from obesity alone, to LMM alone, and to obesity with LMM. HHcy was independently associated with the presence of LMM alone (adjusted odds ratio 1.186 [95% confidence interval 1.117–1.259]) and obesity with LMM (1.424 [1.134–1.788]), respectively. This study demonstrated that HHcys was more strongly associated with coexistence of obesity and LMM than either condition alone in the adult population.
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Affiliation(s)
- Tae Kyung Yoo
- Department of Medicine, MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA, USA
| | - Hye Chang Rhim
- Department of Medicine, MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA, USA
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunanro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunanro, Jongno-gu, Seoul, 03181, Republic of Korea.,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunanro, Jongno-gu, Seoul, 03181, Republic of Korea. .,Medical Research Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Witkam R, Gwinnutt JM, Humphreys J, Gandrup J, Cooper R, Verstappen SM. Do associations between education and obesity vary depending on the measure of obesity used? A systematic literature review and meta-analysis. SSM Popul Health 2021; 15:100884. [PMID: 34401462 PMCID: PMC8350379 DOI: 10.1016/j.ssmph.2021.100884] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/26/2021] [Accepted: 07/26/2021] [Indexed: 01/22/2023] Open
Abstract
Background Consistent evidence suggests a relationship between lower educational attainment and total obesity defined using body mass index (BMI); however, a comparison of the relationships between educational attainment and total obesity (BMI ≥30 kg/m2) and central obesity (waist circumference (WC) > 102 cm for men and WC > 88 cm for women) has yet to be carried out. This systematic literature review (SLR) and meta-analyses aimed to understand whether i) the associations between education and obesity are different depending on the measures of obesity used (BMI and WC), and ii) to explore whether these relationships differ by gender and region. Methods Medline, Embase and Web of Science were searched to identify studies investigating the associations between education and total and central obesity among adults in the general population of countries in the Organisation for Economic Co-operation and Development (OECD). Meta-analyses and meta-regression were performed in a subset of comparable studies (n=36 studies; 724,992 participants). Results 86 eligible studies (78 cross-sectional and eight longitudinal) were identified. Among women, most studies reported an association between a lower education and total and central obesity. Among men, there was a weaker association between lower education and central than total obesity (OR central vs total obesity in men 0.79 (95% CI 0.60, 1.03)). The association between lower education and obesity was stronger in women compared with men (OR women vs men 1.66 (95% CI 1.32, 2.08)). The relationship between lower education and obesity was less strong in women from Northern than Southern Europe (OR Northern vs Southern Europe in women 0.37 (95% CI 0.27, 0.51)), but not among men. Conclusions Associations between education and obesity differ depending on whether total or central obesity is used among men, but not in women. These associations are stronger among women than men, particularly in Southern European countries.
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Affiliation(s)
- Rozemarijn Witkam
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - James M. Gwinnutt
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - Jennifer Humphreys
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
| | - Julie Gandrup
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
| | - Rachel Cooper
- Department of Sport and Exercise Sciences, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, UK
| | - Suzanne M.M. Verstappen
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
- Corresponding author. Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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Misperception of Healthy Weight: Associations Among Weight, Body Size Satisfaction and Body Appreciation in Older Adults. J Prim Prev 2021; 41:1-14. [PMID: 31828501 DOI: 10.1007/s10935-019-00573-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Misperceived body weight in older people can affect their health and quality of life. We analysed the body image of older adults in Primary Health Care services in central Portugal, by considering participants' weight, body size satisfaction and body appreciation. This epidemiological and cross-sectional study involved 150 participants (56% women) with an average age of 74.9 years who completed questionnaires on body size and body appreciation. Forty-nine percent of participants were affected by overweight and 29% by obesity. The majority was not satisfied with their body size (71.2%), but had very high scores related to body appreciation. Around 40% of the participants with normal weight or overweight were satisfied with their body size. Multiple regression analysis revealed that both body size satisfaction and appreciation were negatively associated with obesity, but not with overweight. Older Portuguese adults are not able to assess if their weight is a risk to their health, but regardless of their perceived physical appearance, the elderly respect their body and are receptive to improving their health.
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Pérez-Rodrigo C, Gianzo Citores M, Hervás Bárbara G, Aranceta-Bartrina J. Prevalence of obesity and abdominal obesity in Spanish population aged 65 years and over: ENPE study. Med Clin (Barc) 2021; 158:49-57. [PMID: 33509603 DOI: 10.1016/j.medcli.2020.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/24/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES To assess the prevalence of obesity and abdominal obesity (AO) in the Spanish population aged ≥65 years, to analyse the influence of selected sociodemographic factors and association with risk factors. METHODS The sample comes from the ENPE study, a cross-sectional study of a representative sample of the non-institutionalized population (2014-2015). This analysis refers to the population ≥65 years (n=1,233). Trained observers performed anthropometric measurements at participants' homes following standard international protocols. Obesity was defined as body mass index (BMI) ≥30; AO waist>102cm men; >88cm women. RESULTS Estimated prevalence of obesity in adults ≥65 years was high, higher in women (40.1% [95% CI 36.4-43.8]) than in men (32.5% [95% CI 28.5-36.8]). The prevalence of AO was also higher in women (69.9% [95% CI 66.4-73.1]) than in men (40.7% [95% CI 36.5-44.8]), and estimates were even higher when defining AO by waist-hip ratio or waist-height ratio. Of those classified as AO, 39.8% have a BMI between 25-29. Obesity and AO are higher in the South region compared to East, North-East and Central regions and showed inverse association with educational level. Obesity and AO were associated with increased probability of hypercholesterolaemia and high blood pressure, sarcopenic obesity, and diabetes. CONCLUSION The prevalence of obesity and AO in adults aged ≥65 years is high, higher in women, in people of lower educational level and in the South region compared to East, North-East and Central regions. The high prevalence of OA is especially worrying due to its association with cardiovascular and metabolic complications and poorer quality of life.
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Affiliation(s)
- Carmen Pérez-Rodrigo
- Departamento de Fisiología, Facultad de Medicina y Enfermería, Universidad del País Vasco (UPV/EHU), Leioa, Bizkaia, España; Sociedad Española de Nutrición Comunitaria (SENC)
| | | | | | - Javier Aranceta-Bartrina
- Departamento de Fisiología, Facultad de Medicina y Enfermería, Universidad del País Vasco (UPV/EHU), Leioa, Bizkaia, España; Sociedad Española de Nutrición Comunitaria (SENC); Departamento de Ciencias de la Alimentación y Fisiología, Universidad de Navarra, Pamplona, Navarra, España; Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS), Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España; CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, España.
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The Associations between Functional Fitness Test Performance and Abdominal Obesity in Healthy Elderly People: Results from the National Physical Fitness Examination Survey in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010264. [PMID: 33396485 PMCID: PMC7796088 DOI: 10.3390/ijerph18010264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 12/31/2022]
Abstract
The relationships between different functional fitness performance and abdominal obesity among the elderly have not been widely discussed in the literature. The present study aimed to investigate the associations between functional fitness test performance and abdominal obesity in Taiwanese elderly people. A total of 22,399 items of data from the National Physical Fitness Survey Databases in Taiwan (NPFSD 2014-15) were reviewed and analyzed. The quartiles of functional fitness test results were identified as the dependent variable in the multiple linear regression analysis to examine the association between functional fitness and abdominal obesity status. The results showed that body balance (odds ratios (ORs) listed from 1.18 to 2.29, p < 0.05) and flexibility (ORs listed from 1.23 to 2.16, p < 0.05) were critically associated with abdominal obesity. However, measurements related to muscle strength revealed the limited effect sizes for abdominal obesity. From a disability prevention perspective, the development of muscle strength in the elderly should be emphasized and encouraged to maintain their daily capabilities instead of satisfaction with a lean body.
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Allometric Modeling of Wingate Test among Adult Male Athletes from Combat Sports. ACTA ACUST UNITED AC 2020; 56:medicina56090480. [PMID: 32967169 PMCID: PMC7558848 DOI: 10.3390/medicina56090480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/28/2020] [Accepted: 09/16/2020] [Indexed: 11/17/2022]
Abstract
Background and objectives: Athletes from combat sports are grouped into a series of weight categories that are intended to promote fair competition. Differences in performance are partly attributable to differences in body size. Consequently, ratio standards in which a performance variable is simply divided by an anthropometric characteristic such as body mass are often used, although this application is not recommended. This study aimed to obtain allometric models to interpret Wingate Anaerobic Test (WAnT) outputs among male adult athletes from combat sports. Materials and Methods: The sample was composed of 64 participants aged 18–39 years (24.2 ± 4.6 years). Stature and body mass (BM) were measured and air displacement plethysmography used to estimate fat mass and fat-free mass (FFM). Lower-limb lean soft tissue (LL-LST) was derived from dual energy X-ray absorptiometry. WAnT outputs were peak power (WAnT-PP) and mean power (WAnT-MP). Allometric models were obtained from simple and multiple linear regressions using log-transformed variables. Results: Models derived from a single three-dimension descriptor explained a large portion of variance: WAnT-PP (BM: 31.1%; FFM: 54%; LL-LST: 47.2%) and WAnT-MP (BM: 50.1%; FFM: 57.4%; LL-LST: 62.7%). Finally, the best proportional allometric models emerged from the combination of LL-LST and FFM (WAnT-PP: 55%; WAnT-MP: 65%). Conclusions: The relationship between weight categories and performance did not seem to be explained by the basic principles of geometric similarity.
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Rito AI, Mendes S, Santos M, Goiana-da-Silva F, Cappuccio FP, Whiting S, Dinis A, Rascôa C, Castanheira I, Darzi A, Breda J. Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education-The Eat Mediterranean Program. Nutrients 2020; 12:nu12082213. [PMID: 32722323 PMCID: PMC7469016 DOI: 10.3390/nu12082213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/07/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022] Open
Abstract
High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention—a community-based program to identify and correct nutritional deviations through the implementation of new school menus and through schools’ food handlers training. EM (2015–2017) was developed in 25 schools (pre to secondary education) of two Portuguese Municipalities, reaching students aged 3–21 years old. Samples of the complete meals (soup + main course + bread) from all schools were collected, and nutritional quality and laboratory analysis were performed to determine their nutritional composition, including sodium content. Overall, there was a significant decrease (−23%) in the mean sodium content of the complete school meals, which was mainly achieved by the significant reduction of 34% of sodium content per serving portion of soup. In conclusion, EM had a positive effect on the improvement of the school meals’ sodium content, among the participant schools. Furthermore, school setting might be ideal for nutrition literacy interventions among children, for flavors shaping, and for educating towards less salty food acceptance.
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Affiliation(s)
- Ana Isabel Rito
- WHO Collaborating Centre on Nutrition and Childhood Obesity—National Institute of Health Dr. Ricardo Jorge (INSA, IP), 1649-016 Lisbon, Portugal; (M.S.); (I.C.)
- Centre for Studies and Research in Social Dynamics and Health (CEIDSS), 1649-016 Lisbon, Portugal;
- Correspondence: ; Tel.: +351-217-519-200
| | - Sofia Mendes
- Centre for Studies and Research in Social Dynamics and Health (CEIDSS), 1649-016 Lisbon, Portugal;
- National School of Public Health, NOVA University of Lisbon, 1600-560 Lisbon, Portugal
| | - Mariana Santos
- WHO Collaborating Centre on Nutrition and Childhood Obesity—National Institute of Health Dr. Ricardo Jorge (INSA, IP), 1649-016 Lisbon, Portugal; (M.S.); (I.C.)
- National School of Public Health, NOVA University of Lisbon, 1600-560 Lisbon, Portugal
| | - Francisco Goiana-da-Silva
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK; (F.G.-d.-S.); (A.D.)
| | - Francesco Paolo Cappuccio
- University of Warwick, WHO Collaborating Centre for Nutrition, Warwick Medical School, Coventry CV2 2DX, UK;
| | - Stephen Whiting
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russia; (S.W.); (J.B.)
| | - Ana Dinis
- Regional Health Administration of Lisbon and Tagus Valley (ARSLVT), 1700-179 Lisbon, Portugal; (A.D.); (C.R.)
| | - Carla Rascôa
- Regional Health Administration of Lisbon and Tagus Valley (ARSLVT), 1700-179 Lisbon, Portugal; (A.D.); (C.R.)
| | - Isabel Castanheira
- WHO Collaborating Centre on Nutrition and Childhood Obesity—National Institute of Health Dr. Ricardo Jorge (INSA, IP), 1649-016 Lisbon, Portugal; (M.S.); (I.C.)
| | - Ara Darzi
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London SW7 2AZ, UK; (F.G.-d.-S.); (A.D.)
| | - João Breda
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, 125009 Moscow, Russia; (S.W.); (J.B.)
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12
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Nunes B, Barreto M, Gil AP, Kislaya I, Namorado S, Antunes L, Gaio V, Santos AJ, Rodrigues AP, Santos J, Roquette R, Alves-Alves C, Castilho E, Cordeiro E, Dinis A, Prokopenko T, Silva AC, Vargas P, Lyshol H, Dias CM. The first Portuguese National Health Examination Survey (2015): design, planning and implementation. J Public Health (Oxf) 2020; 41:511-517. [PMID: 30239797 DOI: 10.1093/pubmed/fdy150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/09/2018] [Accepted: 08/03/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In Health Examination Surveys interview information is complemented with objective information, providing more accurate indicators than self-reported data. We report the study design, planning and implementation of the first Portuguese Health Examination Survey (INSEF). METHODS INSEF was a cross-sectional population-based study representative at regional and national level. Individuals aged between 25 and 74 years old, residing in Portugal were selected from the national health users' registry through multi-stage stratified probabilistic sampling. Sample size was set at 4200 individuals. Data was collected in primary care units and included blood pressure, height, weight, hip and waist measurements, blood collection for lipid profile, HbA1c and blood count and a general health questionnaire. European HES procedures were followed. RESULTS A total of 4911 individuals agreed to participate (43.9% participation rate). Participation rate varied by region, sex and age group, being lower in Lisbon and Tagus Valley (32.8%), for men (41.8%) and for those aged 25-34 years old (36%). CONCLUSIONS INSEF has set up an experienced national and regional structure for HES implementation. Nationally representative quality epidemiological data is now available for public health monitoring, planning and research.
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Affiliation(s)
- Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Marta Barreto
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana P Gil
- CICS.NOVA - Centro Interdisciplinar de Ciências Sociais, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Irina Kislaya
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Sónia Namorado
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Liliana Antunes
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Vânia Gaio
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana J Santos
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Ana P Rodrigues
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Joana Santos
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Rita Roquette
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal
| | - Clara Alves-Alves
- Department of Public Health, Norte Regional Health Administration, Porto, Portugal
| | - Emília Castilho
- Department of Public Health, Algarve Regional Health Administration, Faro, Portugal
| | - Eugénio Cordeiro
- Department of Public Health, Centro Regional Health Administration, Coimbra, Portugal
| | - Ana Dinis
- Department of Public Health, Lisbon and Tagus Valley Regional Health Administration, Lisboa, Portugal
| | - Tamara Prokopenko
- Department of Public Health, Alentejo Regional Health Administration, Évora, Portugal
| | - Ana C Silva
- Autonomous Region of Madeira, Regional Government, Vice.Presidency, Funchal, Portugal
| | - Patrícia Vargas
- Regional Directorate for Health, Regional Secretariat for Health, Autonomous Region of Azores, Angra do Heroísmo, Portugal
| | - Heidi Lyshol
- Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway
| | - Carlos M Dias
- Department of Epidemiology, Instituto Nacional de Saúde Doutor Ricardo Jorge, Av. Padre Cruz, 1649-016 Lisboa, Portugal.,Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
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13
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Macek P, Biskup M, Terek-Derszniak M, Krol H, Smok-Kalwat J, Gozdz S, Zak M. Optimal cut-off values for anthropometric measures of obesity in screening for cardiometabolic disorders in adults. Sci Rep 2020; 10:11253. [PMID: 32647283 PMCID: PMC7347554 DOI: 10.1038/s41598-020-68265-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/11/2020] [Indexed: 02/06/2023] Open
Abstract
Excessive accumulation of body fat (BF) promotes obesity, whilst posing a significant health hazard. There being no agreed, optimal quantifying methods, application of BF variable in clinical practice is not deemed an effective assessment option. The study, involving 4,735 patients (33.6% men), aged 45-64, aimed to identify optimal cut-off values for anthropometric indicators of obesity to evaluate cardiometabolic risk. A minimum P-value approach was applied to calculate the cut-offs for BF%. Threshold values for body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height (WHTR) ratio, facilitating optimal differentiation of cardiometabolic risk, were based on BF%, expressed as a binary classifier. The newly estimated cut-off values for predicting cardiometabolic risk, based on BMI, were lower than the referential obesity thresholds, whereas the threshold values of WC, WHR, and WHTR were higher. Apart from dyslipidemia, the odds of cardiometabolic disorders were higher, when the anthropometric indicators under study exceeded the cut-off points in both sexes. The proposed cut-offs proved instrumental in predicting cardiometabolic risk, whilst highlighting diagnostic and clinical potential of BF%, whereas BMI boasted the highest predictive potential. Cardiometabolic risk also proved significantly higher even in the overweight patients.
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Affiliation(s)
- Pawel Macek
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Department of Epidemiology and Cancer Control, Holycross Cancer Centre, 25-734, Kielce, Poland
| | - Malgorzata Biskup
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Department of Rehabilitation, Holycross Cancer Centre, 25-734, Kielce, Poland
| | | | - Halina Krol
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Research and Education Department, Holycross Cancer Centre, 25-734, Kielce, Poland
| | | | - Stanislaw Gozdz
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland
- Clinical Oncology Clinic, Holycross Cancer Centre, 25-734, Kielce, Poland
| | - Marek Zak
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-317, Kielce, Poland.
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14
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Paixão C, Dias CM, Jorge R, Carraça EV, Yannakoulia M, de Zwaan M, Soini S, Hill JO, Teixeira PJ, Santos I. Successful weight loss maintenance: A systematic review of weight control registries. Obes Rev 2020; 21:e13003. [PMID: 32048787 PMCID: PMC9105823 DOI: 10.1111/obr.13003] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long-term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer-reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty-two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.
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Affiliation(s)
- Catarina Paixão
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Carlos M Dias
- Centro de Investigação em Saúde Pública (CISP), NOVA-Escola Nacional de Saúde Pública, Lisbon, Portugal.,Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Rui Jorge
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal.,Unidade de Investigação do Instituto Politécnico de Santarém, Escola Superior Agrária, Instituto Politécnico de Santarém, Santarém, Portugal
| | - Eliana V Carraça
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sirpa Soini
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - James O Hill
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Pedro J Teixeira
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal
| | - Inês Santos
- Centro Interdisciplinar para o Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, Portugal.,Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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15
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Influence of Time Interval from Bariatric Surgery to Conception on Pregnancy and Perinatal Outcomes. Obes Surg 2018; 28:3559-3566. [DOI: 10.1007/s11695-018-3395-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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16
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Oliveira A, Araújo J, Severo M, Correia D, Ramos E, Torres D, Lopes C. Prevalence of general and abdominal obesity in Portugal: comprehensive results from the National Food, nutrition and physical activity survey 2015-2016. BMC Public Health 2018; 18:614. [PMID: 29747603 PMCID: PMC5946450 DOI: 10.1186/s12889-018-5480-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 04/19/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study includes, for the first time, estimates of general and abdominal obesity prevalence for all ages of the Portuguese population, using common standardized methodologies. Results are compared by sex, age groups, educational level and geographical regions. METHODS Participants were a representative sample of the Portuguese population aged between 3 months and 84 years of age (n = 6553), enrolled in the National Food, Nutrition and Physical Activity Survey, 2015-2016. Objective anthropometric measurements included length/height, weight and body circumferences, performed according to standard procedures. Body mass index (BMI) was classified according to the World Health Organization (WHO) growth charts for children and adolescents, and WHO criteria for adults. Abdominal obesity was defined in adults as waist-hip ratio ≥ 0.85 in women or ≥ 0.90 in men. Prevalence estimates and 95% confidence intervals (95%CI) were weighted according to a complex sampling design, considering stratification by seven geographical regions and cluster effect for the selected Primary Health Care Unit. RESULTS The national prevalence of obesity is 22.3% (95%CI: 20.5-24.0), significantly higher in women. Obesity prevalence is much higher in the elderly (39.2%, 95%CI. 34.2-44.2), while children and adolescents have the lowest prevalence around 8-9%. In a regression model, three knot points denoting an inflection of obesity prevalence across the life span were observed around 5, 15 and 75 years. The prevalence of pre-obesity at national level is 34.8% (95%CI: 32.9-36.7), higher in men, and almost 18% of children and 24% of adolescents have pre-obesity. The sex- and age-standardized prevalence of obesity ranged from 38.3% (95%CI: 34.6-42.1) to 13.1% (95%CI: 10.3-15.9) for the less and the most educated individuals, respectively. Although some geographical region disparities, obesity prevalence did not significantly differed across regions (p = 0.094). The national prevalence of abdominal obesity in adults is 50.5% (95%CI: 47.9-53.1), particularly high in the elderly (80.2%). CONCLUSION Almost 60% of the general Portuguese population is obese or pre-obese. Women, elderly and less educated individuals present the highest obesity prevalence. Abdominal obesity, in particular, seems to be a relevant public health problem among the elderly men.
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Affiliation(s)
- Andreia Oliveira
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Joana Araújo
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
| | - Milton Severo
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Daniela Correia
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
| | - Elisabete Ramos
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Duarte Torres
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Faculty of Food and Nutrition Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit – Institute of Public Health, University of Porto, Rua das Taipas, 135-139 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
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17
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Raposo L, Severo M, Santos AC. Adiposity cut-off points for cardiovascular disease and diabetes risk in the Portuguese population: The PORMETS study. PLoS One 2018; 13:e0191641. [PMID: 29377924 PMCID: PMC5788377 DOI: 10.1371/journal.pone.0191641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/09/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives The contribution of adiposity to cardiovascular and diabetes risk justifies the inclusion of an adiposity measure, usually waist circumference, in the definition of metabolic syndrome. However, waist circumference thresholds differ across populations. Our aim was to assess which adiposity measure performs the best in identifying the metabolic syndrome in a sample of Portuguese participants and to estimate cut-off values for these measures. Methods Data were obtained from a cross-sectional study (PORMETS study) conducted in Portugal between 2007 and 2009. A representative sample of non-institutionalized adults, comprising 3,956 participants, aged 18 years and older, was evaluated. A structured questionnaire was administered, collecting information on personal medical history, socio-demographics and behavioral characteristics. Anthropometrics, blood pressure and venous blood samples were also obtained. Metabolic syndrome was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology recommended criteria. Elevated cardiometabolic risk was considered when two or more of the four criteria of metabolic syndrome were present, excluding the waist circumference component. A receiver operating characteristic curve was used to estimate cut-off points. Results This study found that waist-to-height ratio, waist circumference and body adiposity index performed better than other adiposity measures, such as body mass index. The estimated cut-off points for waist-to-height ratio, waist circumference and body adiposity index in women and men were 0.564 / 89 cm / 27.4 and 0.571 / 93.5 cm / 25.5, respectively. Conclusion As waist circumference is currently used as the adiposity measure in the definition of metabolic syndrome and as no relevant differences were observed between this measure and waist-to-height ratio, it is likely that no modification to the metabolic syndrome definition needs to be proposed. Moreover, this study also confirmed the applicability of European cut-off points in the Portuguese population.
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Affiliation(s)
- Luís Raposo
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- * E-mail:
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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18
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Rosário R, Barros R, Padrão P, Santos R, Teixeira VH, Lopes O, Andrade N, Moreira A, Moreira P. Body Mass Index Categories and Attained Height in Portuguese Adults. Obes Facts 2018; 11:287-293. [PMID: 29991056 PMCID: PMC6189534 DOI: 10.1159/000491754] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/03/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To analyze the associations between height and BMI categories in a Portuguese representative sample. METHODS This is a cross-sectional study with a representative sample of 32,644 Portuguese adults (52.4% females). Sociodemographic and lifestyle characteristics were obtained along with self-reported height and weight. We performed generalized linear models to assess the differences in attained height across BMI categories; analyses were adjusted for age, gender, education, family income per month, proxy reporting information, dietary patterns, and smoking. RESULTS BMI categories included underweight and normal weight (46.4%), overweight (37.6%), obese class I and II (15.2%), and obese class III (0.8%). Adults with normal weight had a significantly higher height (females +7 cm and males +5 cm) when compared to obese class III. As BMI categories increased, height decreased. In females and males, after adjusting for confounders, estimates of attained height decreased when compared to the unadjusted model (β = -0.049, 95% CI = -0.050; -0.049 and β = -0.030, 95% CI = -0.031; -0.029, respectively), although they remained still significant. CONCLUSION Our results suggest a significant difference in attained height between BMI categories. Future intervention programs aiming at preventing overweight and obesity should monitor sociodemographic, health and environmental conditions that affect attained height potential.
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Affiliation(s)
- Rafaela Rosário
- School of Nursing, University of Minho, Braga, Portugal
- Research Center in Child Studies, University of Minho, Braga, Portugal
- *Rafaela Rosário, School of Nursing, University of Minho, 3º Piso - Edif. da Biblioteca Geral (BGUM), Campus de Gualtar, 4710-057 Braga, Portugal,
| | - Renata Barros
- Faculty of Nutrition and Food Sciences; University of Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences; University of Porto, Porto, Portugal
- Public Health Institute, Porto, Portugal
| | - Rute Santos
- Early Start Research Institute, University of Wollongong, Wollongong, Australia
- Research Center in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Vitor Hugo Teixeira
- Faculty of Nutrition and Food Sciences; University of Porto, Porto, Portugal
| | - Oscar Lopes
- Sport's Medical Center of Braga, Braga, Portugal
| | - Nelson Andrade
- Faculty of Nutrition and Food Sciences; University of Porto, Porto, Portugal
| | - Andre Moreira
- Public Health Institute, Porto, Portugal
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences; University of Porto, Porto, Portugal
- Public Health Institute, Porto, Portugal
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19
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Owolabi EO, Ter Goon D, Adeniyi OV. Central obesity and normal-weight central obesity among adults attending healthcare facilities in Buffalo City Metropolitan Municipality, South Africa: a cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2017; 36:54. [PMID: 29282137 PMCID: PMC5745975 DOI: 10.1186/s41043-017-0133-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/14/2017] [Indexed: 05/30/2023]
Abstract
BACKGROUND Central obesity (CO) confers a significant threat on the cardio-metabolic health of individuals, independently of overall obesity. Disparities in the measures of fat distribution lead to misclassification of individuals who are at risk of cardio-metabolic diseases. This study sought to determine the prevalence and correlates of central obesity and normal-weight central obesity among adults attending selected healthcare facilities in Buffalo City Metropolitan Municipality (BCMM), South Africa, assess their health risk and examine the association between central obesity and cardio-metabolic diseases among adults with normal weight, measured by body mass index (BMI). METHODS A cross-sectional survey of 998 adults was carried out at the three largest outpatient clinics in BCMM. Overall and central obesity were assessed using BMI, waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHTR). The WHO STEPwise questionnaire was used for data collection. Blood pressure and blood glucose were measured. Normal-weight central obesity was defined as CO among individuals with normal weight, as assessed by BMI. Health risk levels were assessed using the National Institute for Health and Clinical Excellence (NICE) BMI-WC composite index. Bivariate and multivariate analyses were used to determine the prevalence of CO, normal-weight central obesity and the predictors of CO. RESULTS The mean age of participants was 42.6 (± 16.5) years. The prevalence of CO was 67.0, 58.0 and 71.0% by WC, WHR and WHTR, respectively. The prevalence of normal-weight central obesity was 26.9, 36.9 and 29.5% by WC, WHR and WHTR, respectively. About 41% of the participants had a very high health risk, 13% had increased risk or high risk and 33% had no health risk. Central obesity was significantly associated with hypertension but not associated with diabetes among those with normal weight (by BMI). Female sex, age over 30 years, marriage, secondary or tertiary level of education, non-smoking status, diabetes and hypertension significantly predicted central obesity among the study participants. CONCLUSION The prevalence of central obesity among the study participants is high, irrespective of the defining criteria. One in three adults of normal weight had central obesity. Body mass index should therefore not be used alone for clinical assessment by healthcare workers in the study setting.
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Affiliation(s)
- Eyitayo Omolara Owolabi
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, 5271 South Africa
| | - Daniel Ter Goon
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, 5271 South Africa
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Faculty of Health Sciences, Walter Sisulu University/Cecilia Makiwane Hospital, East London Hospital Complex, East London, South Africa
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Different settings, different approaches: a qualitative comparison of Portuguese dietitians' beliefs, attitudes and practices about obesity in public and private settings. Public Health Nutr 2017; 21:435-446. [PMID: 29081334 DOI: 10.1017/s1368980017002543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE With obesity being a major public health epidemic, dietitians are charged with the difficult task to assist clients in modifying their behaviours. Since there are inconsistent data about dietitians' beliefs, attitudes and practices concerning obesity and little is known concerning differences in public and private practice, we conducted the present study to address those gaps. DESIGN Semi-structured interviews analysed according to thematic analysis procedures. SETTING Public primary-care and private settings. SUBJECTS Seventeen Portuguese registered dietitians working in public primary-care (n 10) and private settings (n 7). RESULTS Regardless of work context, 'persistence of efforts' emerged as the main characteristic of dietitians' action. Besides holding negative attitudes towards obese patients, their practices are not negatively influenced. They perceive themselves as active agents in promoting lifestyle changes, offering as many management strategies as possible to empower patients, feeling positive about the accomplishment of a successful weight loss, believing in their own efficacy and competency in helping patients. However, differences in reimbursement, work environment, perceived barriers, patient characteristics and availability of resources seem to contribute to differences in persistence according to the setting in which dietitians are working, evidenced by an increase of efforts and engagement in private practice and a decrease in public primary-care practice. CONCLUSIONS Portuguese dietitians present a positive mindset and actions about obesity treatment outcomes; however, education in behaviour change strategies should be improved. The public health system requires reorganization to enhance effective obesity management delivery. Motivation driving dietitians' work in private settings should be addressed.
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Obesity, Physical Fitness and Inflammation in the Elderly. Geriatrics (Basel) 2017; 2:geriatrics2040030. [PMID: 31011040 PMCID: PMC6371162 DOI: 10.3390/geriatrics2040030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/14/2017] [Accepted: 09/20/2017] [Indexed: 11/17/2022] Open
Abstract
Among the elderly, obesity is paradoxically associated with a lower mortality risk. Thus, this study describes fitness levels by Body Mass Index (BMI) category and the associations of high-sensitivity C-reactive protein (hs-CRP) and Vitamin D levels with muscle strength, in community-dwelling older adults. A cross-sectional study, with 1338 subjects having mean age of 78.3 years, were assessed in anthropometrics, muscle strength, and cardiorespiratory fitness. In a sub-sample, blood samples were collected and objective markers of inflammation were provided: high-sensitivity C-reactive protein (hs-CRP) and Vitamin D (25(OH) D). Obese women (BMI ≥ 30.0 kg/m2) showed significantly better results for grip strength than normal weight group (BMI between 18.5–24.9 kg/m2): 22.3 (7.0) vs. 20.0 (6.8); p = 0.002. After adjustment, higher levels of hs-CRP were an independent predictor of lower levels of grip strength (β = −0.213, 95% CI: −0.424; −0.002) and Vitamin D levels were positively associated with higher levels of muscle strength (β = 0.098, 95% CI: 0.008–0.189). The multivariate analysis found a significant and positive association between 25(OH) D and grip strength: (β = 0.098, 95% CI: 0.008–0.189). A positive pattern of higher levels of absolute strength among obese older subjects could have an important impact on morbidity and mortality risk, through the inverse association with acute inflammation and an increase in Vitamin D profile.
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Yorulmaz İS, Demiraran Y, Salihoğlu Z, Umutoğlu T, Özaydın İ, Doğan S. Effect of PEEP, Zero PEEP and Intraabdominal Pressure Levels on Cerebral Oxygenation in the Morbidly Obese Undergoing Sleeve Gastrectomy. Bariatr Surg Pract Patient Care 2017. [DOI: 10.1089/bari.2017.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- İlknur Suidiye Yorulmaz
- Faculty of Medicine, Department of Anesthesiology and Intensive Care, Duzce University, Duzce, Turkey
| | - Yavuz Demiraran
- Faculty of Medicine, Department of Anesthesiology and Intensive Care, Mega Medipol Hospital, Istanbul Medipol University, Istanbul, Turkey
| | - Ziya Salihoğlu
- Faculty of Medicine, Department of Anesthesiology and Intensive Care, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Tarık Umutoğlu
- Faculty of Medicine, Department of Anesthesiology and Intensive Care, Bezmialem Vakif University, Istanbul, Turkey
| | - İsmet Özaydın
- Faculty of Medicine, Department of General Surgery, Duzce University, Duzce, Turkey
| | - Sami Doğan
- Faculty of Medicine, Department of General Surgery, Duzce University, Duzce, Turkey
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Raposo L, Severo M, Barros H, Santos AC. The prevalence of the metabolic syndrome in Portugal: the PORMETS study. BMC Public Health 2017; 17:555. [PMID: 28595618 PMCID: PMC5465455 DOI: 10.1186/s12889-017-4471-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 05/28/2017] [Indexed: 12/26/2022] Open
Abstract
Background The PORMETS study was designed to estimate the prevalence of metabolic syndrome and its determinants in the overall and administrative regions of the Portuguese mainland. Methods A cross-sectional study of a representative sample of non-institutionalized Portuguese adults selected from primary health care centres lists including 1695 men and 2309 women was conducted from February 2007 to July 2009. A structured questionnaire was administered, collecting information on personal medical history and socio-demographic and behavioural characteristics. Anthropometrics, blood pressure, and venous blood samples were obtained. Metabolic syndrome was defined according to three operational definitions. The prevalence ratios and their respective 95% confidence intervals were calculated using binomial generalized linear regression, with the log link function. Results The prevalence rates of metabolic syndrome in this sample of Portuguese adults were 36.5%, 49.6%, and 43.1%, using the Adult Treatment Panel III, International Diabetes Federation and Joint Interim Statement definitions, respectively. The most prevalent feature of metabolic syndrome in this sample was high blood pressure (64.3%) and the lowest was high fasting glucose (24.9%). After adjustment for age and gender, significant differences were observed for the 18 districts of the Portugal mainland. Additionally, metabolic syndrome was significantly more frequent in non-urban areas than in urban ones (p = 0.001). The prevalence of metabolic syndrome was significantly higher in women (p˂0.001) and older participants (p˂0.001), as well as in those who reported being housewives (p = 0.010), retired (p = 0.046) or unemployed (p = 0.024). Conclusions This study showed that metabolic syndrome is highly prevalent in the Portuguese adult population. Regional differences in the prevalence of this syndrome were observed, and this condition was more common in non-urban areas and less favoured socio-economic categories.
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Affiliation(s)
- Luís Raposo
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal. .,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal.,EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Du P, Wang HJ, Zhang B, Qi SF, Mi YJ, Liu DW, Tian QB. Prevalence of abdominal obesity among Chinese adults in 2011. J Epidemiol 2017; 27:282-286. [PMID: 28427831 PMCID: PMC5463021 DOI: 10.1016/j.je.2017.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/06/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of abdominal obesity is increasing dramatically worldwide. This study aimed to estimate the current prevalence of abdominal obesity from the 2011 China Health and Nutrition Survey (CHNS) and compare the data with other countries. METHODS Waist circumference (WC) of 12,326 Chinese adults (aged 20 years or older) from the 2011 CHNS were analyzed by age group and region. Abdominal obesity was defined as a WC ≥90 cm for men and WC ≥80 cm for women based on World Health Organization (WHO) recommendations for Asians. RESULTS In 2011, the age-adjusted mean WC was 85.9 cm (95% confidence interval [CI], 85.6-86.2 cm) for men and 80.7 cm (95% CI, 80.4-80.9 cm) for women. Based on the WHO recommendations, the age-adjusted prevalence of abdominal obesity was 44.0% (95% CI, 43.1%-44.8%) overall, 35.3% (95% CI, 34.1%-36.6%) in men, and 51.7% (95% CI, 50.5%-52.9%) in women. Moreover, the age-adjusted prevalence was 44.0% (95% CI, 42.7%-45.2%) in rural populations, 42.5% (95% CI, 40.7%-44.2%) in urban populations, and 45.2% (95% CI, 43.5%-46.9%) in megacity populations. The prevalence in China (35.3% for men and 51.7% for women) was lower than in Japan (50.8% for men) and the United States (43.5% for men and 64.7% for women). Similar results were observed when applying the criteria suggested by the Working Group on Obesity in China. CONCLUSIONS In 2011, the age-adjusted prevalence of abdominal obesity in China was 35.3% in men and 51.7% in women.
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Affiliation(s)
- Pei Du
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China; Department of Infection Control and Prevention, The Third Hospital of Hebei Medical University, China
| | - Hui-Jun Wang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, China
| | - Bing Zhang
- National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, China
| | - Su-Fen Qi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China
| | - Ying-Jun Mi
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China
| | - Dian-Wu Liu
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China
| | - Qing-Bao Tian
- Department of Epidemiology and Statistics, School of Public Health, Hebei Medical University, China.
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Kahn HS, Bullard KM. Indicators of abdominal size relative to height associated with sex, age, socioeconomic position and ancestry among US adults. PLoS One 2017; 12:e0172245. [PMID: 28248983 PMCID: PMC5332027 DOI: 10.1371/journal.pone.0172245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/01/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/OBJECTIVES The supine sagittal abdominal diameter (SAD) and standing waist circumference (WC) describe abdominal size. The SAD/height ratio (SADHtR) or WC/height ratio (WHtR) may better identify cardiometabolic disorders than BMI (weight/height2), but population-based distributions of SADHtR and WHtR are not widely available. Abdominal adiposity may differ by sociodemographic characteristics. SUBJECTS/METHODS Anthropometry, including SAD by sliding-beam caliper, was performed on 9894 non-pregnant adults ≥20 years in the US National Health and Nutrition Examination Surveys of 2011-2014. Applying survey design factors and sampling weights, we estimated nationally representative SADHtR and WHtR distributions by sex, age, educational attainment, and four ancestral groups. RESULTS The median (10th percentile, 90th percentile) for men's SADHtR was 0.130 (0.103, 0.165) and WHtR 0.569 (0.467, 0.690). For women, median SADHtR was 0.132 (0.102, 0.175) and WHtR 0.586 (0.473, 0.738). Medians for SADHtR and WHtR increased steadily through age 79. The median BMI, however, reached maximum values at ages 40-49 (men) or 60-69 (women) and then declined. Low educational attainment, adjusted for age and ancestry, was associated with elevated SADHtR more strongly than elevated BMI. While non-Hispanic Asians had substantially lower BMI compared to all other ancestral groups (adjusted for sex, age and education), their relative reductions in SADHtR and WHtR, were less marked. CONCLUSIONS These cross-sectional data are consistent with monotonically increasing abdominal adipose tissue through the years of adulthood but decreasing mass in non-abdominal regions beyond middle age. They suggest also that visceral adipose tissue, estimated by SADHtR, expands differentially in association with low socioeconomic position. Insofar as Asians have lower BMIs than other populations, employing abdominal indicators may attenuate the adiposity differences reported between ancestral groups. Documenting the distribution and sociodemographic features of SADHtR and WHtR supports the clinical and epidemiologic adoption of these adiposity indicators.
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Affiliation(s)
- Henry S. Kahn
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kai McKeever Bullard
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Ellulu MS. Obesity, cardiovascular disease, and role of vitamin C on inflammation: a review of facts and underlying mechanisms. Inflammopharmacology 2017; 25:313-328. [PMID: 28168552 DOI: 10.1007/s10787-017-0314-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/23/2017] [Indexed: 02/07/2023]
Abstract
Obesity means the accumulation of excessive fat that may interfere with the maintenance of optimal state of health. Obesity causes cardiac and vascular disease through well-known mediators such as hypertension, type-2 diabetes mellitus, and dyslipidemia, but there are evidences for other mediators such as chronic inflammation, oxidative stress, and thrombosis. The decreased levels of antioxidants factors and nitric oxide predispose to further cardiovascular adverse events. To reduce the risks, antioxidants can help by neutralizing the free radicals and protecting from damage by donating electrons. Having the capacity, vitamin C protects from oxidative stress, prevention of non-enzymatic glycosylation of proteins, and enhances arterial dilation through its effect on nitric oxide release. It also decreases lipid peroxidation, and alleviates inflammation. The anti-inflammatory property of vitamin C could be attributed to ability to modulate the NF-kB DNA binding activity and down-regulation in the hepatic mRNA expression for the interleukins and tumor factors.
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Affiliation(s)
- Mohammed S Ellulu
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang, Selangor, Malaysia. .,Clinical Nutrition Specialist, Gaza, Palestine.
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The Effect of Bariatric Surgery Type on Lipid Profile: An Age, Sex, Body Mass Index and Excess Weight Loss Matched Study. Obes Surg 2016. [PMID: 26220239 DOI: 10.1007/s11695-015-1825-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Bariatric surgery improves lipid profile. A still unanswered question is whether this improvement is merely weight-dependent or also results from factors inherent to specificities of the bariatric procedure. We aimed to study lipid profile 1 year after bariatric surgery and compare its changes between the different procedures in patients matched for initial weight and weight loss. METHODS We retrospectively analysed patients submitted to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) or sleeve gastrectomy (SG) between 2010 and 2013. Patients were matched for age (±5 years), sex, pre-surgery body mass index (BMI) (±2 Kg/m(2)) and excess weight loss (EWL) (±5%). Baseline and 1-year lipid profile, its variation and percentage of variation was compared between surgeries. RESULTS We analysed 229 patients: 72 pairs RYGB-AGB, 47 pairs RYGB-SG and 33 pairs AGB-SG. The median age was 41 (35-52) years and 11.8% were male. Pre-operative BMI was 44.0 ± 4.6 and 32.1 ± 4.4 Kg/m(2) at 1 year. EWL at 1 year was 64.2 ± 18.9%. There were no differences in baseline lipid profile between patients submitted to different types of bariatric surgery. At 1 year, high-density lipoprotein cholesterol (HDL) and triglycerides (TG) improved similarly with all surgeries. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) at 1 year decreased significantly more in patients submitted to RYGB than in weight-matched patients undergoing AGB or SG. CONCLUSIONS RYGB is the only bariatric surgery that reduces TC and LDL in age-, sex-, BMI- and EWL-matched patients. All three procedures improved TG and HDL similarly when the confounding effect of weight loss is eliminated.
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Guimarães J, Pinho D, Nunes CS, Cavaleiro CS, Machado HS. Effect of Boussignac continuous positive airway pressure ventilation on Pao2 and Pao2/Fio2 ratio immediately after extubation in morbidly obese patients undergoing bariatric surgery: a randomized controlled trial. J Clin Anesth 2016; 34:562-70. [DOI: 10.1016/j.jclinane.2016.06.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 05/09/2016] [Accepted: 06/07/2016] [Indexed: 01/06/2023]
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Soltani P, Figueiredo P, Fernandes RJ, Vilas-Boas JP. Do player performance, real sport experience, and gender affect movement patterns during equivalent exergame? COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Santos I, Vieira PN, Silva MN, Sardinha LB, Teixeira PJ. Weight control behaviors of highly successful weight loss maintainers: the Portuguese Weight Control Registry. J Behav Med 2016; 40:366-371. [PMID: 27586133 DOI: 10.1007/s10865-016-9786-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/13/2016] [Indexed: 01/23/2023]
Abstract
To describe key behaviors reported by participants in the Portuguese Weight Control Registry and to determine associations between these behaviors and weight loss maintenance. A total of 388 adults participated in this cross-sectional study. Assessments included demographic information, weight history, weight loss and weight maintenance strategies, dietary intake, and physical activity. Participants lost on average 18 kg, which they had maintained for ~28 months. Their average dietary intake was 2199 kcal/day, with 33 % of energy coming from fat. About 78 % of participants engaged in levels of moderate-plus-vigorous physical activity exceeding 150 min/week (51 % above 250 min/week), with men accumulating 82 more minutes than women (p < 0.05). The most frequently reported strategies for both weight loss and maintenance were keeping healthy foods at home, consuming vegetables regularly, and having daily breakfast. Greater weight loss maintenance was associated with higher levels of physical activity, walking, weight self-monitoring, establishing specific goals, and with reduced portion size use, reduced consumption of carbohydrates, and increased consumption of protein, (p < 0.05). Results indicate that weight loss maintenance is possible through the adoption of a nutritionally-balanced diet and regular participation in physical activity, but also suggest that adopting different (and, to a degree, individualized) set of behavioral strategies is key for achieving success.
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Affiliation(s)
- Inês Santos
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Paulo N Vieira
- Universidade Europeia, Quinta do Bom Nome, Estrada da Correia 53, 1500-210, Lisbon, Portugal
| | - Marlene N Silva
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Luís B Sardinha
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Pedro J Teixeira
- Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal.
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Zeinali F, Habibi N, Samadi M, Azam K, Djafarian K. Relation between Lifestyle and Socio-Demographic Factors and Body Composition among the Elderly. Glob J Health Sci 2016; 8:53715. [PMID: 27045408 PMCID: PMC5016347 DOI: 10.5539/gjhs.v8n8p172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/18/2015] [Accepted: 12/13/2015] [Indexed: 12/25/2022] Open
Abstract
Background: Aging is accompanied by various changes that can cause changes in diet and body composition resulting sometimes in malnutrition and disability in the elderly. Changes in body composition among the elderly are mainly the result of physical inactivity and nutrition. This study was designed to examine the relationship between lifestyle and socio-demographic factors and body composition. Method: A cross-sectional study was carried out with 380 elderly people aged 60 and over in district 5 of Tehran, Iran. Their body composition was measured by Bioelectrical Impedance Analysis and the Actigraph device was used for assessing physical activity patterns. A three-day food recall was conducted to measure their intake of energy and macronutrients. Lifestyle and socio-demographic information were collected by interview using a pretested questionnaire. Results: Overweight, obesity and central obesity were more prevalent in women than in men (p<0.001). Moreover, 57.1% and 18.7% of participants had high and very high fat mass index, respectively. High fat mass index was seen in 47% of men and 37.5% of women who had normal body mass index (BMI). Meanwhile, age, gender, physical activity, energy intake, the percentage of energy from fat and protein, educational level, job, television watching time, smoking, chronic diseases, and taking medicine were significantly associated with anthropometric measurements (p<0.05). Conclusion: Overweight, obesity and high body fat percentage were common among the aged. Considering the factors that are significantly associated with body composition, programs that can increase their awareness about the dietary balance and suitable physical activity should be organized to address these problems.
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Affiliation(s)
- Fahime Zeinali
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, Ramos-Carrera N, Lázaro-Masedo S. Prevalencia de obesidad general y obesidad abdominal en la población adulta española (25–64 años) 2014–2015: estudio ENPE. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.02.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Camolas J, Ferreira A, Mannucci E, Mascarenhas M, Carvalho M, Moreira P, do Carmo I, Santos O. Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-R. Eat Weight Disord 2016; 21:277-88. [PMID: 26429794 DOI: 10.1007/s40519-015-0222-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/05/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the "individual experience of overweightness". METHODS This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation. RESULTS Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test-retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness. CONCLUSIONS ORWELL-R shows good internal consistency and adequate test-retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.
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Affiliation(s)
- José Camolas
- Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal.
| | | | | | - Mário Mascarenhas
- Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | | | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Isabel do Carmo
- Serviço de Endocrinologia, Hospital de Santa Maria, CHLN/Faculdade de Medicina da Universidade de Lisboa, Piso 6, Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | - Osvaldo Santos
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina da Universidade de Lisboa/DECO PROTESTE, Edf. Egas Moniz, Av. Prof. Egas Moniz, 1649-029, Lisbon, Portugal
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Aranceta-Bartrina J, Pérez-Rodrigo C, Alberdi-Aresti G, Ramos-Carrera N, Lázaro-Masedo S. Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study. ACTA ACUST UNITED AC 2016; 69:579-87. [PMID: 27133458 DOI: 10.1016/j.rec.2016.02.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/11/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES According to the 2013 analysis of the Institute of Health Metrics, high body mass index values are the most important risk factor for disease in Spain. Consequently, we describe the prevalence of total obesity and abdominal obesity in the Spanish adult population (25-64 years) for 2014-2015. METHODS The sample was taken from the ENPE study, a cross-sectional study with a representative sample of the noninstitutionalized population (n = 6800) carried out between May 2014 and May 2015. This analysis refers to the population between age 25 and 64 years (n = 3966). The anthropometric measurements were performed by trained observers at participants' homes according to standard international protocols. Body mass index ≥ 25 was defined as overweight and ≥ 30 as obesity. Abdominal obesity was classified as waist > 102 cm in men and > 88 cm in women. RESULTS The estimated prevalence of overweight in the Spanish adult population (25-64 years) was 39.3% 95% confidence interval [95%CI], 35.7%-42.9%). The prevalence of general obesity was 21.6% (95%CI, 19.0%-24.2%) and, more specifically, was 22.8% (95%CI, 20.6%-25.0%) among men and 20.5% (95%CI, 18.5%-22.5%) among women, and rose with age. The prevalence of abdominal obesity was estimated at 33.4% (95%CI, 31.1%-35.7%) and was higher among women (43.3%; 95%CI, 41.1%-45.8%) than among men (23.3%; 95%CI, 20.9%-25.5%), and also rose with age. CONCLUSIONS The prevalence of general obesity and abdominal obesity in Spain is high, although the distribution differs according to autonomous community. A comparison with earlier data reveals a considerable increase in overweight, indicating the need for routine monitoring and comprehensive initiatives.
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Affiliation(s)
- Javier Aranceta-Bartrina
- Medicina Preventiva y Salud Pública, Facultad de Farmacia, Universidad de Navarra, Pamplona, Navarra, Spain; Sociedad Española de Nutrición Comunitaria (SENC), Barcelona, Spain; Fundación FIDEC, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Basurto-Bilbao, Bizkaia, Spain; CiberOBN, Instituto de Salud Carlos III, Madrid, Spain.
| | - Carmen Pérez-Rodrigo
- Sociedad Española de Nutrición Comunitaria (SENC), Barcelona, Spain; Fundación FIDEC, Euskal Herriko Unibertsitatea-Universidad del País Vasco, Basurto-Bilbao, Bizkaia, Spain
| | - Goiuri Alberdi-Aresti
- Sociedad Española de Nutrición Comunitaria (SENC), Barcelona, Spain; School of Medicine, University College of Dublin, Dublin, Ireland
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Romo-Perez V, Souto D, Mota J. Walking, body mass index, and self-rated health in a representative sample of Spanish adults. CAD SAUDE PUBLICA 2016; 32:S0102-311X2016000100706. [PMID: 26886367 DOI: 10.1590/0102-311x00166414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 08/27/2015] [Indexed: 11/22/2022] Open
Abstract
Obesity and physical inactivity (PI) are risk factors for chronic diseases and are associated with lifestyle and environmental factors. The study tested the association between PI, body mass index (BMI), and self-rated health in a representative sample of the Spanish adult population (N = 21,486). The sample included 41.5% men, with mean age 52.3 years (± 18.03), and age range 20-82 years. Prevalence of overweight/obesity was 34.2%/12.7% in women and 52.1%/12.7% in men (p < 0.001 for obesity in both sexes). 53% of women and 57.5% of men met recommended levels of physical activity by walking (≥ 150 minutes/week). According to logistic regression analysis, individuals that walked less had higher risk of overweight or obesity. Data from the population-based surveillance study support suggestions that regular walking by adults is associated with positive self-rated health and better BMI profile. Obesity and low/very low self-rated health have low prevalence rates to meet the recommendations.
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Affiliation(s)
| | - Dilia Souto
- Universidad Autónoma de Baja California, Mexicali, México
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Marques A, Martins J, Sarmento H, Ramos M, Diniz J, Costa FCD. Socio-demographic correlates of leisure time physical activity among Portuguese adults. CAD SAUDE PUBLICA 2015; 31:1061-70. [PMID: 26083180 DOI: 10.1590/0102-311x00101614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 11/17/2014] [Indexed: 11/22/2022] Open
Abstract
This study aimed to identify socio-demographic correlates of leisure time physical activity among Portuguese adults. Subjects aged 31-60 years (1,076 males, 1,383 females) were categorized into two groups according to recommended physical activities ranging from ≥ 10 or < 10 MET.hours.week-1. Leisure time physical activity data was self-reported, including activities, duration of each session and frequency. Chi-square and logistic regression analyses were applied to the results. Among men, having a high socioeconomic status (OR = 1.89; 95%CI: 1.30-2.76; p = 0.001) was associated with attaining the recommended level of physical activity. For women, middle education levels were associated with physical activity (OR = 1.36; 95%CI: 1.01-1.85). Moreover, middle socioeconomic status (OR = 1.45; 95%CI: 0.80-1.91; p = 0.009) was also positively associated with meeting physical activities recommendations in the unadjusted analysis. Men and women had different patterns of socio-demographic correlates. An intervention designed to improve the levels of physical activity among Portuguese adults may take these correlates into account.
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Affiliation(s)
- Adilson Marques
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - João Martins
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Hugo Sarmento
- Research Center in Sports Sciences, Health Sciences and Human Development, University Institute of Maia, Maia, Portugal
| | - Madalena Ramos
- Centro de Investigação e Estudos de Sociologia, Instituto Universitário de Lisboa, Lisboa, Portugal
| | - José Diniz
- Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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General and abdominal adiposity in a representative sample of Portuguese adults: dependency of measures and socio-demographic factors’ influence. Br J Nutr 2015; 115:185-92. [DOI: 10.1017/s0007114515004055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractThe aims of this study were: (i) to estimate the dependency between BMI and waist:height ratio (WHtR) as measures of general and abdominal adiposity, and (ii) to evaluate the influence of socio-demographic factors on both measures and on their dependency in risk classification. Data from a cross-sectional study conducted in 2009 among a representative sample of 3529 Portuguese adults were used. Height, weight and waist were measured and socio-demographic data (sex, age, education level, occupational status, marital status, region of residence) were obtained. Using logistic regression, crude and adjusted OR for high general (BMI≥25·0 kg/m2) and abdominal (WHtR≥0·5) adiposity, and for incompatible classification between them, were calculated. Above half (50·8 %) of the respondents had high BMI and 42·1 % had high WHtR, and the rates were higher in men than in women. There was an inverse association between education level and both adiposity measures. The lowest prevalence of high general and abdominal adiposity was observed in students and singles, whereas the highest was found in retired, widowed and respondents from Azores, Madeira and Alentejo. Nearly a quarter of respondents (24·0 %) were incompatibly classified by BMI and WHtR, with higher prevalence in men than in women and in low- than in high-educated people. Future surveys should focus on developing at least sex-specific cut-offs for both measures. Implementation of effective strategies for preventing and reducing high adiposity levels in Portugal should be directed primarily to men, older, low-educated individuals, as well as those living in the islands and poor regions of the country.
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Júdice PB, Silva AM, Sardinha LB. Sedentary Bout Durations Are Associated with Abdominal Obesity in Older Adults. J Nutr Health Aging 2015; 19:798-804. [PMID: 26412283 DOI: 10.1007/s12603-015-0501-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES In older adults, sedentary behavior has been positively associated with obesity and impaired metabolic health, additional to low moderate-to-vigorous physical activity (MVPA). Further to the total time spent in sedentary behavior, the manner in which it is accumulated - number of continuous sedentary bouts of different extends - may also be relevant. The association for objectively measured uninterrupted sedentary bouts and respective patterns with abdominal obesity in older adults was examined. DESIGN Cross-sectional. SETTING Community-based older people were recruited in each region of Portugal. Data collection was performed between September, 2007 and May, 2009. PARTICIPANTS 351 older adults (230 women) mean age of 75-years. MEASUREMENTS Sedentary time was measured by an accelerometer (counts/minute <100), worn during waking hours for four consecutive days. Continuous sedentary bouts of 560 length were treated (counts/minute <100). Abdominal obesity was defined by waist circumference (men>102 cm; women>88 cm). RESULTS There were positive and escalating linear associations for the continuum of sedentary bouts' lengths with waist circumference. Logistic regression showed that for each additional sedentary bout of 10< min<20 the odds of being abdominally obese increased by 6.8% (OR=1.07, 95% CI: 1.02 - 1.13) up to 48% (OR=1.48, 95% CI: 1.07 - 2.03) for each 1-hour sedentary bout increment, after controlling for age, gender, total sedentary time, MVPA time, total wear time, movement counts within the sedentary bouts, socio-demographic and other behavioral attributes, and medical history. CONCLUSION These findings indicate positive graded associations for continuous sedentary bouts with abdominal obesity. Public health recommendations regarding breaking up sedentary time more often, potentially avoiding very prolonged bouts of sedentary time, are expected to be relevant for older adults.
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Affiliation(s)
- P B Júdice
- Professor L.B. Sardinha, Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal, Estrada da Costa 1499-002 Cruz-Quebrada, Portugal, Phone: (351) 21 414 91 60; Fax: (351) 21 414 91 93;
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Prevalence, awareness, treatment and control of hypertension and salt intake in Portugal: changes over a decade. The PHYSA study. J Hypertens 2015; 32:1211-21. [PMID: 24675681 DOI: 10.1097/hjh.0000000000000162] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine prevalence, awareness, treatment and control of hypertension and the 24-h sodium excretion (24h-UNa) in the Portuguese adult population and to examine their changes from a similar study done in 2003. DESIGN AND SETTING A population-based cross-sectional survey conducted in 2011-2012. METHODS A multistage-stratified (by age and sex) sampling method was used to select a representative sample of the 18-90-year-old population yielding 3720 participants (52.6% women, 97.1% Caucasians). Hypertension was defined as a SBP of at least 140 mmHg or DBP of at least 90 mmHg [average of 2-3 blood pressure (BP) measurements by trained observers with OMRON M6] or reported knowledge or treatment with antihypertensive drugs at the first visit (V1). A complete clinical information was obtained with a standard questionnaire. This procedure was repeated 10-15 days after visit 2 (V2) and 24-h urinary sample was collected for 24h-UNa, 24-h potassium excretion and creatinine excretion. RESULTS The overall prevalence of hypertension at V1 was 42.2% (44.4% in men, 40.2% in women) (42.1% in 2003). The age-specific prevalence of hypertension was 6.8, 46.9 and 74.9% in people below 35 years, 35-64 years and above 64 years. Comorbidities were 2.2-6.3 times more common in hypertensive patients vs. normotensive individuals. Overall, among the hypertensive patients, 76.6% were aware of the hypertension condition, 74.9% were treated and 42.5% were controlled (BP <140/90 mmHg), that is, respectively, 1.7, 1.9 and 3.8 times higher vs. data in 2003, with lower values in men vs. women and younger vs. older people. Global mean BP was 127.4/74.6 ± 17.7/10.5 vs. 134.7/80.4 ± 21.2/14.1 mmHg in 2003. From V1 to V2, control of hypertension increased on average by 14.8%. Multivariate analysis showed that age and BMI were independently associated with prevalence of hypertension. 24h-UNa (84% valid urinary samples) was 182.5 ± 64.7 mmol/day (10.7 g salt/day) and 24-h potassium excretion 75.2 ± 26.1 mmol/day. 24h-UNa was higher in patients with hypertension than in normotensive individuals (185.4 ± 64.8 vs. 177.8 ± 64.5 mmol/day; P < 0.02) and correlated with SBP (r = 0.05), age (r = 0.08) and BMI (r = 0.10) (P < 0.01). CONCLUSION Hypertension prevalence among Portuguese adults remained stable in the past decade, but proportions of awareness, treatment and control of hypertension improved significantly. Salt intake is still high being almost double the WHO recommendations.
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Teixeira FV, Pais-Ribeiro JL, Maia A. A qualitative study of GPs' views towards obesity: are they fighting or giving up? Public Health 2015; 129:218-25. [PMID: 25698498 DOI: 10.1016/j.puhe.2015.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 12/12/2014] [Accepted: 01/07/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Several studies indicate that general practitioners (GPs) are not taking the issue of obesity as seriously as they should. Therefore, the aim of this study was to understand GPs' views about obesity and obese people and how these professionals perceive their role in the treatment of this disease. STUDY DESIGN Qualitative study using semi-structured interviews. METHODS Sixteen semi-structured interviews were conducted with Portuguese GPs. Data were analyzed according to thematic analysis procedures. RESULTS GPs are negative about their own role in obesity treatment. Although they believe it is part of their job to advise obese patients on the health risks of obesity, the majority of doctors think they are not making any difference in getting their patients to make long term lifestyle changes. GPs hold negative attitudes towards these patients blaming them for being unmotivated and non-compliant and are also pessimistic about their ability to lose weight. Doctors are facing a dilemma in their practices: they want to play an active role but, due to a set of negative beliefs and perceived barriers, they are playing a relatively passive role, feeling defeated and unmotivated, which is reflected in a decrease of efforts and a willing to give up on most of the cases. CONCLUSIONS This issue should be taken in to account during physicians' education since doctors should be aware of how their own beliefs and attitudes influence their behaviour and practices, compromising, therefore, the adherence to and the success in obesity treatment. They seem to need more precise guidelines and better tools for screening and management of obesity, more referral options, and improved coordination with other specialities.
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Affiliation(s)
- F V Teixeira
- Faculty of Psychology and Science Education, University of Porto, Portugal.
| | - J L Pais-Ribeiro
- Faculty of Psychology and Science Education, University of Porto, Portugal.
| | - A Maia
- School of Psychology, University of Minho, Portugal.
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Júdice PB, Silva AM, Santos DA, Baptista F, Sardinha LB. Associations of breaks in sedentary time with abdominal obesity in Portuguese older adults. AGE (DORDRECHT, NETHERLANDS) 2015; 37:23. [PMID: 25844429 PMCID: PMC4346413 DOI: 10.1007/s11357-015-9760-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 02/18/2015] [Indexed: 05/18/2023]
Abstract
In older adults, sedentary time is positively associated with obesity. The manner in which it is accumulated, i.e., the number of breaks in sedentary time, might be also important. We examined the cross-sectional associations of breaks in sedentary time with abdominal obesity in 301 older adults (111 men and 190 women) aged 75.0 ± 6.8 years. Sedentary time (counts min(-1) < 100) and physical activity were objectively measured by accelerometry, worn during waking hours for at least three consecutive days. A break was defined as an interruption (≥ 100 counts min(-1) < 2020) in sedentary time while performing light intensity physical activities. Sedentary time was expressed as the number of daily breaks in sedentary time or hourly breaks in sedentary time. Abdominal obesity was defined by waist circumference (men >102 cm; women >88 cm). Using binary logistic regression analyses, the odds for abdominal obesity decreased 7 % for each additional hourly break in sedentary time in women (OR = 0.93, 95 % CI: 0.87-1.00), but not men, independently of total sedentary time and moderate-to-vigorous physical activity. The odds for abdominal obesity were 3.21 times higher (p = 0.039) for women in quartile 1 (<225 breaks day(-1)) of daily breaks in sedentary time compared to those in quartile 4 (>353 breaks day(-1)) of daily breaks in sedentary time.These findings indicate that older women who interrupt their sedentary time more frequently are less likely to present abdominal obesity. Public health recommendations regarding breaking-up sedentary time complementary to those for physical activity are likely to be relevant.
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Affiliation(s)
- Pedro B. Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Lisboa, Cruz-Quebrada Portugal
| | - Analiza M. Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Lisboa, Cruz-Quebrada Portugal
- Pennington Biomedical Research Center, Baton Rouge, LA USA
| | - Diana A. Santos
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Lisboa, Cruz-Quebrada Portugal
| | - Fátima Baptista
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Lisboa, Cruz-Quebrada Portugal
| | - Luís B. Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Lisboa, Cruz-Quebrada Portugal
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Association between PPAR-γ2 Pro12Ala polymorphism and obesity: a meta-analysis. Mol Biol Rep 2014; 42:1029-38. [PMID: 25502405 DOI: 10.1007/s11033-014-3838-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
Abstract
The peroxisome proliferator-activated receptor-γ2 (PPAR-γ2) gene has been reported in the pathogeny of obesity. However, the results have been inconsistent. The purpose of this meta-analysis was to acquire a more accurate assessment of the association between PPAR-γ2 Pro12Ala polymorphism and obesity. PubMed, Wan Fang (Chinese) databases, Chinese Biomedical Medical databases, and Chinese National Knowledge Infrastructure were searched to identify eligible studies. Finally, 25 studies (6491 cases and 8242 controls) were enrolled in this meta-analysis. The effect summary odds ratio (OR) with 95 % confidence interval (CI) was applied. Random-effects or fixed-effects model was performed based on the heterogeneity. STATA 12.0 was applied for this meta-analysis. The combined results showed that PPAR-γ Pro12Ala polymorphism was associated with the obesity risk (Ala vs. Pro: OR = 1.55, 95 % CI 1.34-1.80; Pro/Ala vs. Pro/Pro: OR = 1.54, 95 % CI 1.31-1.82; Ala/Ala + Pro/Ala vs. Pro/Pro: OR = 1.61, 95 % CI 1.36-1.90). Subgroup analysis by ethnicity showed that there were significant associations between PPAR-γ Pro12Ala polymorphism and obesity risk in Caucasians, Asians, and Mixed population. Subgroup analysis by obesity's cutoff points showed that the associations were found among the patients with the cutoff point of BMI ≥24 and BMI ≥30 but not among the patients with the cutoff point of BMI ≥95th percentile. These results suggested that PPAR-γ Pro12Ala polymorphism might be a risk factor for obesity susceptibility.
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Wasserkampf A, Silva MN, Santos IC, Carraça EV, Meis JJM, Kremers SPJ, Teixeira PJ. Short- and long-term theory-based predictors of physical activity in women who participated in a weight-management program. HEALTH EDUCATION RESEARCH 2014; 29:941-952. [PMID: 25274719 DOI: 10.1093/her/cyu060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study analyzed psychosocial predictors of the Theory of Planned Behavior (TPB) and Self-Determination Theory (SDT) and evaluated their associations with short- and long-term moderate plus vigorous physical activity (MVPA) and lifestyle physical activity (PA) outcomes in women who underwent a weight-management program. 221 participants (age 37.6 ± 7.02 years) completed a 12-month SDT-based lifestyle intervention and were followed-up for 24 months. Multiple linear regression analyses tested associations between psychosocial variables and self-reported short- and long-term PA outcomes. Regression analyses showed that control constructs of both theories were significant determinants of short- and long-term MVPA, whereas affective and self-determination variables were strong predictors of short- and long-term lifestyle PA. Regarding short-term prediction models, TPB constructs were stronger in predicting MVPA, whereas SDT was more effective in predicting lifestyle PA. For long-term models, both forms of PA were better predicted by SDT in comparison to TPB. These results highlight the importance of comparing health behavior theories to identify the mechanisms involved in the behavior change process. Control and competence constructs are crucial during early adoption of structured PA behaviors, whereas affective and intrinsic sources of motivation are more involved in incidental types of PA, particularly in relation to behavioral maintenance.
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Affiliation(s)
- A Wasserkampf
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
| | - M N Silva
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
| | - I C Santos
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
| | - E V Carraça
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
| | - J J M Meis
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
| | - S P J Kremers
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
| | - P J Teixeira
- Department of Health and Social Psychology, Institute of Psychology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center +, P.O. Box 616, 6200 MD Maastricht, The Netherlands and CIPER, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, Cruz Quebrada, 1495-688 Cruz-Quebrada, Portugal
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Maciel J, Infante P, Ribeiro S, Ferreira A, Silva AC, Caravana J, Carvalho MG. Translation, adaptation and validation of a Portuguese version of the Moorehead-Ardelt Quality of Life Questionnaire II. Obes Surg 2014; 24:1940-6. [PMID: 24817428 DOI: 10.1007/s11695-014-1272-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The prevalence of obesity has increased worldwide. An assessment of the impact of obesity on health-related quality of life (HRQoL) requires specific instruments. The Moorehead-Ardelt Quality of Life Questionnaire II (MA-II) is a widely used instrument to assess HRQoL in morbidly obese patients. The objective of this study was to translate and validate a Portuguese version of the MA-II.The study included forward and backward translations of the original MA-II. The reliability of the Portuguese MA-II was estimated using the internal consistency and test-retest methods. For validation purposes, the Spearman's rank correlation coefficient was used to evaluate the correlation between the Portuguese MA-II and the Portuguese versions of two other questionnaires, the 36-item Short Form Health Survey (SF-36) and the Impact of Weight on Quality of Life-Lite (IWQOL-Lite).One hundred and fifty morbidly obese patients were randomly assigned to test the reliability and validity of the Portuguese MA-II. Good internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.80, and a very good agreement in terms of test-retest reliability was recorded, with an overall intraclass correlation coefficient (ICC) of 0.88. The total sums of MA-II scores and each item of MA-II were significantly correlated with all domains of SF-36 and IWQOL-Lite. A statistically significant negative correlation was found between the MA-II total score and BMI. Moreover, age, gender and surgical status were independent predictors of MA-II total score.A reliable and valid Portuguese version of the MA-II was produced, thus enabling the routine use of MA-II in the morbidly obese Portuguese population.
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Affiliation(s)
- João Maciel
- Department of General Surgery, Hospital do Espírito Santo de Évora, Largo Senhor da Pobreza, 7000-811, Évora, Portugal,
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Cortez-Dias N, Robalo Martins S, Belo A, Fiúza M. Characterization of lipid profile in primary health care users in Portugal. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.repce.2013.10.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Cortez-Dias N, Robalo Martins S, Belo A, Fiúza M. [Characterization of lipid profile in primary health care users in Portugal]. Rev Port Cardiol 2013; 32:987-96. [PMID: 24280078 DOI: 10.1016/j.repc.2013.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/07/2013] [Accepted: 06/25/2013] [Indexed: 11/28/2022] Open
Abstract
AIM To characterize the distribution of total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C) and triglycerides in primary health care users. METHODS We performed a cross-sectional study in a primary care setting, involving 719 general practitioners based on stratified distribution proportional to the population density of each region of Portugal. The first two adult patients scheduled for an appointment on a given day were invited to participate. A questionnaire was applied to assess sociodemographic, clinical and laboratory data including lipid profile. RESULTS The study included 16 856 individuals (mean age 58.1±15.1 years; 61.6% women). Data on TC, LDL-C, HDL-C and triglycerides were available for 95.9% (n=16 159), 59.1% (n=9956), 95.4% (n=16 074) and 97.9% (n=16 494) of the population, respectively. Hypercholesterolemia (TC ≥200 mg/dl) was detected in 47%, and 38.4% had high levels of LDL-C (≥130 mg/dl). Hypertriglyceridemia (≥200 mg/dl) and low HDL-C (<40 mg/dl) were less prevalent, affecting roughly 13% of the population. Dyslipidemia was more common in middle-aged men and in post-menopausal women. Of the population aged over 40, 54.1% met eligibility criteria for lipid-lowering therapy and 44.7% were medicated with statins, but only 16.0% of these had TC ≤175 mg/dl. CONCLUSIONS Dyslipidemia is highly prevalent in primary health care users in Portugal. It is particularly common in middle-aged men and post-menopausal women, who should be considered target groups for preventive public health measures.
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Affiliation(s)
- Nuno Cortez-Dias
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal; Programa de Formação Médica Avançada da Fundação Calouste Gulbenkian, Fundação Champalimaud, Ministério da Saúde e Fundação para a Ciência e Tecnologia, Lisboa, Portugal; Centro de Cardiologia da Universidade de Lisboa, Clínica Universitária de Cardiologia da Universidade de Lisboa, Lisboa, Portugal.
| | - Susana Robalo Martins
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal; Centro de Cardiologia da Universidade de Lisboa, Clínica Universitária de Cardiologia da Universidade de Lisboa, Lisboa, Portugal
| | - Adriana Belo
- Centro Nacional de Colecção de Dados em Cardiologia, Sociedade Portuguesa de Cardiologia, Lisboa, Portugal
| | - Manuela Fiúza
- Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal; Centro de Cardiologia da Universidade de Lisboa, Clínica Universitária de Cardiologia da Universidade de Lisboa, Lisboa, Portugal
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Burkert NT, Rásky É, Großschädl F, Muckenhuber J, Freidl W. The influence of socioeconomic factors on health parameters in overweight and obese adults. PLoS One 2013; 8:e65407. [PMID: 23755228 PMCID: PMC3673947 DOI: 10.1371/journal.pone.0065407] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 04/29/2013] [Indexed: 11/24/2022] Open
Abstract
The prevalence of being overweight and of obesity is increasing worldwide, and is associated with a high risk to health. Therefore, the aim of our study was to investigate whether normal weight, overweight and obese subjects of low, middle or high socioeconomic status (SES) differ with regard to their health behavior, health, quality of life, and the use of medical care. Data from the Austrian Health Interview Survey (ATHIS) 2006/07, comprising 3 groups of 1,077 individuals, each of whom were normal weight, overweight, or obese, respectively, and matched according to their age, sex and SES, were analyzed concerning health outcomes. The results show that subjects with a low SES differ significantly from those of high SES in terms of their health behavior, self-perceived health, levels of impairment, chronic conditions, quality of life, and health care. Additionally, obesity in adults is associated with sub-optimal dietary practices and worse health, poorer quality of life and medical care than normal weight and overweight individuals. A significant interaction between the weight class and SES was found concerning physical exercise, impairment due to health problems and chronic diseases. A low SES has a strong negative impact on health, especially in obese individuals. Therefore a continuous target group-oriented, non-discriminatory public health program is required, prioritizing obese subjects with low SES.
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Affiliation(s)
- Nathalie T Burkert
- Institute of Social Medicine and Epidemiology, Medical University Graz, Graz, Styria, Austria.
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