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Quirke-McFarlane S, Ogden J. Care or sabotage? A reflexive thematic analysis of perceived partner support throughout the bariatric surgery journey. Br J Health Psychol 2024; 29:835-854. [PMID: 38783153 DOI: 10.1111/bjhp.12733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/09/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Social support is mostly seen as a positive resource for many health outcomes. However, some research indicates that weight loss may disrupt the equilibrium of relationships and highlights the potential for a more negative form of social support. This qualitative study aimed to explore bariatric surgery (BS) patients' perceptions of the way in which their current or previous partner supported them throughout their BS journey. DESIGN BS patients (N = 30) participated in semi-structured interviews. METHODS The data were analysed using an inductive approach to reflexive thematic analysis. RESULTS Four themes were derived from the data. While two themes reflected social support as a form of caring (Mutual Investment and Positive Reinforcements), the other two themes indicated aspects of sabotage (Feeder Behaviours and Negative Reactions to Weight Loss Attempts and Successes). Transcending these themes was the notion of Bariatric Surgery as an Opportunity or Threat to the Relationship. CONCLUSIONS Some patients perceived social support as a positive resource in BS success involving Mutual Investment from their partners and being offered Positive Reinforcements for changes in their weight status and wellbeing. Some, however, described more negative aspects of support which had undermined their BS goals, either unintentionally or intentionally, through acts of sabotage including Feeder Behaviours and Negative Reactions to Weight Loss Attempts and Successes. Future research should develop interventions to help prepare the partners of those undergoing BS for the changes to both their partner's weight status and the dynamics of their relationship.
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Affiliation(s)
| | - Jane Ogden
- School of Psychology, University of Surrey, Guildford, Surrey, UK
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2
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Kurniawan AL, Schretzmann J, Paramastri R, Cho A, Sié A, Fischer MS, Bärnighausen T, Ditzen B. Relationship satisfaction and metabolic health parameters: a cross-sectional study in Burkinabe population of older adults. BMC Public Health 2024; 24:827. [PMID: 38491462 PMCID: PMC10943782 DOI: 10.1186/s12889-024-17998-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Over- and undernutrition coexist in many African countries and pose a threat to metabolic health. This study assessed the associations between relationship satisfaction and Body Mass Index (BMI), waist circumference (WC), and glycated hemoglobin (HbA1c), in a rural population of older adults in Burkina Faso. It also explored potential gender differences and the mediating role of depressive symptoms. METHODS Data from the "Centre de Recherche en Santé de Nouna (CRSN) Heidelberg Aging Study (CHAS)," a cross-sectional population-based study conducted in 2018 in Burkina Faso, were used in our study. Hierarchical linear regression models were applied for each of the three outcome variables. Among 2291 participants aged 40 years or older who provided data on relationship satisfaction, 2221, 2223, and 2145 participants had BMI, waist circumference (WC), and HbA1c values respectively. RESULTS Higher relationship satisfaction (CSI-4 score) was associated with increased BMI (β = 0.05, p = 0.031) and WC (β = 0.12, p = 0.039). However, the association of CSI-4 and BMI became non-significant after controlling for depressive symptoms (PHQ-9 score) and physical inactivity (BMI: β = 0.04, p = 0.073). Depressive symptoms fully mediated the relationship between relationship satisfaction and BMI (β = -0.07, p = 0.005). There was no significant association between relationship satisfaction and HbA1c. These results were consistent across genders and age groups. CONCLUSION Higher relationship satisfaction may lead to increased body weight among Burkinabe adults aged 40 years and older, and depressive symptoms may be a mediator in this association.
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Affiliation(s)
- Adi Lukas Kurniawan
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
| | - Julius Schretzmann
- Institute of Medical Psychology, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rathi Paramastri
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Alyssa Cho
- Epidemiology, Public Health, and Impact, International Vaccine Institute, Seoul, South Korea
| | - Ali Sié
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Melanie S Fischer
- Institute of Medical Psychology, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Psychology, University of Marburg, Marburg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
- Africa Health Research Institute (AHRI), KwaZulu-Natal, Somkhele, South Africa.
| | - Beate Ditzen
- Institute of Medical Psychology, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.
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Devlin EA, Newcomb ME, Whitton S. Demographic and Minority Stress Risk Factors for Obesity Among Sexual Minority Youth Assigned Female at Birth. LGBT Health 2024; 11:103-110. [PMID: 37819720 PMCID: PMC10924190 DOI: 10.1089/lgbt.2021.0122] [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] [Indexed: 10/13/2023] Open
Abstract
Purpose: Sexual minority youth (adolescents and young adults) assigned female at birth (SM-AFAB) are at disproportionate risk of developing obesity compared with heterosexual cisgender youth AFAB. Grounded in minority stress theory, this study aimed to identify potential risk factors for obesity among SM-AFAB youth to inform the development of prevention and intervention efforts for this high-risk population. Methods: Data were collected in 2017 from 367 SM-AFAB youth (ages 16-20 years). Multinominal logistic regression was used to assess cross-sectional associations of race/ethnicity, sexuality, gender identity, household income, and sexual minority (SM) stressors (internalized stigma, microaggressions, and victimization) with weight status (normal, overweight, and obese). Results: Roughly half (53.1%) of participants' body mass index were in the normal weight range, with 24.8% in the overweight range and 22.1% in the obese range. Rates of obesity in Black and Latinx participants were 3-4.5 times those of White participants. Bisexual, pansexual, and queer individuals were at greater risk for obesity than gay/lesbian participants; only bisexual participants were at higher risk for overweight. Participants with a household income <$20,000 and between $20,000 and $39,000 were at greater risk for obesity than participants with household income >$80,000. Microaggressions were positively associated with obesity. Conclusion: Findings highlight risk for obesity among SM-AFAB youth, particularly for those who identify as racial minority, as low income, as being attracted to more than one gender, and for those who experience high levels of anti-SM microaggressions. Targeted obesity prevention and treatment programs should consider the unique needs, challenges, and strengths of SM-AFAB youth.
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Affiliation(s)
- Emily A. Devlin
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern University, Evanston, Illinois, USA
| | - Sarah Whitton
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
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Huang G, Sun M, Jiang LC. Core social network size is associated with physical activity participation for fitness app users: The role of social comparison and social support. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107169] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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5
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Kianfar M, Afshari P, Abedi P, Haghighizadeh M. The relationship of a weight-efficacy lifestyle with anthropometric indices among middle-aged Iranian women. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2051305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mahbobeh Kianfar
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Poorandokht Afshari
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Midwifery Department, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hosseini Z, Safari A, Khan NA, Veenstra G, Conklin AI. Adiposity and the role of diverse social supports: an observational, gender-sensitive study using the baseline Canadian Longitudinal Study on Aging. Public Health Nutr 2021; 24:6103-6112. [PMID: 34462039 PMCID: PMC11148584 DOI: 10.1017/s1368980021003724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To quantify associations between four types of social support and measured adiposity among women and men. DESIGN The cross-sectional sample from the Canadian Longitudinal Study on Aging (CLSA, 2012-2015). Height, weight and waist circumference (WC) were clinically measured, and perceived availability of informational, tangible, emotional and belonging social supports was self-reported. SETTING Canada. PARTICIPANTS 28 779 adults aged 45-85 years from the CLSA. RESULTS All social support types were associated with WC and BMI among women but not among men. Women reporting the lowest informational support had significantly higher mean BMI (28·84 kg/m2 (95 % CI 28·63, 29·05)) and WC (90·81 cm (95 % CI 90·31, 91·30)) compared with women reporting maximum support (respectively, 28·09 kg/m2 (95 % CI 27·88, 28·30) and 88·92 cm (95 % CI 88·43, 89·4)). Women's abdominal obesity was associated with low levels of informational, emotional and belonging support, and women's general obesity with informational and emotional support. Notably, informational and emotional support were associated with both obesity outcomes independent of other supports among women. Only a low level of informational support was significantly independently associated with higher odds of obesity among men. CONCLUSIONS Our study provides novel insights into gender-specific associations between different types of social support and adiposity. Prospective studies are needed to further investigate potential causality of these associations between the specific social supports and future weight status, especially among women.
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Affiliation(s)
- Zeinab Hosseini
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Office 4623, Vancouver, BCV6T 1Z3, Canada
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Abdollah Safari
- Data, Analytics, Statistics and Informatics (DASI), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Nadia A Khan
- Department of Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, Canada
| | - Gerry Veenstra
- Department of Sociology, Faculty of Arts, University of British Columbia, Vancouver, Canada
| | - Annalijn I Conklin
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Office 4623, Vancouver, BCV6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, Canada
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Cuevas AG, Greatorex-Voith S, Assari S, Slopen N, Economos CD. Longitudinal Analysis of Psychosocial Stressors and Body Mass Index in Middle-Aged and Older Adults in the United States. J Gerontol B Psychol Sci Soc Sci 2021; 76:1580-1589. [PMID: 32857165 DOI: 10.1093/geronb/gbaa142] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Psychosocial stress may be a risk factor for obesity and overweight in middle-aged and older adults. However, research on psychosocial stress and excess body weight has typically been cross-sectional and focused on single stressors. METHODS Using 3 waves of data from the Health and Retirement Study, we conducted longitudinal analyses to assess associations between 5 psychosocial stressors-individually and in combination-and body mass index (BMI), adjusting for sociodemographic factors, alcohol use, and smoking history. We tested interaction effects between race and gender with stressors on BMI. RESULTS A total of 3,956 participants were included in the main analyses. Most participants were White (88.04%) and more than half were female (60.39%). Perceived discrimination, financial stress, and relationship stress were positively associated with BMI. A greater cumulative stress burden was associated with higher BMI. In stratified analyses, greater financial stress was associated with higher BMI among White participants, whereas greater neighborhood stress was associated with lower BMI among Black participants. Greater relationship stress, financial stress, cumulative high stress, and overall cumulative stress burden were associated with higher BMI for women, but not men. DISCUSSION Different sources of stress may be risk factors to weight gain and affect BMI in adults. White and female adults may be more susceptible to the obesogenic effects of stressors. Reducing exposure to stress may help reduce the burden of high BMI among middle-aged and older adults.
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Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, Medford, Massachusetts
| | | | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland, College Park
| | - Christina D Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
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Barton BB, Zagler A, Engl K, Rihs L, Musil R. Prevalence of obesity, metabolic syndrome, diabetes and risk of cardiovascular disease in a psychiatric inpatient sample: results of the Metabolism in Psychiatry (MiP) Study. Eur Arch Psychiatry Clin Neurosci 2020; 270:597-609. [PMID: 31302731 DOI: 10.1007/s00406-019-01043-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 07/03/2019] [Indexed: 01/20/2023]
Abstract
The information on prevalence of obesity, diabetes, metabolic syndrome (MetS) and cardiovascular risk (CVR) and on sociodemographic variables available in patients with psychiatric diseases about to be treated with weight gain-associated medication (e.g., clozapine, mirtazapine, quetiapine) is limited. In a naturalistic study, psychiatric inpatients (age: 18-75) of all F diagnoses according to ICD-10, who were about to be treated with weight gain-associated medication, were included. Demographic variables were assessed as well as biological parameters to calculate the Body Mass Index (BMI), MetS, diabetes and CVR. A total of 163 inpatients were included (60.1% male; mean age: 39.8 (± 15.1, 18-75 years). The three most common disorders were depression (46.0%), bipolar disorder (20.9%) and drug addiction (20.2%). The three most common pharmacotherapeutic agents prescribed were quetiapine (29.4%), mirtazapine (20.9%) and risperidone (12.9%). Of the included inpatients 30.1% were overweight, 17.2% obese, and 26.9% and 22.4% fulfilled the criteria for a MetS according to the International Diabetes Federation (IDF) and the National Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP ATP III), respectively, 3.8% had (pre)diabetes and 8.3% had a moderate and 1.9% a high CVR according to the Prospective Cardiovascular Münster (PROCAM) score. Detailed information is reported on all assessed parameters as well as on subgroup analyses concerning sociodemographic variables. The results suggest that psychiatric patients suffer from multiple metabolic disturbances in comparison to the general population. Monitoring weight, waist circumference, blood pressure and cholesterol regularly is, therefore, highly relevant.
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Affiliation(s)
- Barbara B Barton
- Department of Psychiatry and Psychotherapy, University Hospital , LMU Munich, Germany, Nußbaumstraße 7, 80336, Munich, Germany.
| | - Anja Zagler
- Department of Psychiatry and Psychotherapy, University Hospital , LMU Munich, Germany, Nußbaumstraße 7, 80336, Munich, Germany
| | - Katharina Engl
- Department of Psychiatry and Psychotherapy, University Hospital , LMU Munich, Germany, Nußbaumstraße 7, 80336, Munich, Germany
| | - Leonie Rihs
- Department of Psychiatry and Psychotherapy, University Hospital , LMU Munich, Germany, Nußbaumstraße 7, 80336, Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, University Hospital , LMU Munich, Germany, Nußbaumstraße 7, 80336, Munich, Germany
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Birditt KS, Newton NJ, Cranford JA, Webster NJ. Chronic Stress and Negative Marital Quality Among Older Couples: Associations With Waist Circumference. J Gerontol B Psychol Sci Soc Sci 2019; 74:318-328. [PMID: 27664418 DOI: 10.1093/geronb/gbw112] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 08/10/2016] [Indexed: 01/29/2023] Open
Abstract
Objective More than a third of the U.S. population of older adults is obese. The present study tests the Dyadic Biopsychosocial Model of Marriage and Health, which hypothesizes that, among married couples, individual and partner chronic stress predicts increased waist circumference and these links are exacerbated in negative quality marriages. Method Participants were from the nationally representative longitudinal Health and Retirement Study (HRS). A total of 2,042 married individuals (in 1,098 married couples) completed psychosocial and waist circumference assessments in 2006 and 2010. Analyses examined whether negative marital quality and chronic stress in Wave 1 (2006) were associated with changes in waist circumference over time. Results Actor-partner interdependence models revealed that greater partner stress, rather than individuals' own reports of stress, was associated with increased waist circumference over time. Higher perceived negative marital quality among husbands and lower negative marital quality among wives exacerbated the positive link between partner stress and waist circumference. Discussion Consistent with the Dyadic Biopsychosocial Model of Marriage and Health, partner stress has direct associations with waist circumference among couples and this link is moderated by negative marital quality. Thus, dyadic perceptions of stress and negative marital quality are important to consider for understanding marriage and obesity.
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Affiliation(s)
- Kira S Birditt
- Life Course Development Program, Institute for Social Research, University of Michigan, Ann Arbor
| | - Nicky J Newton
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jim A Cranford
- Department of Psychiatry, University of Michigan, Ann Arbor
| | - Noah J Webster
- Life Course Development Program, Institute for Social Research, University of Michigan, Ann Arbor
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Is Pre-operation Social Connectedness Associated with Weight Loss up to 2 Years Post Bariatric Surgery? Obes Surg 2019; 28:3524-3530. [PMID: 30043144 DOI: 10.1007/s11695-018-3378-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND To date, little attention has been paid to supportive relationships as factors contributing to weight loss from bariatric surgery. MATERIAL AND METHODS This prospective study examined whether total percentage weight loss (%TWL) at 3, 12 and 24 months post-surgery varies by distinct aspects of pre-surgery social support (received emotional and practical support and contact with friends and family) in a sample of bariatric surgery candidates (n = 182). These associations were tested with linear regression models adjusted for gender, age, ethnicity, employment status, self-esteem, mastery and time elapsed since the day of surgery. RESULTS One hundred fifty-four participants underwent a bariatric procedure, and all but seven provided weight loss data at least at one occasion. Emotional support and contact with friends were positively associated with %TWL at 3, 12 and 24 months, and the magnitude of these associations was large. For instance, in the fully adjusted models, %TWL at 24 months increased by 2.36% (SE 1.17, p = 0.048) with each increase of one standard deviation in emotional support and was higher by 9.23% (SE 4.31, p = 0.035) for participants who reported seeing 1-5 friends per month compared with those who saw none. There was some evidence for a positive association between practical support and %TWL at 3 and 12 months post-surgery. CONCLUSION Supportive relationships are important contributors to weight loss from bariatric surgery. If replicated in future studies, these findings could inform clinical care and interventions aimed at improving support systems of bariatric surgery candidates.
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Campbell AD, Baker EH. Do income inequalities in higher weight status depend on social integration? SOCIAL SCIENCE RESEARCH 2019; 83:102301. [PMID: 31422839 PMCID: PMC8088976 DOI: 10.1016/j.ssresearch.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 03/27/2019] [Accepted: 04/18/2019] [Indexed: 05/03/2023]
Abstract
Those with higher incomes tend to have better health outcomes, including healthy weight status. We use data from the 2003-2008 National Health and Nutrition Examination Survey (NHANES) to examine whether the association between higher weight status and social integration varies by income. We examine gender differences in weight status, measured by BMI and obesity, by social integration and income, and find evidence that high social integration is a risk factor for higher weight status among low-income men. The association between income and higher weight status operates differently for women and men and is dependent, in part, on their level of social integration. Income is negatively associated with weight status for men who are highly integrated, but is positively associated with weight status among men who have low integration. We conclude that higher numbers of close friends and family places low-income men at greater risk of higher weight status.
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Tymoszuk U, Kumari M, Batterham R, Stafford M. Social support and trajectories of body mass index and waist to hip ratio from mid-adulthood to old age. J Epidemiol Community Health 2018; 73:111-116. [PMID: 30381465 DOI: 10.1136/jech-2018-210525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 09/26/2018] [Accepted: 10/11/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Although social networks' influence on obesity has been increasingly recognised, it remains unclear if different dimensions of social support, for example, emotional or practical support, received from one's closest relationship are associated with weight outcomes over mid-life and old age. METHODS Using linear mixed models we examined whether person-level body mass index (BMI) and waist to hip ratio (WHR) trajectories vary according to levels of emotional, practical and negative aspects of social support in a large UK-based cohort of healthy civil servant workers (n=5460) with objectively measured anthropometry data on five occasions over two decades (1989-1990 to 2012-2013). RESULTS We found that gender modified the associations, with more consistent patterns found in men. In men, high negative aspects of support compared with low were consistently associated with steeper increase in BMI (0.024, 95% CI 0.001 to 0.047 kg/m2) and WHR (0.00020, 95% CI -0.00001 to 0.00040) after adjustment for demographic and socioeconomic covariates, mental health, health behaviours and long-standing illness. We found that low emotional support, compared with high, was associated with steeper BMI gain in men (0.024, 95% CI 0.0001 to 0.047 kg/m2). CONCLUSIONS Low levels of negative aspects of the relationships with the closest person and high levels of emotional support may be protective against weight gain over time, particularly in men. If replicated in other studies, these results would suggest that the quality of social support in close relationships has been an overlooked risk factor for weight gain in an ageing population.
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Affiliation(s)
- Urszula Tymoszuk
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Meena Kumari
- Department of Epidemiology and Public Health, University College London, London, UK.,Institute for Social and Economic Research (ISER), University of Essex, Colchester, UK
| | - Rachel Batterham
- Department of Medicine, Centre for Obesity Research, Rayne Institute, University College London, London, UK.,University College London Hospital (UCLH) Bariatric Centre for Weight Management and Metabolic Surgery, London, UK.,National Institute of Health Research, UCLH Biomedical Research Centre, London, UK
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing at UCL, UCL, London, UK
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Unfavorable and favorable changes in modifiable risk factors and incidence of coronary heart disease: The Whitehall II cohort study. Int J Cardiol 2018; 269:7-12. [PMID: 30005835 PMCID: PMC6152587 DOI: 10.1016/j.ijcard.2018.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 06/12/2018] [Accepted: 07/02/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few studies have examined long-term associations of unfavorable and favorable changes in vascular risk factors with incident coronary heart disease (CHD). We examined this issue in a middle-aged disease-free population. METHODS We used repeat data from the Whitehall II cohort study. Five biomedical, behavioral and psychosocial examinations of 8335 participants without CHD produced up to 20,357 person-observations to mimic a non-randomized pseudo-trial. After measurement of potential change in 6 risk factors twice (total cholesterol, blood pressure, smoking, overweight, psychological distress, problems in social relationships), a 5-year follow-up of CHD was undertaken. RESULTS Incidence of CHD was 7.4/1000 person-years. Increases from normal to high cholesterol (hazard ratio, HR = 1.59, 95% CI 1.26-2.00) and from normal to high blood pressure (HR = 1.64, 95% CI 1.33-2.03), as compared to remaining at the normal level, were associated with increased risk of CHD. In contrast, decreases from high to low levels of cholesterol (HR = 0.73, 95% CI 0.58-0.91), psychological distress (HR = 0.68, 95% CI 0.51-0.90), and problems in social relationships (HR = 0.65, 95% CI 0.50-0.85), and quitting smoking (HR = 0.49, 95% CI 0.29-0.82) were associated with a reduced CHD risk compared to remaining at high risk factor levels. The highest absolute risk was associated with persistent exposure to both high cholesterol and hypertension (incidence 18.1/1000 person-years) and smoking and overweight (incidence 17.7/1000 person-years). CONCLUSIONS While persistent exposures and changes in biological and behavioral risk factors relate to the greatest increases and reductions in 5-year risk of CHD, also favorable changes in psychosocial risk factors appear to reduce CHD risk.
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Munck B, Björklund A, Jansson I, Lundberg K, Wagman P. Adulthood transitions in health and welfare; a literature review. Nurs Open 2018; 5:254-260. [PMID: 30062017 PMCID: PMC6056437 DOI: 10.1002/nop2.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 02/02/2018] [Indexed: 12/03/2022] Open
Abstract
AIM The aim of the literature review was to describe how adulthood transition is used in health and welfare. DESIGN A qualitative design with a deductive approach were used. METHODS As material, 283 articles published in scientific journals, between 2011-August 2013, were selected. The search was conducted August 2013. The data were analysed and sorted in a categorization matrix. RESULTS Transition was identified as a process mainly related to the four types previously identified; developmental, situational, health-illness and organizational transitions. Another one transition was also identified, lifestyle transition.
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Affiliation(s)
- Berit Munck
- School of Health and WelfareADULT research groupJönköping UniversityJönköpingSweden
| | - Anita Björklund
- School of Health and WelfareADULT research groupJönköping UniversityJönköpingSweden
| | - Inger Jansson
- School of Health and WelfareADULT research groupJönköping UniversityJönköpingSweden
| | - Kristina Lundberg
- School of Health and WelfareADULT research groupJönköping UniversityJönköpingSweden
- Faculty of Caring science, Work Life and Social WelfarePre Hospen ‐ Centre for Prehospital ResearchUniversity of BoråsBoråsSweden
| | - Petra Wagman
- School of Health and WelfareADULT research groupJönköping UniversityJönköpingSweden
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Surkan PJ, Sakyi KS, Hu A, Olinto MT, Gonçalves H, Horta BL, Gigante DP. Impact of stressful life events on central adiposity in the Pelotas Birth Cohort. Rev Saude Publica 2018; 52:61. [PMID: 29791680 PMCID: PMC5958973 DOI: 10.11606/s1518-8787.2018052000161] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 05/08/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE: To investigate how stressful life events and social support relate to central adiposity in Southern Brazil. METHODS: Data included information from 802 participants in the 1982 Pelotas Birth Cohort that was collect in 2004-2005 and 2006. Stratifying by sex, we studied self-reported stressful life events during the year before 2004-2005 in relation to change in waist circumference between 2004-2005 and 2006 and waist-to-hip ratio in 2006, using both bivariate and multivariate linear regression models. RESULTS: In adjusted models, the experience of stressful life events during the year before 2004-2005 predicted a change in waist circumference in 2006 in men and a change in both waist-to-hip ratio in 2006 and waist circumference between 2004-2005 and 2006 in women. Men who experienced two or more stressful events had on average a one centimeter increase in their waist circumference between 2004-2005 and 2006 (β = 0.97, 95%CI 0.02-1.92), compared to those reporting no stressful events. For women, those who had one and those who had two or more stressful life events had over a 1 cm increase in their waist circumference from 2004-2005 to 2006 (β = 1.37, 95%CI 0.17-2.54; β = 1.26, 95%CI 0.11-2.40, respectively), compared to those who did not experience any stressful event. For both sexes, social support level was not significantly related to either waist-to-hip ratio or change in waist circumference, and it did not modify the association between stress and central adiposity. CONCLUSIONS: The experience of more than one stressful life event was associated with distinct indicators of central adiposity for men versus women.
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Affiliation(s)
- Pamela J Surkan
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Kwame S Sakyi
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Alice Hu
- Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Maria T Olinto
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil
| | - Helen Gonçalves
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Denise P Gigante
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
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Xu T, Magnusson Hanson LL, Lange T, Starkopf L, Westerlund H, Madsen IEH, Rugulies R, Pentti J, Stenholm S, Vahtera J, Hansen ÅM, Kivimäki M, Rod NH. Workplace bullying and violence as risk factors for type 2 diabetes: a multicohort study and meta-analysis. Diabetologia 2018; 61:75-83. [PMID: 29130114 PMCID: PMC6005336 DOI: 10.1007/s00125-017-4480-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 09/21/2017] [Indexed: 11/05/2022]
Abstract
AIMS/HYPOTHESIS The aim of this multicohort study was to examine whether employees exposed to social stressors at work, such as workplace bullying and violence, have an increased risk of type 2 diabetes. METHODS The study included 45,905 men and women (40-65 years of age and free of diabetes at baseline) from four studies in Sweden, Denmark and Finland. Workplace bullying and violence were self-reported at baseline. Incident diabetes was ascertained through national health and medication records and death registers. Marginal structural Cox models adjusted for age, sex, country of birth, marital status and educational level were used for the analyses. RESULTS Nine per cent of the population reported being bullied at work and 12% were exposed to workplace violence or threats of violence. Bullied participants had a 1.46 (95% CI 1.23, 1.74) times higher risk of developing diabetes compared with non-bullied participants. Exposure to violence or threats of violence was also associated with a higher risk of diabetes (HR 1.26 [95% CI 1.02, 1.56]). The risk estimates attenuated slightly when taking BMI into account, especially for bullying. The results were similar for men and women, and were consistent across cohorts. CONCLUSIONS/INTERPRETATION We found a higher risk of incident type 2 diabetes among employees exposed to bullying or violence in the workplace. Further research is needed to determine whether policies to reduce bullying and violence at work may reduce the incidence of type 2 diabetes in working populations. Research on the mechanisms is also highly warranted.
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Affiliation(s)
- Tianwei Xu
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1014, Copenhagen, Denmark.
- Stress Research Institute, Stockholm University, Frescati hagväg 16, 104 05, Stockholm, Sweden.
| | | | - Theis Lange
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Statistics Science, Peking University, Beijing, People's Republic of China
| | - Liis Starkopf
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Frescati hagväg 16, 104 05, Stockholm, Sweden
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1014, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Åse M Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1014, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Naja H Rod
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1014, Copenhagen, Denmark
- Stress Research Institute, Stockholm University, Frescati hagväg 16, 104 05, Stockholm, Sweden
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The Longitudinal Relation Between Accumulation of Adverse Life Events and Body Mass Index From Early Adolescence to Young Adulthood. Psychosom Med 2017; 79:365-373. [PMID: 27680602 DOI: 10.1097/psy.0000000000000401] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Stressors, such as adverse life events, can cause weight changes through behavioral and biological mechanisms. Whether the accumulation of adverse life events is related to body mass index (BMI) across multiple time points from early adolescence to young adulthood has not been investigated to date. METHODS Data are from 2188 children participating at T1 (10-12 years), T3 (14-18 years), and/or T5 (21-23 years) of the prospective Tracking Adolescents' Individual Lives Survey cohort study. Adverse events before T1 and between T1, T3, and T5 were measured with a parent interview at T1 and a semistructured interview (Event History Calendar) with the adolescent at T3 and T5. An adverse events score was calculated per wave. Body mass index z-scores were determined from objectively measured height and weight using the LMS (skewness, median, and coefficient of variation) reference curves of the International Obesity Task Force for children 18 years or younger. Data were analyzed using a modified bivariate autoregressive cross-lagged structural equation model. RESULTS Adverse events before T1 and between T3 and T5 were related to BMI at T5 (β = 0.06, p = .001 and β = -0.04, p = .04, respectively). Specifically, health events before T1 were associated with a higher BMI at T5, and events related to relationships and victimhood events between T3 and T5 were associated with a lower BMI at T5. CONCLUSIONS Adverse relationship and victimhood events in their recent past were related to a lower BMI in young adults, whereas adverse health events during childhood were related to a higher BMI in young adults. No relationships were found between adverse life events with BMI in children and adolescents.
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Abstract
ABSTRACTThis study investigates gender differences in trajectories of support from close relationships among adults in the transition from middle to old age, taking into account stability and change in the identity of the closest persons. Multi-level modelling was used to estimate gendered age-trajectories in three dimensions of support: emotional support, practical support and negative encounters, which were repeatedly measured over ten years amongst 6,718 Whitehall II participants. Men were more likely than women to nominate their partner as their closest person throughout follow-up; whereas women drew support from a wider range of sources. Gender differences were only evident in age-related trajectories of emotional support, and were contingent on stability and change in the closest relationships. Men reported increased emotional support from closest relationships with age, except for those who transitioned out of a partnership. For women, emotional support was stable among those whose closest person remained consistent, but decreased among those who changed their closest person. Further, emotional support increased with age for all married men, which was only the case for married women who nominated their partner as their closest person. Our analysis highlights gender-specific trajectories of perceived support from adults’ closest relationships in late life, and indicate more pronounced socio-emotional selectivity in older men than women.
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The Biobehavioral Family Model: Close relationships and allostatic load. Soc Sci Med 2015; 142:232-40. [DOI: 10.1016/j.socscimed.2015.08.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 08/04/2015] [Accepted: 08/14/2015] [Indexed: 11/22/2022]
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Structural and functional measures of social relationships and quality of life among older adults: does chronic disease status matter? Qual Life Res 2015; 25:153-64. [PMID: 26143057 DOI: 10.1007/s11136-015-1052-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the relative importance of structural and functional social relationships for quality of life (QoL) and the extent to which diagnosed chronic disease modifies these associations. METHODS Multivariate linear regression was used to investigate time-lagged associations between structural and functional measures of social relationships and QoL assessed 5 years apart by CASP-19, in 5925 Whitehall II participants (mean age 61, SD 6.0). Chronic disease was clinically verified coronary heart disease, stroke, diabetes or cancer. RESULTS Social relationships-QoL associations were consistent across disease status (P-values for interaction: 0.15-0.99). Larger friend network (β = 1.9, 95% CI 1.5-2.3), having a partner (β = 1.2, 95% CI 0.5-1.7), higher confiding support (β = 2.2, 95% CI 1.8-2.7) and lower negative aspects of close relationships (β = 3.3, 95% CI 2.8-3.8) were independently related to improved QoL in old age. The estimated difference in QoL due to social relationships was equivalent to up to 0.5 SD of the CASP-19 score and was stronger than the effect of chronic disease (coronary heart disease β = 2.0, 95% CI 1.4-2.6). CONCLUSIONS We found that beneficial aspects of social relationships in relation to QoL were, in order of importance: avoiding negative aspects of close relationships, having confiding support, having a wide network of friends and having a partner. These associations were not modified by chronic disease. Thus, despite inevitable physical deterioration, we may be able to enhance a satisfying late life by optimizing our social relationships.
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Liu H, Umberson D. Gender, stress in childhood and adulthood, and trajectories of change in body mass. Soc Sci Med 2015; 139:61-9. [PMID: 26151391 DOI: 10.1016/j.socscimed.2015.06.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 01/04/2023]
Abstract
Despite substantial evidence of the linkage between stress and weight change, previous studies have not considered how stress trajectories that begin in childhood and fluctuate throughout adulthood may work together to have long-term consequences for weight change. Working from a stress and life course perspective, we investigate the linkages between childhood stress, adulthood stress and trajectories of change in body mass (i.e., Body Mass Index, BMI) over time, with attention to possible gender variation in these processes. Data are drawn from a national longitudinal survey of the Americans' Changing Lives (N = 3617). Results from growth curve analyses suggest that both women and men who experienced higher levels of childhood stress also report higher levels of stress in adulthood. At the beginning of the study period, higher levels of adulthood stress are related to greater BMI for women but not men. Moreover, women who experienced higher levels of childhood stress gained weight more rapidly throughout the 15-year study period than did women who experienced less childhood stress, but neither childhood nor adulthood stress significantly modified men's BMI trajectories. These findings add to our understanding of how childhood stress-a more important driver of long-term BMI increase than adult stress-reverberates throughout the life course to foster cumulative disadvantage in body mass, and how such processes differ for men and women. Results highlight the importance of considering sex-specific social contexts of early childhood in order to design effective clinical programs that prevent or treat overweight and obesity later in life.
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Affiliation(s)
- Hui Liu
- Department of Sociology, Michigan State University, USA.
| | - Debra Umberson
- Department of Sociology and Population Research Center, The University of Texas at Austin, USA
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Woods SB, Priest JB, Roush T. The biobehavioral family model: testing social support as an additional exogenous variable. FAMILY PROCESS 2014; 53:672-685. [PMID: 24981970 DOI: 10.1111/famp.12086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n = 1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends' social support, and relatives' social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (χ(2) = 846.04, p = .000, SRMR = .039, CFI = .924, TLI = .914, RMSEA = .043). Negative marital interactions predicted biobehavioral reactivity (β = .38, p < .001), as did relatives' social support, inversely (β = -.16, p < .001). Biobehavioral reactivity predicted disease activity (β = .40, p < .001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.
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Affiliation(s)
- Sarah B Woods
- Department of Family Sciences, Texas Woman's University, Denton, TX
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Liao J, Head J, Kumari M, Stansfeld S, Kivimaki M, Singh-Manoux A, Brunner EJ. Negative aspects of close relationships as risk factors for cognitive aging. Am J Epidemiol 2014; 180:1118-25. [PMID: 25342204 PMCID: PMC4239796 DOI: 10.1093/aje/kwu236] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The extent to which social relationships influence cognitive aging is unclear. In this study, we investigated the association of midlife quality of close relationships with subsequent cognitive decline. Participants in the Whitehall II Study (n = 5,873; ages 45–69 years at first cognitive assessment) underwent executive function and memory tests 3 times over a period of 10 years (1997–1999 to 2007–2009). Midlife negative and positive aspects of close relationships were assessed twice using the Close Persons Questionnaire during the 8 years preceding cognitive assessment. Negative aspects of close relationships, but not positive aspects, were associated with accelerated cognitive aging. Participants in the top third of reported negative aspects of close relationships experienced a faster 10-year change in executive function (−0.04 standard deviation, 95% confidence interval: −0.08, −0.01) than those in the bottom third, which was comparable with 1 extra year of cognitive decline for participants aged 60 years after adjustment for sociodemographic and health status. Longitudinal analysis found no evidence of reverse causality. This study highlights the importance of differentiating aspects of social relationships to evaluate their unique associations with cognitive aging.
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Affiliation(s)
- Jing Liao
- Correspondence to Jing Liao, UCL Research Department of Epidemiology and Public Health, Faculty of Population Health Sciences, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom (e-mail: )
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Bergmann N, Gyntelberg F, Faber J. The appraisal of chronic stress and the development of the metabolic syndrome: a systematic review of prospective cohort studies. Endocr Connect 2014; 3:R55-80. [PMID: 24743684 PMCID: PMC4025474 DOI: 10.1530/ec-14-0031] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Chronic psychosocial stress has been proposed as a risk factor for the development of the metabolic syndrome (MES). This review gives a systematic overview of prospective cohort studies investigating chronic psychosocial stress as a risk factor for incident MES and the individual elements of MES. Thirty-nine studies were included. An association between chronic psychosocial stress and the development of MES was generally supported. Regarding the four elements of MES: i) weight gain: the prospective studies supported etiological roles for relationship stress, perceived stress, and distress, while the studies on work-related stress (WS) showed conflicting results; ii) dyslipidemi: too few studies on psychosocial stress as a risk factor for dyslipidemia were available to draw a conclusion; however, a trend toward a positive association was present; iii) type 2 diabetes mellitus (DM2): prospective studies supported perceived stress and distress as risk factors for the development of DM2 among men, but not among women, while WS was generally not supported as a risk factor among neither men nor women; iv) hypertension: marital stress and perceived stress might have an influence on blood pressure (BP), while no association was found regarding distress. Evaluating WS the results were equivocal and indicated that different types of WS affected the BP differently between men and women. In conclusion, a longitudinal association between chronic psychosocial stress and the development of MES seems present. However, the number of studies with sufficient quality is limited and the design of the studies is substantially heterogeneous.
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Affiliation(s)
- N Bergmann
- Endocrine UnitDepartment of Medicine O, Herlev University Hospital, DK-2730 Herlev, DenmarkThe National Research Centre for the Working EnvironmentCopenhagen, DenmarkFaculty of Health SciencesCopenhagen University, Copenhagen, Denmark
| | - F Gyntelberg
- Endocrine UnitDepartment of Medicine O, Herlev University Hospital, DK-2730 Herlev, DenmarkThe National Research Centre for the Working EnvironmentCopenhagen, DenmarkFaculty of Health SciencesCopenhagen University, Copenhagen, Denmark
| | - J Faber
- Endocrine UnitDepartment of Medicine O, Herlev University Hospital, DK-2730 Herlev, DenmarkThe National Research Centre for the Working EnvironmentCopenhagen, DenmarkFaculty of Health SciencesCopenhagen University, Copenhagen, DenmarkEndocrine UnitDepartment of Medicine O, Herlev University Hospital, DK-2730 Herlev, DenmarkThe National Research Centre for the Working EnvironmentCopenhagen, DenmarkFaculty of Health SciencesCopenhagen University, Copenhagen, Denmark
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MacInnis RJ, Hodge AM, Dixon HG, Peeters A, Johnson LEA, English DR, Giles GG. Predictors of increased body weight and waist circumference for middle-aged adults. Public Health Nutr 2014; 17:1087-97. [PMID: 23635351 PMCID: PMC10282478 DOI: 10.1017/s1368980013001031] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 02/28/2013] [Accepted: 03/08/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To identify predictors of increased adiposity for different measures of adiposity. DESIGN Prospective cohort study, the Melbourne Collaborative Cohort Study (MCCS), with data at baseline (1990-1994) and wave 2 (2003-2007). SETTING Participants recruited from the community. SUBJECTS Australian-born participants (n 5879) aged 40 to 69 years who were not current smokers and who were free from common chronic diseases at recruitment. At baseline and at wave 2, weight and waist circumference were measured; while demographic and lifestyle variables were obtained at baseline via structured interviews. RESULTS Participants who reported any recreational physical activity at baseline had lower weight and smaller waist circumference at wave 2 than those who did not, particularly for younger participants and for vigorous physical activity. Walking for leisure was not associated, and greater physical activity at work was associated, with greater adiposity measures at wave 2. A diet low in carbohydrates and fibre, but high in fat and protein, predicted greater weight and waist circumference at wave 2. Participants were less likely to have elevated weight or waist circumference at wave 2 if they consumed low to moderate amounts of alcohol. CONCLUSIONS Our findings indicate that promoting vigorous physical activity, encouraging a diet high in carbohydrate and fibre but low in fat and protein, and limiting alcohol intake could be promising approaches for preventing obesity in middle-aged adults. Similar interventions should successfully address the management of both weight and waist circumference, as they were predicted by similar factors.
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Affiliation(s)
- Robert J MacInnis
- Cancer Epidemiology Centre, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Allison M Hodge
- Cancer Epidemiology Centre, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - Helen G Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Carlton, Victoria, Australia
| | - Anna Peeters
- Obesity & Population Health Unit, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
- School of Population Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lucinda EA Johnson
- Cancer Epidemiology Centre, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - Dallas R English
- Cancer Epidemiology Centre, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, The University of Melbourne, Carlton, Victoria, Australia
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Kershaw KN, Hankinson AL, Liu K, Reis JP, Lewis CE, Loria CM, Carnethon MR. Social relationships and longitudinal changes in body mass index and waist circumference: the coronary artery risk development in young adults study. Am J Epidemiol 2014; 179:567-75. [PMID: 24389018 PMCID: PMC3927980 DOI: 10.1093/aje/kwt311] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 11/19/2013] [Indexed: 01/01/2023] Open
Abstract
Few studies have examined longitudinal associations between close social relationships and weight change. Using data from 3,074 participants in the Coronary Artery Risk Development in Young Adults Study who were examined in 2000, 2005, and 2010 (at ages 33-45 years in 2000), we estimated separate logistic regression random-effects models to assess whether patterns of exposure to supportive and negative relationships were associated with 10% or greater increases in body mass index (BMI) (weight (kg)/height (m)(2)) and waist circumference. Linear regression random-effects modeling was used to examine associations of social relationships with mean changes in BMI and waist circumference. Participants with persistently high supportive relationships were significantly less likely to increase their BMI values and waist circumference by 10% or greater compared with those with persistently low supportive relationships after adjustment for sociodemographic characteristics, baseline BMI/waist circumference, depressive symptoms, and health behaviors. Persistently high negative relationships were associated with higher likelihood of 10% or greater increases in waist circumference (odds ratio = 1.62, 95% confidence interval: 1.15, 2.29) and marginally higher BMI increases (odds ratio = 1.50, 95% confidence interval: 1.00, 2.24) compared with participants with persistently low negative relationships. Increasingly negative relationships were associated with increases in waist circumference only. These findings suggest that supportive relationships may minimize weight gain, and that adverse relationships may contribute to weight gain, particularly via central fat accumulation.
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Affiliation(s)
- Kiarri N. Kershaw
- Correspondence to Dr. Kiarri N. Kershaw, Department of Preventive Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, IL 60611 (e-mail: )
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Conklin AI, Forouhi NG, Suhrcke M, Surtees P, Wareham NJ, Monsivais P. Socioeconomic status, financial hardship and measured obesity in older adults: a cross-sectional study of the EPIC-Norfolk cohort. BMC Public Health 2013; 13:1039. [PMID: 24188462 PMCID: PMC4228357 DOI: 10.1186/1471-2458-13-1039] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 10/24/2013] [Indexed: 01/30/2023] Open
Abstract
Background Socioeconomic status is strongly associated with obesity. Current economic circumstances are also independently associated with self-reported weight status in Finnish civil servants. We aimed to examine three types of financial hardship in relation to measured general and central obesity in a general population of older adults, while considering conventional socioeconomic indicators. Methods Data from 10,137 participants (≥50 years) in the EPIC-Norfolk cohort who responded to a postal Health and Life Experiences Questionnaire (1996–2000) and attended a clinical assessment (1998–2002). Multivariable logistic regression models assessed likelihood of general obesity (BMI ≥30 kg/m2) and central obesity (women: ≥88 cm; men: ≥102 cm) calculated from measured anthropometrics. Results Obesity prevalence was consistently patterned by standard socioeconomic indicators, with over-50s in the lowest social class being twice as likely to be obese than those in the highest class (women OR 2.10 [CI95: 1.41—3.13]; men OR 2.36 [1.44—3.87]). After adjustment for socioeconomic status, reporting having less than enough money for one’s needs (compared to more than enough) was associated with obesity in women (OR 2.04 [1.54—2.69]) and men (OR 1.83 [1.34—2.49]). Similar associations were demonstrated between obesity and always or often not having enough money for food/clothing (women OR 1.40 [1.03—1.90]; men OR 1.81 [1.28—2.56]), compared to reporting this never occurred. The strongest independent associations were seen for obesity and reported greatest level of difficulty paying bills (women OR 2.20 [1.37—3.55]; men 2.40 [1.38—4.17]), compared to having no difficulties. Findings for central obesity were slightly higher in women and lower in men. Conclusions Obesity in British over-50s was more likely in study participants who reported greater financial hardship, even after education, social class and home ownership were taken into account. Public health policies need to consider the hitherto neglected role of financial hardship in older people, especially difficulty paying bills, as part of strategies to prevent or reduce obesity.
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Affiliation(s)
| | | | | | | | | | - Pablo Monsivais
- UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Forvie Site, Robinson Way, Box 296, Cambridge CB2 0SR, UK.
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Abstract
OBJECTIVE To examine the incidence of clinically significant weight gain 1 year after occupational back injury, and risk factors for that gain. METHODS A cohort of Washington State workers with wage-replacement benefits for back injuries completed baseline and 1-year follow-up telephone interviews. We obtained additional measures from claims and medical records. RESULTS Among 1263 workers, 174 (13.8%) reported clinically significant weight gain (≥7%) 1 year after occupational back injury. Women and workers who had more than 180 days on wage replacement at 1 year were twice as likely (adjusted odds ratio = 2.17, 95% confidence interval = 1.54 to 3.07; adjusted odds ratio = 2.40, 95% confidence interval = 1.63 to 3.53, respectively; both P < 0.001) to have clinically significant weight gain. CONCLUSIONS Women and workers on wage replacement for more than 180 days may be susceptible to clinically significant weight gain after occupational back injury.
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Czech B, Neumann ID, Müller M, Reber SO, Hellerbrand C. Effect of chronic psychosocial stress on nonalcoholic steatohepatitis in mice. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2013; 6:1585-1593. [PMID: 23923077 PMCID: PMC3726974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/20/2013] [Indexed: 06/02/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is characterized by hepatic lipid accumulation which may progress towards inflammation (nonalcoholic steatohepatitis (NASH)). NAFLD is regarded as a consequence of a sedentary, food-abundant lifestyle which, in the modern world, often coincides with chronically high levels of perceived psychosocial stress. Here, we aimed to characterize the effect of chronic psychosocial stress on the development of NAFLD/NASH in male mice either fed with standard chow or NASH-inducing high fat diet. Chronic psychosocial stress was induced by chronic subordinate colony housing (CSC), a pre-clinically validated paradigm relevant for human affective and somatic disorders. Single housed (SHC) mice served as controls. Under standard chow conditions CSC mice revealed lower hepatic triglyceride levels but higher hepatic TNFα, MCP-1 and HMOX mRNA expression, while serum transaminase levels did not significantly differ from SHC mice. Under the NASH-inducing high-fat diet CSC and SHC mice showed similar body weight-gain and serum levels of glucose and adiponectin. Moreover, liver histology as well as TNFα, MCP-1 and HMOX expression were similar in CSC and SHC mice fed with HFD. Surprisingly, CSC showed even significantly lower transaminase levels than SHC mice fed with the same NASH-inducing diet. Together, these data indicate that under normal dietary conditions the CSC model induces noticeable hepatic oxidative stress and inflammation without causing manifest hepatocellular injury. In contrast, CSC exhibited a protective effect on hepatocellular injury in a dietary NASH-model. Identification of the underlying mechanisms of this phenomenon may lead to novel therapeutic strategies to prevent progression of NAFLD.
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Affiliation(s)
- Barbara Czech
- Department of Internal Medicine I, University Hospital RegensburgGermany
| | - Inga D Neumann
- Department of Behavioral and Molecular Neurobiology, Institute of Zoology, University of RegensburgGermany
| | - Martina Müller
- Department of Internal Medicine I, University Hospital RegensburgGermany
| | - Stefan O Reber
- Department of Behavioral and Molecular Neurobiology, Institute of Zoology, University of RegensburgGermany
- Laboratory for Molecular Psychosomatics, Clinic for Psychosomatic Medicine and Psychotherapy, University of UlmGermany
| | - Claus Hellerbrand
- Department of Internal Medicine I, University Hospital RegensburgGermany
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Wilson SE. Marriage, gender and obesity in later life. ECONOMICS AND HUMAN BIOLOGY 2012; 10:431-453. [PMID: 22795874 DOI: 10.1016/j.ehb.2012.04.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 04/28/2012] [Indexed: 06/01/2023]
Abstract
A large body of literature argues that marriage promotes health and increases longevity. But do these benefits extend to maintaining a healthy body weight, as the economic theory of health investment suggests they should? They do not. Using the Health and Retirement Study (HRS), I find that entry into marriage among both men and women aged 51-70 is associated with weight gain and exit from marriage with weight loss. I evaluate three additional theories with respect to the cross-sectional and longitudinal variation in the data. First, it may be that a broader set of shared risk factors (such as social obligations regarding meals) raises body mass for married couples. However, the shared risk factor model predicts that the intra-couple correlation should increase with respect to marital duration. Instead, it declines. Second, scholars have recently promoted a "crisis" model of marriage in which marital transitions, not marital status, determine differences in body mass. The crisis model is consistent with short-term effects seen for divorce, but not for the persistent weight gains associated with marriage or the persistent weight loss following widowhood. And transition models, in general, cannot explain significant cross-sectional differences across marital states in a population that is no longer experiencing many transitions, nor can it account for the prominent gender differences (in late middle-age, the heaviest group is unmarried women and the lightest are unmarried men). Third, I argue that pressures of the marriage market, in combination with gendered preferences regarding partner BMI, can account for all the longitudinal and cross-sectional patterns found in the data.
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Affiliation(s)
- Sven E Wilson
- 830 SWKT, Brigham Young University, Provo, UT 84602, United States.
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Abstract
The prevalence of overweight and obesity has markedly increased during the past few decades. Stress has been suggested as one environmental factor that may contribute to the development of obesity. In this review, we discuss the role that exposure to chronic stress may play in the development of obesity, with particular attention to the effects of chronic psychosocial stress. Of particular importance is the effect that social stress has on dietary preference, food consumption, and regional distribution of adipose tissue. We present evidence from human and animal studies that links sympathetic nervous system and hypothalamic-pituitary-adrenal axis hyperactivity with visceral obesity, and that stress tends to alter the pattern of food consumption, and promotes craving of nutrient-dense "comfort foods." Lastly, we discuss the visible burrow system, a model of chronic social stress used in our laboratory to assess the effects of social subordination on behavioral and metabolic profile.
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Affiliation(s)
- Karen A. Scott
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, 2170 East Galbraith Road, E 212, Cincinnati, OH 45237, USA
| | - Susan J. Melhorn
- University of Washington, Harborview Medical Center, 925 Ninth Avenue, Box 359780, Seattle, WA 98104, USA
| | - Randall R. Sakai
- Department of Psychiatry and Behavioral Neurosciences, University of Cincinnati College of Medicine, 2170 East Galbraith Road, E 212, Cincinnati, OH 45237, USA
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