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Wang Y, Steinke D, Gavan SP, Chen TC, Carr MJ, Ashcroft DM, Cheung KL, Chen LC. Survival Outcomes in Older Women with Oestrogen-Receptor-Positive Early-Stage Breast Cancer: Primary Endocrine Therapy vs. Surgery by Comorbidity and Frailty Levels. Cancers (Basel) 2024; 16:749. [PMID: 38398140 PMCID: PMC10886896 DOI: 10.3390/cancers16040749] [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: 01/23/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Primary endocrine therapy (PET) offers non-surgical treatment for older women with early-stage breast cancer who are unsuitable for surgery due to frailty or comorbidity. This research assessed all-cause and breast cancer-specific mortality of PET vs. surgery in older women (≥70 years) with oestrogen-receptor-positive early-stage breast cancer by frailty and comorbidity levels. This study used UK secondary data to analyse older female patients from 2000 to 2016. Patients were censored until 31 May 2019 and grouped by the Charlson comorbidity index (CCI) and hospital frailty risk score (HFRS). Cox regression models compared all-cause and breast cancer-specific mortality between PET and surgery within each group, adjusting for patient preferences and covariates. Sensitivity analyses accounted for competing risks. There were 23,109 patients included. The hazard ratio (HR) comparing PET to surgery for overall survival decreased significantly from 2.1 (95%CI: 2.0, 2.2) to 1.2 (95%CI: 1.1, 1.5) with increasing HFRS and from 2.1 (95%CI: 2.0, 2.2) to 1.4 (95%CI 1.2, 1.7) with rising CCI. However, there was no difference in BCSM for frail older women (HR: 1.2; 0.9, 1.9). There were no differences in competing risk profiles between other causes of death and breast cancer-specific mortality with PET versus surgery, with a subdistribution hazard ratio of 1.1 (0.9, 1.4) for high-level HFRS (p = 0.261) and CCI (p = 0.093). Given limited survival gains from surgery for older patients, PET shows potential as an effective option for frail older women with early-stage breast cancer. Despite surgery outperforming PET, surgery loses its edge as frailty increases, with negligible differences in the very frail.
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Affiliation(s)
- Yubo Wang
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester M13 9PT, UK; (D.S.); (T.-C.C.); (M.J.C.); (D.M.A.); (L.-C.C.)
| | - Douglas Steinke
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester M13 9PT, UK; (D.S.); (T.-C.C.); (M.J.C.); (D.M.A.); (L.-C.C.)
| | - Sean P. Gavan
- Manchester Centre for Health Economics, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK;
| | - Teng-Chou Chen
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester M13 9PT, UK; (D.S.); (T.-C.C.); (M.J.C.); (D.M.A.); (L.-C.C.)
| | - Matthew J. Carr
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester M13 9PT, UK; (D.S.); (T.-C.C.); (M.J.C.); (D.M.A.); (L.-C.C.)
| | - Darren M. Ashcroft
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester M13 9PT, UK; (D.S.); (T.-C.C.); (M.J.C.); (D.M.A.); (L.-C.C.)
- NIHR Greater Manchester Patient Safety Research Collaboration (PSRC), The University of Manchester, Manchester M13 9PT, UK
| | - Kwok-Leung Cheung
- Royal Derby Hospital Centre, School of Medicine, University of Nottingham, Uttoxeter Road, Derby DE22 3DT, UK;
| | - Li-Chia Chen
- Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Stopford Building, Oxford Road, Manchester M13 9PT, UK; (D.S.); (T.-C.C.); (M.J.C.); (D.M.A.); (L.-C.C.)
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Zare H, Aazami A, Shalby N, Gilmore DR, Thorpe RJ. Measuring Racial Differences in Obesity Risk Factors in Non-Hispanic Black and White Men Aged 20 Years or Older. Am J Mens Health 2023; 17:15579883231205845. [PMID: 37978812 PMCID: PMC10657537 DOI: 10.1177/15579883231205845] [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: 09/19/2022] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 11/19/2023] Open
Abstract
Obesity prevalence in the United States has increased drastically in the last two decades. Racial differences in obesity have emerged with the increase in obesity, with temporal trends because of individual, socioeconomic, and environmental factors, eating behaviors, lack of exercise, etc., raising questions about understanding the mechanisms driving these racial differences in the prevalence of obesity among non-Hispanic Black (NHB) and non-Hispanic White (NHW) men. Although many studies have measured obesity using body mass index (BMI), little is known about waist circumference (WC). This study examines variations in obesity among NHW and NHB using BMI and WC. We used National Health and Nutrition Examination Surveys (1999-2016) with a sample of 9,000 NHW and 3,913 NHB men aged 20 years or older. To estimate the association between the prevalence of obesity (BMI ≥30) and race, we applied modified Poisson regression; to explore and decompose racial differences, we used Oaxaca-Blinder decomposition (OBD). We found that NHW had higher abdominal obesity (WC ≥102) than NHB, but NHB were more likely to be obese (BMI ≥30) during most years, with some fluctuations. Modified Poisson regression showed that NHB had a higher prevalence of obesity (prevalence ratio [PR]: 1.11, 95% confidence interval [CI] = [1.04, 1.18]) but lower abdominal obesity (PR: 0.845; 95% CI = [0.801, 0.892]) than NHW. OBD showed that age, access to health care, smoking, and drinking contributed to the differences in abdominal obesity. The study identifies a significant increase in obesity among men over the last two decades; generalized obesity (based on BMI) was more problematic for NHB men, but abdominal obesity was more problematic for NHW men.
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Affiliation(s)
- Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- The School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, USA
| | - Aida Aazami
- The University of Texas at Dallas, Dallas, TX, USA
| | - Noran Shalby
- Public Health Studies in the Johns Hopkins Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Danielle R. Gilmore
- Trachtenberg School of Public Policy & Administration, George Washington University, Washington, DC, USA
- Department of Health, Behavior, and Society Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Roland J. Thorpe
- Department of Health, Behavior, and Society Program for Research on Men’s Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Candio P, Mujica FP, Frew E. Socio-economic accounting of inequalities in excess weight: a population-based analysis. BMC Public Health 2023; 23:721. [PMID: 37081498 PMCID: PMC10116779 DOI: 10.1186/s12889-023-15592-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The prevalence of excess weight has been increasing globally in the last decades, affecting disproportionally adults from low socio-economic backgrounds and putting undue pressure on health systems and societal resources. In England, tackling unfair and unjust health inequalities is at the heart of national public health policy, and a prerequisite for enabling these decision makers to set policy priorities is an understanding of the prevalence and determinants of excess weight inequalities in their local population. METHODS We conducted both pooled (England) and regional-level (nine regions: North-East, North-West, Yorkshire and Humber, East Midlands, West Midlands, East of England, London, South East and South West) analyses of individual level data from a nationally representative sample of adults (N = 6,387). We used the Corrected Concentration Index (CCI) to measure absolute inequalities in excess weight across three dimensions of socio-economic deprivation: neighbourhood-level deprivation, occupational status and educational qualification. We used a Shapley decomposition method to evaluate their relative contribution to inequality. RESULTS At a national level, all three dimensions of socio-economic deprivation were found to be positively associated with excess weight across the adult population, as measured by the CCI, with educational qualification ranking first [CCI: -0.090, p < 0.01], closely followed by neighbourhood-level deprivation [CCI: -0.050, p < 0.01]. Large variation was found between regions and genders, with inequality being either considerably higher or exclusively patterned among women. The strongest independent factor contributing to excess weight inequalities was having a long-lasting limiting illness, especially among women and towards the right tail of the excess weight spectrum. Heterogeneous patterns of contribution across the excess weight spectrum were found, however age played a dominant role toward the left tail of the distribution. CONCLUSIONS While socio-economic inequalities in excess weight exist in the English adult population, our findings underscore the importance of considering multiple dimensions of deprivation and the unique needs of different populations when developing policies to address overweight and obesity. Targeted interventions for adults with overweight and obesity with long-lasting illnesses and women can generate both short-term and long-term economic benefits, by reducing healthcare costs and increasing workforce productivity.
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Affiliation(s)
- Paolo Candio
- Department of Economics and Management, University of Trento, Trento, Italy.
- Centre for Economics of Obesity, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Fiorella Parra Mujica
- Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, Rotterdam, Netherlands
- Nuffield Department of Population Health, Health Economics Research Centre (HERC), University of Oxford, Oxford, UK
| | - Emma Frew
- Centre for Economics of Obesity, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Shirvani Shiri M, Emamgholipour S, Heydari H, Fekri N, Karami H. The Effect of Human Development Index on Obesity Prevalence at the Global Level: A Spatial Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:829-839. [PMID: 37551189 PMCID: PMC10404321 DOI: 10.18502/ijph.v52i4.12456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/11/2022] [Indexed: 08/09/2023]
Abstract
Background Obesity is one of the major public health concerns, and its prevalence is increasing worldwide. This study aimed to investigate the effect of human development index on the prevalence of obesity across 152 countries. Methods Country-level data on obesity prevalence and its influencing variables related to 152 countries were obtained during 2000-2019 from several sources. A Spatial Bayesian Hierarchical model was employed in this research, and the analyses were performed using R statistical software (version 3.6.1). Results We found a positive relation between HDI and obesity prevalence, in such a way if low HDI countries advance to high HDI countries, the obesity rate is expected to increase significantly by 7.45%. Moreover, the association between obesity prevalence and the percentage of people aged 40-59 (β=0.07), urbanization rate (β=0.11), percentage of internet users (β=0.01), percentage of alcohol users (β=0.16), milk consumption per capita (β=0.15) and Percentage of depression (β=0.58) was significantly positive. Conversely, per capita consumption of fruits and vegetables (β=-0.15), and smoking rate (β=-0.02) was negatively associated with obesity prevalence. Conclusion The prevalence of obesity is growing across all countries, especially in the countries with high and very high HDI. Therefore, policymakers must also pay attention to the negative effects of development when trying to improve the welfare of society.
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Affiliation(s)
- Maryam Shirvani Shiri
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Emamgholipour
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Heydari
- Department of Economics, School of Management and Economics, Tarbiat Modares University, Tehran, Iran
| | - Nazanin Fekri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Karami
- Department of Health Economics‚ School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Meta-analytic evidence for a sex-diverging association between alcohol use and body mass index. Sci Rep 2022; 12:21869. [PMID: 36535973 PMCID: PMC9763242 DOI: 10.1038/s41598-022-25653-w] [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: 04/20/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Alcohol use is an important health issue and has been suggested to contribute to the burden produced by obesity. Both alcohol use and obesity are subject to sex differences. The available studies on the relationship between alcohol use and body mass index (BMI) report inconsistent results with positive, negative, and null findings which requests a meta-analytic approach. Therefore, we conducted a meta-analysis of case-control, cohort, and cross-sectional studies. The systematic literature search and data extraction was performed by 3 independent raters. We conducted sex-separated meta-analyses and -regressions to investigate how alcohol consumption associates with BMI. Our systematic literature search resulted in 36 studies with 48 data sets (Nmen = 172,254; kmen = 30; Nwomen = 24,164; kwomen = 18; Nunknown sex = 672,344; kunknown sex = 24). Alcohol use was associated with higher BMI in men (g = 0.08 [0.07; 0.09]) and lower BMI in women (g = - 0.26 [- 0.29; - 0.22]). Moreover, we found the amount of daily alcohol intake in men (β = 0.001 [0.0008; 0.0014]) and ethnicity in women (g[Caucasians] = - 0.45 versus g[Asians] = - 0.05; z = 11.5, p < 0.0001) to moderate these effects. We here identified sex-diverging relationships between alcohol use and BMI, found daily alcohol intake and ethnicity to sex-specifically moderate these effects, and argue that sex-specific choice of beverage type and higher amount of daily alcohol use in men than in women account for these observations. Future research is needed to provide empirical evidence for the underlying mechanisms.
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Bajaj JS, Fagan A, McGeorge S, Sterling RK, Rogal S, Sikaroodi M, Gillevet PM. Area Deprivation Index and Gut-Brain Axis in Cirrhosis. Clin Transl Gastroenterol 2022; 13:e00495. [PMID: 35537854 PMCID: PMC9236605 DOI: 10.14309/ctg.0000000000000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/22/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Neighborhood deprivation has been associated with chronic diseases and with gut microbial alterations. Although cirrhosis is associated with gut microbiome changes and hepatic encephalopathy (HE), their association is unclear. METHODS Demographics and cirrhosis details (model for end-stage liver disease [MELD], prior HE, and medications) were recorded from outpatients with cirrhosis. Area deprivation index (ADI), which ranks neighborhoods by socioeconomic disadvantage, was recorded as state decile and national percentile (high = worse for both) and dichotomized on the median. Patients underwent cognitive testing to diagnose minimal HE (MHE). Stool microbiota was analyzed using 16S ribosomal RNA for α/β-diversity. Multivariable analysis was used to evaluate the factors independently associated with MHE. RESULTS A total of 321 people with cirrhosis (60 years, 78% men, 75% non-Hispanic White, 24% non-Hispanic African American, 4% Hispanic) were included. 45% had prior HE and 56% MHE. For ADI, the national percentile was 49.1 ± 21.8 while the state decile was 6.1 ± 2.3. ADI was not associated with race, ethnicity, MELD, or HE-related variables on regression. Regarding microbiota, α-diversity was lower in MHE and prior HE patients but similar across ADI rankings. Low vs high ADIs were associated with different β-diversity in univariable but not multivariable analyses. Multivariable analyses showed positive associations with MELD, prior HE, and lactate producers ( Lactobacillus and Lacticaseibacillus ) and negative associations with short-chain fatty acid producers ( Blautia , Lachnoclostridium , and Anaerobutyricum ) with MHE. DISCUSSION Cirrhosis-related variables may be more influential in determining gut microbiome composition and cognitive impairment than ADI. Therefore, the focus should be on improving cirrhosis care, regardless of ADI, but studies evaluating other measures of social determinants are needed in cirrhosis.
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Affiliation(s)
- Jasmohan S. Bajaj
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, USA
| | - Andrew Fagan
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, USA
| | - Sara McGeorge
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, USA
| | - Richard K. Sterling
- Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, USA
| | - Shari Rogal
- Department of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Masoumeh Sikaroodi
- Microbiome Analysis Center, George Mason University, Manassas, Virginia, USA
| | - Patrick M. Gillevet
- Microbiome Analysis Center, George Mason University, Manassas, Virginia, USA
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What factors drive gender differences in the body mass index? Evidence from Turkish adults. J Biosoc Sci 2022; 55:538-563. [PMID: 35509172 DOI: 10.1017/s0021932022000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.
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Liu J, Yang L, Xiao L, Tao Z. Perceived Neighborhood Environment Impacts on Health Behavior, Multi-Dimensional Health, and Life Satisfaction. Front Public Health 2022; 10:850923. [PMID: 35359780 PMCID: PMC8964045 DOI: 10.3389/fpubh.2022.850923] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/16/2022] [Indexed: 11/23/2022] Open
Abstract
The impacts of perceived neighborhood environment on adults' health and life satisfaction have drawn increasing academic attention. However, previous studies usually examine multi-dimensional (physical, mental, and perceived) health and life satisfaction separately, and few studies dealt with them simultaneously. Moreover, limited research revealed the mechanisms behind the effects of perceived neighborhood environment on health and life satisfaction, as well as how such effects are moderated by socio-demographics. Therefore, employing the 2016 China Family Panel Study Dataset and using structural equation modeling, this study delves into the complicated relationships among perceived neighborhood environment, health behavior, health outcomes (i.e., body mass index, self-rated health status, and depression), and life satisfaction. Notably, it considers mediation and moderation simultaneously. It finds: (1) Better perceived neighborhood environment significantly promotes physical activity and reduces sedentary behavior, smoking, and drinking; (2) Health behavior fully mediates the effects of perceived neighborhood environment on health; (3) Perceived neighborhood environment significantly affects life satisfaction both directly and indirectly (through health behavior and health outcomes); (4) Socio-demographics moderate the above relationships. This study disentangles the complicated impacts of perceived neighborhood environment on adults' multi-dimensional health and life satisfaction, thus providing policy makers and practitioners with nuanced knowledge for intervention.
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Affiliation(s)
- Jixiang Liu
- Department of Urban Planning, School of Architecture and Civil Engineering, Xiamen University, Xiamen, China
- Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Linchuan Yang
- Department of Urban and Rural Planning, School of Architecture, Southwest Jiaotong University, Chengdu, China
| | - Longzhu Xiao
- Department of Urban Planning, School of Architecture and Civil Engineering, Xiamen University, Xiamen, China
- Department of Architecture and Civil Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Zhuolin Tao
- Faculty of Geographical Science, Beijing Normal University, Beijing, China
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Xu Y, Wang A, Lin X, Xu J, Shan Y, Pan X, Ye J, Shan P. Global burden and gender disparity of vision loss associated with diabetes retinopathy. Acta Ophthalmol 2021; 99:431-440. [PMID: 33124190 DOI: 10.1111/aos.14644] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 08/04/2020] [Accepted: 09/17/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To assess the trend patterns and gender disparity in global burden of vision loss due to diabetic retinopathy (DR) by year, age, region and socioeconomic status using prevalence and years lived with disability (YLDs) from Global Burden of Disease (GBD) study 2017. METHODS Prevalence and YLDs data of vision loss attributable to DR were extracted from GBD Study 2017 in 195 countries and territories. Socio-demographic Index (SDI) in 2017 was cited as indicators of socioeconomic status. Kruskal-Wallis test, Dunn's multiple comparisons and Pearson linear correlation were adopted to evaluate the gender disparity and association with socioeconomic levels. RESULTS Globally, total age-standardized prevalence and YLDs rates of vision loss due to DR peaked around 2005, with prevalence rate of 58.98 [95% uncertainty interval (UI) 50.95-68.56] and YLDs rate of 5.00 (95% UI 3.51-6.84) per 100 000 population, respectively. The burden were expected to increase to 65.74 (95% UI 60.14-70.86) and 5.68 (95% UI 4.07-7.22) by 2050. The burden would increase according to our projection based on current epidemiological situation. However, gender disparity has existed since 1990 and been enlarging in recent years, with female being more heavily impacted. This pattern remained with ageing among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized prevalence rates was positively related to SDI (r = 0.1661, p = 0.0203). Diabetes has become a more important risk over the past 3 decades among the leading causes of vision loss. CONCLUSIONS The DR-related vision loss burden tended to increase under ageing population according to our projection with significant gender disparity. Public awareness of DR and gender sensitive health policy should be emphasized.
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Affiliation(s)
- Yufeng Xu
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Aihong Wang
- Department of Endocrinology PLA Strategic Support Force Characteristic Medical Center Beijing China
| | - Xiling Lin
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Jingya Xu
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Yi Shan
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Juan Ye
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Peng‐Fei Shan
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
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Slater J, Kruger R, Douwes J, O’Brien WJ, Corbin M, Miles-Chan JL, Breier BH. Objectively Measured Physical Activity Is Associated With Body Composition and Metabolic Profiles of Pacific and New Zealand European Women With Different Metabolic Disease Risks. Front Physiol 2021; 12:684782. [PMID: 34122148 PMCID: PMC8188826 DOI: 10.3389/fphys.2021.684782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/03/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: To assess associations between physical activity (PA), body composition, and biomarkers of metabolic health in Pacific and New Zealand European (NZE) women who are known to have different metabolic disease risks. Methods: Pacific (n = 142) or NZE (n = 162) women aged 18-45 years with a self-reported body mass index (BMI) of either 18.5-25.0 kg⋅m-2 or ≥30.0 kg⋅m-2 were recruited and subsequently stratified as either low (<35%) or high (≥35%) BF%, with approximately half of each group in either category. Seven-day accelerometery was used to assess PA levels. Fasting blood was analysed for biomarkers of metabolic health, and whole body dual-energy X-ray absorptiometry (DXA) was used to estimate body composition. Results: Mean moderate-to-vigorous physical activity (MVPA; min⋅day-1) levels differed between BF% (p < 0.05) and ethnic (p < 0.05) groups: Pacific high- 19.1 (SD 15.2) and low-BF% 26.3 (SD 15.6) and NZE high- 30.5 (SD 19.1) and low-BF% 39.1 (SD 18.4). On average Pacific women in the low-BF% group engaged in significantly less total PA when compared to NZE women in the low-BF% group (133 cpm); no ethnic difference in mean total PA (cpm) between high-BF% groups were observed: Pacific high- 607 (SD 185) and low-BF% 598 (SD 168) and NZE high- 674 (SD 210) and low-BF% 731 (SD 179). Multiple linear regression analysis controlling for age and deprivation showed a significant inverse association between increasing total PA and fasting plasma insulin among Pacific women; every 100 cpm increase in total PA was associated with a 6% lower fasting plasma insulin; no significant association was observed in NZE women. For both Pacific and NZE women, there was an 8% reduction in fasting plasma insulin for every 10-min increase in MVPA (p ≤ 0.05). Conclusion: Increases in total PA and MVPA are associated with lower fasting plasma insulin, thus indicating a reduction in metabolic disease risk. Importantly, compared to NZE, the impact of increased total PA on fasting insulin may be greater in Pacific women. Considering Pacific women are a high metabolic disease risk population, these pre-clinical responses to PA may be important in this population; indicating promotion of PA in Pacific women should remain a priority.
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Affiliation(s)
- Joanne Slater
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Rozanne Kruger
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Wendy J. O’Brien
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Marine Corbin
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Jennifer L. Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Bernhard H. Breier
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
- Riddet Centre of Research Excellence, Palmerston North, New Zealand
- Microbiome Otago, University of Otago, Dunedin, New Zealand
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Hawkins M, Fuchs H, Watts E, Irvine Belson S, Snelling A. Development of a Nutrition Literacy Survey for Use among Elementary School Students in Communities with High Rates of Food Insecurity. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1928577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Melissa Hawkins
- Department of Health Studies, American University, College of Arts & Sciences, Washington, DC, USA
| | - Hannah Fuchs
- Department of Health Studies, American University, College of Arts & Sciences, Washington, DC, USA
| | - Erin Watts
- Department of Health Studies, American University, College of Arts & Sciences, Washington, DC, USA
| | | | - Anastasia Snelling
- Department of Health Studies, American University, College of Arts & Sciences, Washington, DC, USA
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12
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Google Trends on Obesity, Smoking and Alcoholism: Global and Country-Specific Interest. Healthcare (Basel) 2021; 9:healthcare9020190. [PMID: 33572379 PMCID: PMC7916197 DOI: 10.3390/healthcare9020190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 11/17/2022] Open
Abstract
Unhealthy habits or lifestyles, such as obesity, smoking, and alcohol consumption, are involved in the development of non-communicable diseases. The aim of this study was to analyze different communities' interest in seeking obesity, smoking, and alcohol-related terms through relative search volumes (RSVs) of Google Trends (GT). Internet search query data on obesity, smoking, and alcohol-related terms were obtained from GT from the period between 2010 and 2020. Comparisons and correlations between different topics were calculated considering both global searches and English-, Spanish-, and Italian-speaking areas. Globally, the RSVs for obesity and alcohol-related terms were similar (mean RSVs: 76% and 77%), but they were lower for smoking (65%). High RSVs were found in winter for obesity and smoking-related terms. Worldwide, a negative correlation was found between alcohol and smoking terms (r = -0.72, p < 0.01). In Italy, the correlation was positive (r = 0.58). The correlation between obesity and alcohol was positive in all the cases considered. The interest of global citizens in obesity, smoking, and alcohol was high. The RSVs for obesity were globally higher and correlated with alcohol. Alcohol and smoking terms were related depending on the area considered.
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13
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Min J, Goodale H, Xue H, Brey R, Wang Y. Racial-Ethnic Disparities in Obesity and Biological, Behavioral, and Sociocultural Influences in the United States: A Systematic Review. Adv Nutr 2021; 12:1137-1148. [PMID: 33427291 PMCID: PMC8433490 DOI: 10.1093/advances/nmaa162] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/24/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022] Open
Abstract
For a comprehensive understanding of high-level obesity in the USA, we studied the trends of obesity prevalence since 2007, and related biological, behavioral, and sociocultural factors in obesity racial/ethnic disparities. We searched PubMed, Embase, and national data archives for the studies using national survey data and published in English from January 1, 2007 to September 11, 2020. Forty-seven studies met the inclusion criteria and were systematically reviewed. After a short leveling-off during 2009-2012, the US national prevalence of obesity has steadily increased. Although women had higher racial/ethnic disparities in obesity and severe obesity than men, it decreased due to the significant drop in non-Hispanic black (NHB) women in the last 10 y. However, obesity and severe obesity prevalence increased in Mexican-American (MA) men, MA boys, and MA girls and became similar to or surpassing NHB groups. Substantial racial/ethnic disparities remained in the past decade. Even at the same level of BMI, MAs and non-Hispanic Asians had a higher percent of body fat and metabolic syndrome than other ethnic/racial groups. NHB's cultural preference for a large body significantly associated weight misperception and lower weight control practices. In addition to socioeconomic status, health behaviors, neighborhood environments, and early childhood health factors explained substantial racial/ethnic differences in obesity. Differences in biological, behavioral, and sociocultural characteristics should be considered in future public health intervention efforts to combat obesity in the USA.
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Affiliation(s)
- Jungwon Min
- Systems-Oriented Global Childhood Obesity Intervention
Program, Fisher Institute of Health and Well-being, College of Health,
Ball State University, Muncie, IN, USA,Department of Biomedical and Health Informatics, The
Children's Hospital of Philadelphia, Philadelphia,
PA, USA
| | - Hailee Goodale
- Systems-Oriented Global Childhood Obesity Intervention
Program, Fisher Institute of Health and Well-being, College of Health,
Ball State University, Muncie, IN, USA,Department of Nutrition and Health Science, College of Health,
Ball State University, Muncie, IN, USA
| | - Hong Xue
- Department of Health Administration and Policy, College of
Health and Human Services, George Mason University,
Fairfax, VA, USA
| | - Rebecca Brey
- Department of Nutrition and Health Science, College of Health,
Ball State University, Muncie, IN, USA
| | - Youfa Wang
- Address correspondence to YW (e-mail: ; )
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14
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Press DJ, Pierce B, Lauderdale DS, Aschebrook-Kilfoy B, Lin Gomez S, Hedeker D, Wright NE, Fantus RJ, Bettencourt L, Ahsan H, Eggener S. Tobacco and marijuana use and their association with serum prostate-specific antigen levels among African American men in Chicago. Prev Med Rep 2020; 20:101174. [PMID: 33088675 PMCID: PMC7566952 DOI: 10.1016/j.pmedr.2020.101174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/05/2020] [Accepted: 08/05/2020] [Indexed: 11/30/2022] Open
Abstract
AA men are under-represented in PSA research, a biomarker of prostate cancer aggresiveness. Cigarette smoking was associated with an increase in PSA among older AA men. Tobacco use was associated with an increase in PSA among older AA men. Marijuana use was associated with a decrease in PSA among older AA men. Future behavioral risk factor studies linked to biopsy outcomes are warranted.
African American (AA) men experience more than twice the prostate cancer mortality as White men yet are under-represented in academic research involving prostate-specific antigen (PSA), a biomarker of prostate cancer aggressiveness. We examined the impact of self-reported tobacco (cigarette pack-years and current tobacco use including e-cigarettes) and current regular marijuana use on serum PSA level based on clinical laboratory testing among 928 AA men interviewed 2013–2018 in Chicago. We defined outcome of elevated PSA ≥ 4.0 ng/mL for logistic regression models and continuous PSA increases for general linear models. All models were adjusted for age, sociodemographic characteristics, healthcare utilization, body mass index, and self-reported health. Among 431 AA men age ≥ 55 years, we observed ∼ 5 times the odds of elevated PSA among those with > 1 pack-years of cigarette smoking vs. never-smokers (odds ratio [OR] = 5.09; 95% confidence interval [CI] = 1.57–16.6) and a quarter the odds of elevated PSA among current marijuana users vs. non-users (OR = 0.27; 95% CI = 0.08–0.96). PSA increased on average 1.20 ng/mL among other current tobacco users vs. non-users. Among older AA men, cigarette smoking history and current tobacco use were positively associated with an increase in PSA levels and current marijuana use were inversely associated with PSA levels. Future work with studies of diverse patient populations with cancer outcomes are needed to assess whether these behavioral characteristics contribute to racial/ ethnic disparities in prostate cancer outcomes. Our study provides novel evidence regarding potential differences in PSA levels among older AA men according to behavioral characteristics.
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Affiliation(s)
- David J. Press
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- The Center for Health Information Partnerships (CHiP), Institute of Public Health & Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Corresponding author at: Department of Public Health Sciences, The University of Chicago Biological Sciences, 5841 S. Maryland Ave., Chicago, IL 60637, USA.
| | - Brandon Pierce
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Diane S. Lauderdale
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Briseis Aschebrook-Kilfoy
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Donald Hedeker
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Nathaniel E. Wright
- Medical Scientist Training Program, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Luís Bettencourt
- Mansueto Institute for Urban Innovation, University of Chicago, Chicago, IL, USA
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
- Department of Sociology, University of Chicago, Chicago, IL, USA
- Santa Fe Institute, Santa Fe, NM, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
- Institute for Population and Precision Health, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Scott Eggener
- Department of Surgery, University of Chicago, Chicago, IL, USA
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15
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Chung W, Kim R. A Reversal of the Association between Education Level and Obesity Risk during Ageing: A Gender-Specific Longitudinal Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186755. [PMID: 32948024 PMCID: PMC7559988 DOI: 10.3390/ijerph17186755] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/12/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022]
Abstract
This study aimed to examine and quantify obesity risk across different education levels during ageing using the dataset of a nationally representative longitudinal survey. A total of 45,391 observations of 9991 individuals aged ≥45 years were included in this study. Obesity was defined as a body mass index of ≥25, according to a guideline for Asians by the World Health Organization, and education level was grouped into three categories. Socio-demographics, lifestyles, and health conditions were used as covariates. Adjusted odds ratios and predicted probabilities of obesity were computed and adjusted for a complex survey design. With respect to gender, education level and age were significantly associated with obesity risk, and the association was stronger in women than in men. Furthermore, education level was negatively associated with obesity risk in the middle age in each gender. However, the association became positive in the old age, specifically among highly educated women. Therefore, policy efforts to reduce obesity risk and the resulting education gradients should be established based on studies considering their old age. Further longitudinal studies are required to examine whether these findings are valid in other socio-cultural or economic settings.
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Affiliation(s)
- Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea;
- Institute of Health Services Research, Yonsei University, Seoul 03722, Korea
| | - Roeul Kim
- Labor Welfare Research Institute, Korea Workers’ Compensation and Welfare Service, Seoul 07254, Korea
- Correspondence: ; Tel.: +82-2-2670-0448
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16
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Streb AR, Duca GFD, Silva RPD, Benedet J, Malta DC. [Simultaneity of risk behaviors for obesity in adults in the capitals of Brazil]. CIENCIA & SAUDE COLETIVA 2020; 25:2999-3007. [PMID: 32785536 DOI: 10.1590/1413-81232020258.27752018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/14/2018] [Indexed: 12/22/2022] Open
Abstract
The scope of this study was to verify the association between risk behaviors and obesity in adults (18 to 59 years of age) in Brazilian capitals. It involved a cross-sectional population-based study conducted by telephone interview. The self-reported variables were obesity, defined by weight and height (BMI ≥ 30 kg/m²) and risk behaviors: physical inactivity (≤ 149 minutes/week), excess sedentarism (≥ 4 hours/day), frequent consumption of sweets (≥ 5 days/week) and meat with fat and/or chicken with skin (≥ 1 day/week). The simultaneity of risk behaviors was analyzed for reasons of observed and expected prevalence. The Poisson and multinomial logistic regressions were used in crude analyses and adjusted for sociodemographic factors. Among the 35,448 adults, the simultaneous consumption of meat with fat, excess sedentarism and physical inactivity (PR: 1.94, 95% CI: 1.45, 2.60), as well as the presence of the four risk behaviors (PR: 1.72, 95% CI: 1.16, 2.53) were associated with obesity in men. In women, the simultaneous consumption of sweets and meat with fat (PR: 1.77, 95% CI: 1.19, 2.66) was also associated with the outcome. In both sexes, there was an increase in the tendency of obesity according to the sum total of risk behaviors.
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Affiliation(s)
- Anne Ribeiro Streb
- Centro de Desportos, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Giovani Firpo Del Duca
- Centro de Desportos, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Robert Passos da Silva
- Centro de Desportos, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Jucemar Benedet
- Centro de Desportos, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
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17
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Lin X, Xu Y, Xu J, Pan X, Song X, Shan L, Zhao Y, Shan PF. Global burden of noncommunicable disease attributable to high body mass index in 195 countries and territories, 1990-2017. Endocrine 2020; 69:310-320. [PMID: 32488838 DOI: 10.1007/s12020-020-02352-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/15/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE The increasing burden of noncommunicable diseases (NCDs) attributable to high body mass index (BMI) represents both a threat and an opportunity for intervention. Estimates of the global latest trend of high BMI-related NCDs and its association with socioeconomic status can facilitate strategic intervention and inform further research. METHODS This global burden of disease study extracted global, regional, and national data on death and disability-adjusted life years (DALYs) attributable to high BMI-related NCDs from the GBD Study 2017. Secondary analyses were performed by year, age, sex, and specific causes of death and DALYs. The 2017 Socio-demographic Index (SDI) was used as an indicator of national socioeconomic status. The association between age-standardized death or DALYs rate and socioeconomic status were analyzed. RESULTS Worldwide, 4.7 million deaths and 147.7 million DALYs of NCDs were related to high BMI in 2017, with a projection to 5.5 million deaths and 176.9 million DALYs in 2025. Globally, high BMI-related burden showed an increasing trend with males being more heavily impacted overall. The trend and magnitude of high BMI-related disease burden varied substantially in different geographical and socioeconomic regions. Specifically, the low-middle, middle, and high-middle SDI countries were associated with a higher burden. The leading three causes of DALYs attributable to high BMI in 2017 were ischemic heart diseases, stroke, and diabetes mellitus. CONCLUSIONS High BMI-related burden of NCDs is worsening, particularly in developing countries. Our findings may enhance public awareness of interventions to reduce the diseases burden caused by high BMI.
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Affiliation(s)
- Xiling Lin
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Yufeng Xu
- Department of Ophthalmology, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Jingya Xu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Xiaoxiao Song
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Lizhen Shan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Yiming Zhao
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Peng-Fei Shan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of ZheJiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China.
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18
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Cuevas AG, Chen R, Slopen N, Thurber KA, Wilson N, Economos C, Williams DR. Assessing the Role of Health Behaviors, Socioeconomic Status, and Cumulative Stress for Racial/Ethnic Disparities in Obesity. Obesity (Silver Spring) 2020; 28:161-170. [PMID: 31858741 PMCID: PMC6927482 DOI: 10.1002/oby.22648] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/13/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aimed to examine the explanatory role of health behaviors, socioeconomic position (SEP), and psychosocial stressors on racial/ethnic obesity disparities in a multiethnic and multiracial sample of adults. METHODS Using data from the Chicago Community Adult Health Study (2001-2003), Oaxaca-Blinder decomposition analysis was conducted to quantify the extent to which health behaviors (fruit and vegetable consumption and physical activity), SEP, and cumulative stressors (e.g., perceived discrimination, financial strain) each explained differences in obesity prevalence in Black, US-born Hispanic, and non-US-born Hispanic compared with non-Hispanic White participants. RESULTS SEP and health behaviors did not explain obesity differences between racial/ethnic minorities and White individuals. Having high levels of stress in four or more domains explained 4.46% of the differences between Black and White individuals, whereas having high levels of stress in three domains significantly explained 14.13% of differences between US-born Hispanic and White. Together, the predictors explained less than 20% of differences between any racial/ethnic minority group and White individuals. CONCLUSIONS Exposure to stressors may play a role in obesity disparities, particularly among Black and US-born Hispanic individuals. Other obesity-related risk factors need to be examined to understand the underlying mechanisms explaining obesity disparities.
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Affiliation(s)
| | - Ruijia Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD
| | - Katherine A Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Norbert Wilson
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - Chris Economos
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA
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19
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Lin LY, Hsu CY, Lee HA, Tinkov AA, Skalny AV, Wang WH, Chao JCJ. Gender difference in the association of dietary patterns and metabolic parameters with obesity in young and middle-aged adults with dyslipidemia and abnormal fasting plasma glucose in Taiwan. Nutr J 2019; 18:75. [PMID: 31733645 PMCID: PMC6858632 DOI: 10.1186/s12937-019-0503-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/07/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increasing prevalence of obesity has become a pandemic problem, and dietary patterns are one of the important factors causing obesity. Although the correlation between dietary patterns and obesity has been well explored, the gender difference on the association between dietary patterns and obesity remains unclear. The objective of this study examined whether gender difference existed in the relationship of dietary patterns with metabolic parameters and specific indices of adiposity among young and middle-aged adults with dyslipidemia and abnormal fasting plasma glucose (FPG) in Taiwan. METHODS A total of 14,087 subjects aged between 20 and 50 years with dyslipidemia and abnormal FPG were recruited in Taiwan between 2001 and 2010 for a cross-sectional study. Dyslipidemia was defined primarily according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with minor modification. Abnormal FPG level was defined by the American Diabetes Association. Principal component analysis was conducted to identify dietary patterns. Multivariate logistic regression analysis was performed to evaluate the association of dietary patterns and metabolic parameters with different indices of adiposity including general obesity, central obesity, and high body fat, stratified by gender. RESULTS Two dietary patterns derived from principal component analysis were the prudent dietary pattern and the western dietary pattern. Both men and women in the highest quartile of the western dietary pattern had a significantly increased odds ratio of general obesity, central obesity, and high body fat. However, only male subjects in the higher quartiles of the prudent dietary pattern had a significantly decreased odds ratio of all indices of obesity. Both men and women with higher high-density lipoprotein cholesterol and total cholesterol levels had a significantly reduced odds ratio of general and central obesity, while those with higher triglycerides and FPG levels had a significantly increased odds ratio of general and central obesity. Higher low-density lipoprotein cholesterol level was significantly associated with an elevated odds ratio of high body fat, while higher total cholesterol level was significantly correlated with a reduced odds ratio of high body fat only in women. CONCLUSIONS Gender difference exists in the association of dietary patterns and metabolic parameters with obesity and body fat in young and middle-aged adults with dyslipidemia and abnormal FPG in Taiwan.
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Affiliation(s)
- Li-Yin Lin
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei, 11219, Taiwan.,Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
| | - Hsiu-An Lee
- Department of Computer Science and Information Engineering, Tamkang University, 151 Yingzhuan Road, Tamsui District, New Taipei, 25137, Taiwan
| | - Alexey A Tinkov
- Yaroslavl State University, Yaroslavl, 150003, Russia.,IM Sechenov First Moscow State Medical University, Moscow, 119146, Russia.,RUDN University, Moscow, 117198, Russia
| | - Anatoly V Skalny
- IM Sechenov First Moscow State Medical University, Moscow, 119146, Russia.,RUDN University, Moscow, 117198, Russia.,Federal Research Centre of Biological Systems and Agro-technologies of the Russian Academy of Sciences, Orenburg, 460000, Russia
| | - Wan-Hsiang Wang
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei, 11219, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan. .,Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan. .,Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei, 11031, Taiwan.
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20
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Cohen SA, Greaney ML, Sabik NJ. Assessment of dietary patterns, physical activity and obesity from a national survey: Rural-urban health disparities in older adults. PLoS One 2018; 13:e0208268. [PMID: 30517166 PMCID: PMC6281245 DOI: 10.1371/journal.pone.0208268] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/14/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Obesity is a critical public health issue, affecting over one-third of all Americans, and is an underlying cause of numerous health issues across the lifespan. For older adults, obesity is linked to premature declines in physical and mental health and cognitive functioning. The occurrence of obesity and related health behaviors and chronic diseases are higher in rural areas than in urban areas. Furthermore, rural areas of the United States have a higher proportion of older adults than urban areas. Few studies, to date, have explored rural-urban differences in the relationships between dietary patterns and obesity among older adults. Therefore, the purpose of this study is to assess rural-urban differences in obesity rates in older adults, and the potential for the associations between obesity and physical activity and dietary patterns to vary by rural-urban status. METHODS Data were abstracted from respondents aged 65 and above from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) database linked to Census-based county-level information on rural-urban status and socioeconomic status. Generalized linear models were utilized to assess rural-urban disparities in obesity, and the potential for associations between obesity and known risk factors (fruit consumption, green vegetable consumption and physical activity) to vary by rural-urban status, accounting for complex sampling and confounders. RESULTS Obesity rates were highest and fruit consumption was lowest in the most rural areas. However, for older adults in the most urban areas, there was a significant negative association between obesity and fruit and green vegetable consumption. This association was not observed in more rural older adults. CONCLUSION These findings underscore the need to take into account place-based factors such as rural-urban status, when designing and implementing policies and interventions designed to reduce obesity through risk factor mitigation in older adults. To reduce rural-urban disparities in older adults, all policies, programs, and interventions should address the unique barriers and needs specific to rural and urban older adults.
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Affiliation(s)
- Steven A. Cohen
- Health Studies Program, Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Mary L. Greaney
- Health Studies Program, Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, United States of America
| | - Natalie J. Sabik
- Health Studies Program, Department of Kinesiology, University of Rhode Island, Kingston, Rhode Island, United States of America
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21
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Vézina-Im LA, Nicklas TA, Baranowski T. Associations Among Sleep, Body Mass Index, Waist Circumference, and Risk of Type 2 Diabetes Among U.S. Childbearing-Age Women: National Health and Nutrition Examination Survey. J Womens Health (Larchmt) 2018; 27:1400-1407. [PMID: 29583069 DOI: 10.1089/jwh.2017.6534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women of childbearing age (18-44 years) present an important group for understanding sleep, but few studies have focused on this population. No study has investigated the associations among sleep, overweight/obesity, and risk of type 2 diabetes among childbearing-age women in the National Health and Nutrition Examination Survey (NHANES). METHODS Data were from NHANES, 2005-2008. The study population consisted of 18-44 year old women. Pregnant women and those diagnosed with sleep disorders were excluded. Sleep duration and quality were self-reported. Body mass index (BMI), waist circumference (WC) measurements, and a 2-hour 75 g oral glucose tolerance test (OGTT) were performed by trained NHANES staff. An unadjusted linear regression analysis; a second adjusted for demographics only (partially adjusted model); and a third adjusted for demographics and variables associated with overweight/obesity and diabetes (fully adjusted model) were computed to assess associations among sleep duration/quality and BMI, WC, and 2-hour OGTT. RESULTS Total sample consisted of 2388 childbearing-age women. Only sleep duration was significantly associated with BMI and WC in the unadjusted and partially adjusted models, but was no longer significant in the fully adjusted model. Neither sleep duration nor quality was significantly associated with 2-hour OGTT in any of the models. CONCLUSIONS Targeting sleep duration and sleep quality alone would not likely contribute to significantly lower BMI, WC, or risk of type 2 diabetes in US childbearing-age women. Additional studies, especially longitudinal ones using objective measures of sleep, are needed to confirm these findings.
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Affiliation(s)
- Lydi-Anne Vézina-Im
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
| | - Theresa A Nicklas
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
| | - Tom Baranowski
- Children's Nutrition Research Center, Baylor College of Medicine , Houston, Texas
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Banerjee ES, Herring SJ, Hurley K, Puskarz K, Yebernetsky K, LaNoue M. Determinants of Successful Weight Loss in Low-Income African American Women: A Positive Deviance Analysis. J Prim Care Community Health 2018; 9:2150132718792136. [PMID: 30084705 PMCID: PMC6081755 DOI: 10.1177/2150132718792136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We set out to investigate the behaviors of low-income African American women who successfully lost weight. METHODS From an urban, academic, family medicine practice, we used a mixed methods positive deviance approach to evaluate 35 low-income African American women who were obese and lost at least 10% of their maximum weight, and maintained this loss for 6 months, comparing them with 36 demographically similar control participants who had not lost weight. Survey outcomes included demographics and behaviors that were hypothesized to be related to successful weight loss. Interviews focused on motivations, barriers, and what made weight loss successful. Survey data were analyzed using t tests and linear regression for continuous outcomes and chi-square tests and logistic regression for categorical outcomes. Interviews were analyzed using a modified approach to grounded theory. RESULTS In adjusted analyses, women in the positive deviant group were more likely to be making diet changes compared with those women who did not lose at least 10% of their initial body weight. Major themes from qualitative analyses included ( a) motivations (of health, appearance, quality of life, family, and epiphanies), ( b) opportunity (including time and support), ( c) adaptability. CONCLUSIONS The findings of this study may be useful in developing motivational interviewing strategies for primary care providers working with similar high-risk populations.
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Affiliation(s)
- Elaine Seaton Banerjee
- Thomas Jefferson University, Philadelphia, PA, USA
- Lehigh Valley Health Network, Allentown, PA, USA
| | | | - Katelyn Hurley
- Thomas Jefferson University, Philadelphia, PA, USA
- ACT.md, Boston, MA, USA
| | | | - Kyle Yebernetsky
- Thomas Jefferson University, Philadelphia, PA, USA
- Geisinger Health System, Danville, PA, USA
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Zaccaro HN, Atherton E. Bright spots, physical activity investments that work-Complete Streets: redesigning the built environment to promote health. Br J Sports Med 2017; 52:1168-1169. [PMID: 28903948 DOI: 10.1136/bjsports-2017-097717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Heather N Zaccaro
- National Complete Streets Coalition, Smart Growth America, Washington, District of Columbia, USA
| | - Emiko Atherton
- National Complete Streets Coalition, Smart Growth America, Washington, District of Columbia, USA
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