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Hu L, Han X, Chen M, Zhang T. Association of waist circumference and BMI with premature death in young and middle-aged population. Front Public Health 2024; 12:1389766. [PMID: 38873315 PMCID: PMC11169795 DOI: 10.3389/fpubh.2024.1389766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Premature death is a global health indicator, significantly impacted by obesity, especially in young and middle-aged population. Both body mass index (BMI) and waist circumference (WC) assess obesity, with WC specifically indicating central obesity and showing a stronger relationship with mortality. However, despite known associations between BMI and premature death, as well as the well-recognized correlation between WC and adverse health outcomes, the specific relationship between WC and premature death remains unclear. Therefore, focusing on young and middle-aged individuals, this study aimed to reliably estimate independent and combined associations between WC, BMI and premature death, thereby providing causal evidence to support strategies for obesity management. Methods This study involved 49,217 subjects aged 18-50 years in the United States from 1999 to 2018 National Health and Nutrition Examination Survey (NHANES). Independent and combined associations between WC and BMI with premature death across sex and age stratum were examined by Cox regression. Survey weighting and inverse probability weighting (IPW) were further considered to control selection and confounding bias. Robustness assessment has been conducted on both NHANES and China Health and Retirement Longitudinal Study (CHARLS) data. Results A linear and positive relationship between WC and all-cause premature death was found in both males and females, with adjusted HRs of 1.019 (95%CI = 1.004-1.034) and 1.065 (95%CI = 1.039-1.091), respectively. Nonlinear relationships were found with respect to BMI and all-cause premature death. For females aged 36-50 with a BMI below 28.6 kg/m2, the risk of premature death decreased as BMI increased, indicated by adjusted HRs of 0.856 (95%CI = 0.790-0.927). Joint analysis showed among people living with obesity, a larger WC increased premature death risk (HR = 1.924, 95%CI = 1.444-2.564). Discussion WC and BMI exhibited prominent associations with premature death in young and middle-aged population. Maintaining an appropriate WC and BMI bears significant implications for preventing premature death.
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Affiliation(s)
| | | | | | - Tao Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Shi Z, Guo Y, Ye P, Luo Y. Abdominal obesity in Chinese patients undergoing hemodialysis and its association with all-cause mortality. Front Endocrinol (Lausanne) 2023; 14:1287834. [PMID: 37955012 PMCID: PMC10637872 DOI: 10.3389/fendo.2023.1287834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Obesity in patients undergoing hemodialysis is common. However, there is limited information on the relationship between obesity types defined by the combined body mass index (BMI) and waist circumference (WC) classification criteria and all-cause mortality in Chinese hemodialysis patients. Our objective was to determine the association between obesity types and all-cause mortality in hemodialysis patients. Methods We conducted a prospective cohort study including patients from 11 hemodialysis centers in Beijing. According to the World Health Organization's standards, patients were classified into 2 categories with WC and 4 categories with BMI and then followed up for 1 year. Kaplan-Meier survival analysis was used to compare the difference in the cumulative survival rate in different BMI and WC groups. A multivariate Cox regression analysis was used to determine the association between different types of obesity and all-cause mortality. Results A total of 613 patients were enrolled, the mean age was 63.8 ± 7.1 years old, and 42.1% were women. Based on the baseline BMI, there were 303 (49.4%) patients with normal weight, 227 (37.0%) with overweight, 37(6.0%) with obesity, and 46 (7.5%) with underweight. Based on the baseline WC, 346 (56.4%) patients had abdominal obesity. During a median follow-up of 52 weeks, 69 deaths occurred. Kaplan-Meier plots demonstrated a significant association of BMI categories (log-rank χ2 = 18.574, p<0.001) and WC categories (log-rank χ2 = 5.698, p=0.017) with all-cause death. With normal BMI and non-abdominal obesity as a reference, multivariate Cox regression analysis results showed that obesity (HR 5.36, 95% CI, 2.09-13.76, p<0.001), underweight (HR, 5.29, 95% CI, 2.32-12.07, p<0.001), normal weight combined with abdominal obesity (HR 2.61, 95% CI, 1.20-5.66, p=0.016), and overweight combined with abdominal obesity (HR 1.79, 95% CI, 1.03-3.73, p=0.031, respectively) were significantly associated with higher risks of all-cause mortality. Conclusion Our study indicated that abdominal obesity is common and associated with all-cause mortality among Chinese hemodialysis patients.
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Affiliation(s)
- Zhihua Shi
- Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yidan Guo
- Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Luo
- Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Liu S, Cao W, Li Z, Wang S, Yang S, Lu M, Li H, Song Y, Chen S, Li X, Li R, Wang J, Yang J, Liu M, He Y. Association between different adiposity measures and all-cause mortality risk among centenarians: A prospective cohort study. Clin Nutr 2023; 42:1219-1226. [PMID: 37236872 DOI: 10.1016/j.clnu.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
IMPORTANCE Little evidence on the association between adiposity measures and all-cause mortality was observed among centenarians, and no targeted development of optimal weight recommendations for them. OBJECTIVE To comprehensively assess the association between adiposity indices and all-cause mortality among centenarians. DESIGN SETTING, AND PARTICIPANTS This prospective population-based cohort study included 1002 centenarians registered in 18 counties and cities in Hainan Province from June 2014 to May 2021. The age of participants at baseline was provided by the civil affairs bureau and verified before enrollment. MAIN OUTCOMES AND MEASURES All-cause mortality was rigorously confirmed as the primary outcome. BMI was calculated by height and weight. BRI was calculated by height and waist circumference. RESULTS At baseline, the mean (SD) age was 102.8 ± 2.7 years, and 180 participants (18.0%) were men. The median follow-up time was 5.0 (4.8-5.5) years, with 522 deaths. In BMI categories, compared with the lowest group (mean BMI = 14.2 kg/m2), the highest group (mean BMI = 22.2 kg/m2) had lower mortality (hazard ratio [HR], 0.61; 95%CI, 0.47-0.79) (P for trend = 0.001). In BRI categories, compared with the lowest group (mean BRI = 2.3), the highest group (mean BRI = 5.7) had lower mortality (hazard ratio [HR], 0.66; 95%CI, 0.51-0.85) (P for trend = 0.002), and the risk did not decrease after BRI exceeded 3.9 in women. Higher BRI was associated with lower HRs after adjusting for interaction with comorbidities status. E-values analysis suggested robustness to unmeasured confounding. CONCLUSIONS AND RELEVANCE BMI and BRI were inverse linear associated with mortality risk in the whole population, while BRI was observed to be J-shaped in women. The interaction of lower multiple complication incidence and BRI had a significant effect on the reduced risk of all-cause mortality.
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Affiliation(s)
- Shaohua Liu
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Wenzhe Cao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China
| | - Zhiqiang Li
- School of Public Health, China Medical University, Shenyang, 110122, China; Center for Disease Control and Prevention of Chinese People's Liberation Army, Beijing, 100071, China
| | - Shengshu Wang
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mingming Lu
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Haowei Li
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Yang Song
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Shimin Chen
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Xuehang Li
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Rongrong Li
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Jianhua Wang
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Junhan Yang
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School of Chinese PLA General Hospital & Chinese PLA Medical Academy, Beijing 100853, China.
| | - Yao He
- Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, Second Medical Center of Chinese People's Liberation Army (PLA) General Hospital, PLA Medical School, Beijing, China.
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Barcın-Güzeldere HK, Aksoy M, Demircan T, Yavuz M, Beler M. Association between the anthropometric measurements and dietary habits on telomere shortening in healthy older adults: A-cross-sectional study. Geriatr Gerontol Int 2023. [PMID: 37329271 DOI: 10.1111/ggi.14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/22/2023] [Accepted: 05/28/2023] [Indexed: 06/19/2023]
Abstract
AIM This study aimed to evaluate the effect of anthropometric measurements and dietary habits on telomere length in healthy older residents in rural and urban areas. METHODS This was a cross-sectional study. The study population included 81 healthy older individuals aged ≥80 years. A quantitative food frequency questionnaire was used to determine dietary habits. Anthropometric measurements were taken by researchers. The telomere length of individuals was determined from leukocytes using quantitative polymerase chain reaction. RESULTS Urban women had longer telomeres than rural women (P < 0.05). Rural men had significantly higher hip circumference, middle-upper arm circumference and fat-free mass than urban men (P < 0.05). It was shown that while fresh vegetable consumption was higher in rural areas, carbonated drink consumption was higher in urban areas (P < 0.05). In women, homemade bread and sugar consumption were higher in rural areas, and honey consumption was higher in urban (P < 0.05). Red meat, milk-based dessert and pastry consumption explain telomere shortening by 22.5%, 24.8% and 17.9%, respectively. In addition, the model based on anthropometric measurements also contributes to explaining telomere shortening by 42.9%. CONCLUSION Red meat, milk-based dessert and pastry consumption, and waist circumference, hip circumference, waist-to-hip ratio and waist-to-height ratio are associated with telomere length. Longer telomeres are associated with a healthy, balanced, adequate diet and maintaining a healthy body weight/proportion, and they are crucial for achieving healthy aging. Geriatr Gerontol Int 2023; ••: ••-••.
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Affiliation(s)
- Hatice Kübra Barcın-Güzeldere
- Department of Nutrition and Dietetic, Istanbul Medeniyet University, Istanbul, Turkey
- Institue of Health Science, Istanbul Medipol University, Istanbul, Turkey
| | | | - Turan Demircan
- School of Medicine, Department of Medical Biology, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mervenur Yavuz
- Institute of Health Sciences, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Mahmut Beler
- Fethiye School of Health Service, Muğla Sıtkı Koçman University, Fethiye, Turkey
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Wang X, Ying Y, Pei M, Ma X, Sun Y, Wang Y, Li N. Calf circumference change and all-cause mortality among community-dwelling Chinese older people. Clin Nutr 2023; 42:277-281. [PMID: 36724725 DOI: 10.1016/j.clnu.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Previous studies have described an association between single time point calf circumference (CC) and mortality. Evidence of associations between CC change and mortality is lacking. We aimed to determine the relationship between the CC change over time and all-cause mortality. METHODS We conducted a retrospective cohort study of 906 participants in the 2014-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Restricted cubic splines were used to analyze associations between the relative CC change (exposure) and all-cause mortality (primary outcome). When there was evidence of non-linearity, a piecewise Cox regression model was next fitted, adjusting for sociodemographic characteristics, health behaviours, health status and baseline CC. RESULTS The mean (SD) age was 83.8 (12.2) years old, and 50.2% (455/906) of participants were male. We observed a U-shaped association between the relative CC change (%) and all-cause mortality (P for non-linearity <0.001). Participants with stable CC over time had the lowest risk of death. After adjusting for covariates, when CC decreased over time, the hazard ratio per 10% higher in CC change was 1.32 (1.01-1.69). When CC increased over time, the hazard ratio per 10% higher in CC change was 1.35 (1.10-1.66). CONCLUSION Stable CC over time was associated with the lowest mortality risk. Our findings indicate the practical significance of monitoring CC change in older adult.
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Affiliation(s)
- Xiaoxiao Wang
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Youyou Ying
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China; School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Minyue Pei
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Xinjie Ma
- The Third Clinical Medical College, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Yuehao Sun
- The Third Clinical Medical College, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Yupeng Wang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China.
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Optimal body composition indices cutoff values based on all-cause mortality in the elderly. Exp Gerontol 2023; 171:112026. [PMID: 36400117 DOI: 10.1016/j.exger.2022.112026] [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: 09/24/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
The cutoffs of body composition indices are inconclusive in older populations. This study is designed toward determining the optimal cutoffs of the body composition indices based on the association with all-cause mortality. During 2009 and 2010, a cohort population of 1200 was enrolled in central western Taiwan. Of the 1200 subjects, 428 older subjects (mean age: 72.5 ± 5.4 yrs.; 47.7 % were women) were censored in this study. The waist circumference (WC) and body mass index (BMI) were measured using standard anthropometric methods. A multi-frequency bioelectrical impedance analysis device was utilized to estimate each participant's body composition indices, including percent body fat (PBF) and skeletal muscle mass index (SMMI). All claims records of death from 2009 to 2018 in the National Health Insurance Research Databank were identified. A receiver operating characteristic curve method and the highest Youden index were used to identify the optimal cutoffs. A Cox proportional hazards regression analysis was used to model associations between each of the recommended cutoff values with all-cause mortality. The all-cause mortality rate was 20.09 % after a follow-up period of 5.86 ± 2.39 person-years. The significant indices cutoff value was identified to be WC (86.7 cm) for older women and BMI (23.8 kg/m2) and as WC (77.6 cm), and SMMI (8.7 kg/m2) for older men. The recommended optimal cutoffs of the body composition indices were gender-specific and can be utilized to predict the risk of all-cause mortality.
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Moura LDANE, Pagotto V, Camargo Pereira C, de Oliveira C, Silveira EA. Does Abdominal Obesity Increase All-Cause, Cardiovascular Disease, and Cancer Mortality Risks in Older Adults? A 10-Year Follow-Up Analysis. Nutrients 2022; 14:nu14204315. [PMID: 36296999 PMCID: PMC9607321 DOI: 10.3390/nu14204315] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
There is insufficient evidence on the impact of abdominal obesity (AO) on mortality in older adults. Therefore, the objective to analyze the 10-year impact of AO, assessed using different diagnostic criteria, on all-cause, cardiovascular disease (CVD), and cancer mortality in older adults. In this prospective cohort study of older adults (≥60 years), sociodemographic, lifestyle, clinical history, laboratory test, and anthropometric data were analyzed. The considered were used for AO diagnostic: waist circumference (WC) of ≥88 cm for women and ≥102 cm for men; WC of ≥77.8 cm for women and ≥98.8 cm for men; and increased waist-to-hip ratio (WHR), being the highest tertile of distribution by sex. Multivariate Cox regression and Kaplan-Meier analyses were performed. A total of 418 individuals, with an average age of 70.69 ± 7.13 years, participated in the study. In the analysis adjusted for sex and age, WHR was associated with a high risk of all-cause mortality (p = 0.044). Both cutoff points used for the WC were associated with an increased CVD mortality risk. None of the AO parameters were associated with cancer mortality. An increased WHR was associated to a higher all-cause mortality risk factor, while an increased WC was a risk factor for a higher CVD mortality in older adults.
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Affiliation(s)
- Letícia de Almeida Nogueira e Moura
- Graduate Program in Health Sciences, Medicine Faculty, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
- Correspondence: (L.d.A.N.e.M.); (E.A.S.)
| | - Valéria Pagotto
- Graduate Program in Nursing, Nursing Faculty, Federal University of Goiás, Goiânia 74605-080, GO, Brazil
| | - Cristina Camargo Pereira
- Graduate Program in Health Sciences, Medicine Faculty, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK
| | - Erika Aparecida Silveira
- Graduate Program in Health Sciences, Medicine Faculty, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK
- Correspondence: (L.d.A.N.e.M.); (E.A.S.)
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Dynapenia in middle-aged and older persons with and without abdominal obesity and the complex relationship with behavioral, physical-health and mental-health variables: Learning Bayesian network structures. Clin Nutr ESPEN 2021; 42:366-372. [PMID: 33745607 DOI: 10.1016/j.clnesp.2021.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Few studies have analyzed the relationship between dynapenia and lifestyle, physical-health and mental-health variables in middle-aged and older persons classified according to their waist circumference. The aim of this study was to identify the relationships between dynapenia and behavioral, physical-health and mental-health variables in middle-aged and older persons with and without abdominal obesity using Bayesian networks, a graphical analysis technique that allows simultaneous associations between variables to be identified. METHODS A cross-sectional study of 2526 participants without abdominal obesity and 2729 with abdominal obesity (waist circumference > 102 cm in men and >88 cm in women) aged 50 years or older who took part in the Brazilian Longitudinal Study of Aging. Two network structures including behavioral, physical-health and mental-health variables and dynapenia (grip strength < 26 kg for men and <16 kg for women) were learnt with the hill-climbing score-based algorithm for a sample of individuals with and without abdominal obesity. Statistical resampling tests were performed to quantify the strength of the relationships between factors associated with dynapenia. RESULTS In middle-aged and older persons without abdominal obesity, dynapenia was strongly associated with and influenced by at-risk alcohol consumption while in middle-aged and older persons with abdominal obesity the condition was strongly associated with and influenced by diabetes and depression. In the latter group, dynapenia was also strongly associated with and influenced the disability. CONCLUSIONS The use of Bayesian networks allowed different factors associated with dynapenia in middle-aged and older persons classified according to the presence or absence of abdominal obesity to be identified.
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Nascimento-Souza MA, Mambrini JVDM, Peixoto SV, Lima-Costa MF. Association between "a body shape index" and mortality: Bambuí Cohort Study of Aging, Brazil. CAD SAUDE PUBLICA 2021; 37:e00016020. [PMID: 33440407 DOI: 10.1590/0102-311x00016020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/15/2020] [Indexed: 11/22/2022] Open
Abstract
This article aims to evaluate the joint and separate association between abdominal and general adiposity indicators and mortality. Data was collected from 1,366 older adults in the Bambuí Cohort Study of Aging with complete information for all variables of interest. The outcome variable was all-cause time until death; exposure variables were a body shape index (ABSI), waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI), assessed at the beginning of the study, and at the 3rd, 5th and 11th year of follow-up. Association between the quartiles of anthropometric indicators and mortality was calculated using an extended Cox proportional hazards model and adjusted for socioeconomic and behavioral confounding factors. Older adults in the 4th ABSI quartile had a higher risk of mortality regardless of BMI (1.27; 95%CI: 1.01-1.58), but this association was not observed in sensitivity analyses. Older adults in the 2nd, 3rd and 4th BMI quartiles had a lower risk of mortality, even when adjusted for WC or ABSI. WC and WHtR showed no association consistent with all-cause mortality after adjustment for confounding factors. Considering the loss of significance in the sensitivity analyses, ABSI's predictive capacity for mortality is still weak. Thus, adopting ABSI in clinical practice or in epidemiological surveys, in conjunction or replacing BMI and WC, requires more in-depth studies.
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Affiliation(s)
| | | | - Sérgio Viana Peixoto
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil.,Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Maria Fernanda Lima-Costa
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil.,Programa de Pós-graduação em Saúde Púbica, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Smith MK, Christianto E, Staynor JMD. Obesity and visceral fat in Indonesia: An unseen epidemic? A study using iDXA and surrogate anthropometric measures. Obes Res Clin Pract 2020; 15:26-32. [PMID: 33234489 DOI: 10.1016/j.orcp.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/16/2020] [Accepted: 11/06/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Indonesia's dramatic rise in chronic disease belies their relatively low obesity prevalence. This study provides normative iDXA and anthropometry measures in an Indonesian cohort. We also compare obesity prevalence determined by traditional measures. METHODS 2623 Indonesian adults were measured by an iDXA and had waist and hip circumferences collected. Normative data were stratified by sex and age. Obesity prevalence was compared using body mass index (BMI) and body fat percentage (BF%). Specificity, sensitivity, and Youden's Index evaluated the ability of cut-off values to identify individuals with high visceral adipose tissue (VAT). RESULTS Overweight and obese prevalence by BF% was 72 % for males and 63 % for females. BMI incorrectly categorized 40 % of obese individuals as normal/overweight. Waist circumference provided the highest Youden's Index (0.69-0.73), identifying 91 % of Indonesians with high VAT mass. CONCLUSIONS Normative BF% and VAT mass are higher among Indonesians when compared with Caucasian populations. This highlights the rise of chronic disease is potentially due to high BF% and VAT mass. Compared with criterion iDXA BF%, obesity prevalence is severely underestimated by BMI. Measuring waist circumference is recommended in clinical settings due to its ability to identify participants with high VAT mass.
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Affiliation(s)
- Marc K Smith
- Body Composition Technologies, Pty Ltd., South Perth, Western Australia, Australia; School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia.
| | | | - Jonathan M D Staynor
- Body Composition Technologies, Pty Ltd., South Perth, Western Australia, Australia
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Jayedi A, Soltani S, Zargar MS, Khan TA, Shab-Bidar S. Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies. BMJ 2020; 370:m3324. [PMID: 32967840 PMCID: PMC7509947 DOI: 10.1136/bmj.m3324] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included. DATA SYNTHESIS A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves. RESULTS Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index. CONCLUSIONS Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.
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Affiliation(s)
- Ahmad Jayedi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, PO Box 14155/6117, Tehran, Iran
| | - Sepideh Soltani
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdieh Sadat Zargar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Tauseef Ahmad Khan
- Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis & Clinical Trials Unit, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, PO Box 14155/6117, Tehran, Iran
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Oddo VM, Maehara M, Izwardy D, Sugihantono A, Ali PB, Rah JH. Risk factors for nutrition-related chronic disease among adults in Indonesia. PLoS One 2019; 14:e0221927. [PMID: 31469876 PMCID: PMC6716634 DOI: 10.1371/journal.pone.0221927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/19/2019] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE To conduct a secondary data analysis detailing the associations between sociodemographic and behavioral factors and nutrition-related chronic disease. METHODS These analyses utilized 2014 data from the Indonesian Family Life Survey, a home-based survey that collected socioeconomic, dietary intake, physical activity, and biological data among adults. We explored four outcomes in relation to sociodemographic and behavioral determinants: 1) hypertension, 2) elevated high-sensitivity c-reactive protein (hs-CRP), and 3) central obesity, as these are critical metabolic determinants in the progression to cardiovascular disease, and 4) type 2 diabetes. Hypertension was defined as systolic blood pressure ≥140 mm or diastolic blood pressure ≥ 90mm or current use of antihypertensive medication. Elevated hs-CRP was defined as hs-CRP >3 mg/dL. Central obesity was defined as waist circumference ≥ 90 cm if male and waist circumference ≥ 80 cm if female, which are specific to South Asia. Type 2 diabetes was defined as glycated hemoglobin ≥ 6.5%. We employed separate gender-stratified multivariate logistic regression models to test the associations between sociodemographic and behavioral determinants and each nutrition-related chronic disease outcome. All analyses employed sampling weights, which account for the survey design. RESULTS In 2014, about 30% of adults were hypertensive and one-fifth had elevated hs-CRP. Approximately 70% of women had central obesity and 11.6% of women and 8.9% of men had diabetes. Older-age was consistently associated with nutrition-related chronic disease and being overweight was associated with hypertension, elevated hs-CRP, and type 2 diabetes. Regularly consuming instant noodles (women) and soda (men) were associated with elevated hs-CRP and soda consumption was associated with central obesity among men. CONCLUSIONS Large segments of the adult population in Indonesia now have or are at risk for non-communicable disease. Our analyses provide preliminary empirical evidence that interventions that target healthful food intake (e.g. reduce the intake of ultra-processed foods) should be considered and that the reduction of overweight is critical for preventing chronic diseases in Indonesia.
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Affiliation(s)
- Vanessa M. Oddo
- University of Washington School of Public Health, Department of Health Services, Seattle, Washington, United States of America
| | - Masumi Maehara
- Child Survival and Development, United Nations Children’s Fund, Jakarta, Indonesia
| | - Doddy Izwardy
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
| | - Anung Sugihantono
- Disease Prevention and Control, Ministry of Health, Jakarta, Indonesia
| | - Pungkas B. Ali
- Public Health and Nutrition, Ministry of National Development Planning, Jakarta, Indonesia
| | - Jee Hyun Rah
- Child Survival and Development, United Nations Children’s Fund, Jakarta, Indonesia
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Ponti F, Santoro A, Mercatelli D, Gasperini C, Conte M, Martucci M, Sangiorgi L, Franceschi C, Bazzocchi A. Aging and Imaging Assessment of Body Composition: From Fat to Facts. Front Endocrinol (Lausanne) 2019; 10:861. [PMID: 31993018 PMCID: PMC6970947 DOI: 10.3389/fendo.2019.00861] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/25/2019] [Indexed: 01/10/2023] Open
Abstract
The aging process is characterized by the chronic inflammatory status called "inflammaging", which shares major molecular and cellular features with the metabolism-induced inflammation called "metaflammation." Metaflammation is mainly driven by overnutrition and nutrient excess, but other contributing factors are metabolic modifications related to the specific body composition (BC) changes occurring with age. The aging process is indeed characterized by an increase in body total fat mass and a concomitant decrease in lean mass and bone density, that are independent from general and physiological fluctuations in weight and body mass index (BMI). Body adiposity is also re-distributed with age, resulting in a general increase in trunk fat (mainly abdominal fat) and a reduction in appendicular fat (mainly subcutaneous fat). Moreover, the accumulation of fat infiltration in organs such as liver and muscles also increases in elderly, while subcutaneous fat mass tends to decrease. These specific variations in BC are considered risk factors for the major age-related diseases, such as cardiovascular diseases, type 2 diabetes, sarcopenia and osteoporosis, and can predispose to disabilities. Thus, the maintenance of a balance rate of fat, muscle and bone is crucial to preserve metabolic homeostasis and a health status, positively contributing to a successful aging. For this reason, a detailed assessment of BC in elderly is critical and could be an additional preventive personalized strategy for age-related diseases. Despite BMI and other clinical measures, such as waist circumference measurement, waist-hip ratio, underwater weighing and bioelectrical impedance, are widely used as a surrogate measure for body adiposity, they barely reflect the distribution of body fat. Because of the great advantages offered by imaging tools in research and clinics, the attention of clinicians is now moving to powerful imaging techniques such as computed tomography, magnetic resonance imaging, dual-energy X-ray absorptiometry and ultrasound to obtain a more accurate estimation of BC. The aim of this review is to present the state of the art of the imaging techniques that are currently available to measure BC and that can be applied to the study of BC changes in the elderly, outlining advantages and disadvantages of each technique.
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Affiliation(s)
- Federico Ponti
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Aurelia Santoro
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- *Correspondence: Aurelia Santoro
| | - Daniele Mercatelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Chiara Gasperini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Conte
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- C.I.G. Interdepartmental Centre “L. Galvani”, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Morena Martucci
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Luca Sangiorgi
- Department of Medical Genetics and Rare Orthopedic Disease & CLIBI Laboratory, IRCCS, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Department of Applied Mathematics, Institute of Information Technology, Mathematics and Mechanics (ITMM), Lobachevsky State University of Nizhny Novgorod-National Research University (UNN), Nizhny Novgorod, Russia
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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