The association between excess weight and comorbidity and self-rated health in the Italian population

Factors associated with adherence to recommendations for medical visits following annual health checkups among Japanese employees: A prospective cohort study

There are growing concerns in Japanese workplaces that many employees do not follow recommendations to visit medical institutions for further examinations following annual health checkups. Although previous studies have shown that job- and health-related factors affect adherence to such recommendations, these longitudinal associations are unknown. We examined the longitudinal associations between job- and health-related factors and visiting medical institutions after annual health checkups among Japanese employees. We conducted a prospective cohort study in a food-related company in fiscal year 2019. Participants completed a self-administered questionnaire to assess job- and health-related factors. Of 2914 employees who completed the questionnaire, 615 received recommendations to visit medical institutions following annual health checkups in fiscal year 2020; these employees comprised our sample. We used logistic regression analysis to examine the associations between each factor and medical institution visits. Of participants, 474 (77.1 %) were men, 432 (70.2 %) were aged over 40 years, and 293 (47.6 %) visited a medical institution. Logistic regression analysis showed that participants with a primary doctor and those with obesity were more likely to visit medical institutions. In Japanese workplaces, having a primary doctor may be important in increasing adherence to medical visit recommendations following annual health checkups. However, more focus is also needed on employees without obesity who may be more confident about their health and so less likely to follow recommendations. Further intervention studies focusing on these factors are needed to identify effective interventions to improve adherence to medical recommendations.

Obesity, Disability and Self-Perceived Health Outcomes in Australian Adults: A Longitudinal Analysis Using 14 Annual Waves of the HILDA Cohort

BACKGROUND

Both obesity and disability have been widely recognised as major public health challenges because they play significant roles in determining self-perceived general and mental health. Longitudinal studies of the relationship between obesity and disability with self-reported health outcomes are scarce. Therefore, the objective of the present study is to examine the relationship between obesity and disability with self-perceived general and mental health among Australian adults aged 15 years and above.

METHODS

Data were extracted from the most recent 14 waves (waves 6 through 19) of the annual individual person dataset of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The longitudinal random-effects logistic regression model was adopted to investigate the relationships between obesity and disability with self-reported health outcomes.

RESULTS

The results revealed that obese individuals and adults with some form of disability are more likely to report poor or fair general and mental health. The odds of self-reporting poor or fair general health were 2.40 and 6.07 times higher among obese (aOR: 2.40, 95% CI: 2.22-2.58) and adults with some form of disability (aOR: 6.07, 95% CI: 5.77-6.39), respectively, relative to adults with healthy weight and those without disability . The results also showed that self-rated poor or fair mental health were 1.22 and 2.40 times higher among obese adults (aOR: 1.22, 95% CI: 1.15-1.30) and adults with disability (aOR: 2.40, 95% CI: 2.30-2.51), respectively, compared to their healthy weight peers and peers without disability.

CONCLUSION

As governmental and non-governmental organisations seek to improve the community's physical and mental well-being, these organisations need to pay particular attention to routine health care prevention, specific interventions, and treatment practices, especially for obese and/or people with disabilities.

Modeling the impact of obesity on cost of hip and knee arthroplasty

PURPOSE

This study aimed to determine the proportions of total knee arthroplasty (TKA) and total hip arthroplasty (THA) attributable to obesity in Ireland and the associated hospital costs.

METHODS

Sex- and age-specific numbers of primary TKA and THA procedures and length of stay were estimated using Irish population data from the Central Statistics Office (sex and age) and data from the national Hospital Inpatient Enquiry (numbers of TKA and THA procedures, length of stay, diagnostic-related group codes, sex, and age). Population attributable fractions of TKA and THA related to obesity were calculated using relative risks for different weight groups obtained from published literature. Nationally representative weight and height data were available from the 2015 Healthy Ireland Survey (n = 6142) and extrapolated to the Irish population. Diagnostic-related group tariffs from the Healthcare Pricing Office were used to estimate hospital costs of TKA and THA.

RESULTS

In 2015, 2296 TKA and 3411 THA procedures were performed in public hospitals in Ireland. Of those procedures, 43% of TKA and 20% of THA were attributable to obesity. This equates to €16.0 million out of €52.1 million of TKA- and THA-related hospital costs.

CONCLUSIONS

Effective obesity control has potential to decrease the demand for joint replacements and associated costs.

Is the association of weight disorders with perceived health status and life satisfaction independent of physical activity in children and adolescents? The CASPIAN-IV Study

BACKGROUND

Physical activity (PA) and weight status have been suggested as predictors of life satisfaction (LS) and perceived health status (PHS). Therefore the present study aims to investigate and compare the impacts of body mass index (BMI) and PA on LS and PHS in a population of Iranian children and adolescents.

MATERIAL AND METHODS

This study was conducted in 2011-12 as a nationwide population-based study among 14 880 students of age 6-18 years. Students were selected via a multistage cluster sampling method from 30 provinces of Iran. Information on demographics, PA, PHS and LS was obtained using the World Health Organization Global School-based Student Health Survey (WHO-GSHS) questionnaire. PA values were considered as low (<2 /week), moderate (2-4 h/week) and high (>2 h/week).

RESULTS

The current study has a participation rate of 90.6% (50.8% boys). PA was significantly associated with both LS and PHS [odds ratio (OR), 1.37 in both), while in BMI, this association was significant for only PHS (in underweight: OR, 0.65; 95% CI, 0.57-0.75; in excess weight: OR, 0.82; 95% CI, 0.73-0.93). In the combined group of BMI-PA, the influence of PA prevailed over the impact of BMI on PHS and LS, and therefore, PA was found to be the stronger factor.

CONCLUSION

Although BMI and PA could both significantly impact LS and PHS, the stronger influence of PA on LS and PHS suggests that upgrading the 'activity level' of children and adolescents should be underscored and included on the agenda, rather than merely focusing on their BMI and weight status.

Multimorbidity in patients with chronic migraine and medication overuse headache

OBJECTIVES

Patients with chronic migraine (CM) display a considerable amount of comorbidities, particularly psychiatric and cardiovascular, and the presence of multiple comorbidities, that is, the so-called multimorbidity, is a risk factor for migraine chronification or maintenance of CM. Our aim was to address the rate and impact of multimorbidity in patients with CM and medication overuse headache (MOH).

MATERIALS & METHODS

In a sample of patients with CM attending a structured withdrawal for coexisting MOH, we defined multimorbidity as the presence of two or more conditions in addition to CM-MOH. We compared patients with and without multimorbidity for demographic and clinical variables, quality of life, and disability; we also tested whether patients with multimorbidity had higher likelihood to attend emergency room, relapse into CM, and require further withdrawal treatments by 12 months.

RESULTS

One hundred and ninety-four patients were enrolled as follows: 61% had at least one comorbidity, the most common being mental (34%), circulatory (18%), and endocrine conditions (13%); 32% were multimorbidity cases. Patients with multimorbidity had higher headaches frequency, older age, lower education and lower employment rates, higher disability and lower QoL. They were more frequently opioids/barbiturates overusers and were more likely to attend ER (OR: 2.36), relapse into CM (OR: 2.19), and undergo another withdrawal (OR: 2.75) by 12 months after discharge, after controlling for age, gender, years of education, and headache frequency.

CONCLUSIONS

Recognizing multimorbidity in patients with CM-MOH is important to enhance the management of these complex patients, who are at risk of polypharmacy and increased health care utilization.

Body Mass Index and Poor Self-Rated Health in 49 Low-Income and Middle-Income Countries, By Sex, 2002-2004

This study investigated whether the relationship between body mass index (BMI) and poor self-rated health differed by sex in low-income countries and middle-income countries. We analyzed data from the World Health Survey (2002-2004) on 160,099 participants from 49 low-income and middle-income countries by using random-intercept multilevel logistic regressions. We found a U-shaped relationship between BMI and poor self-rated health among both sexes in both low-income and middle-income countries, but the relationship differed by sex in strength and direction between low-income countries and middle-income countries. Differential perception of body weight and general health might explain some of the observed sex differences.

Body mass index and health status in diabetic and non-diabetic individuals

Background/Objectives:

There is controversy regarding the existence of a body mass index (BMI) mortality paradox in diabetes, whereby the optimal BMI category is higher than it is in non-diabetic persons. To explore possible pathways to a mortality paradox, we examined the relationship of BMI with physical and mental health status in diabetic and non-diabetic persons.

Subjects/Methods:

We examined adjusted SF-12 Physical and Mental Component Summary (PCS-12 and MCS-12) scores by BMI (kg m⁻²) category (underweight, <20; normal weight, 20 to <25; overweight, 25 to <30; obese, 30 to <35; severely obese ⩾35) in adult diabetic and non-diabetic respondents to the 2000–2011 United States national Medical Expenditure Panel Surveys (N=119 161). Adjustors were age, sex, race/ethnicity, income, health insurance, education, smoking, comorbidity, urbanicity, geographic region and survey year.

Results:

In non-diabetic persons the adjusted mean PCS-12 score was highest (that is, most optimal) in the normal-weight category, whereas for diabetic persons the optimal adjusted mean PCS-12 score was in the overweight category (adjusted difference between non-diabetic and diabetic persons in the difference in PCS-12 means for overweight versus normal-weight category=0.8 points, 95% confidence interval; CI 0.1, 1.6; P=0.03). This paradoxical pattern was not evident for the MCS-12, and the adjusted difference between non-diabetic and diabetic persons in the difference in MCS-12 means for overweight versus obese persons was not significant (−0.3 points, 95% CI −0.9, 0.4; P=0.43). The findings were not significantly moderated by smoking status, cancer diagnosis or time period.

Conclusions:

The optimal BMI category for physical health status (but not mental health status) was higher among diabetic than non-diabetic persons. The findings are consistent with a BMI physical health status paradox in diabetes and, in turn, a mortality paradox.

Association between body mass index and perceived weight status with self-rated health and life satisfaction in Iranian children and adolescents: the CASPIAN-III study

PURPOSE

Adolescent obesity is a well-known worldwide issue with growing prevalence and complications. The concept of body image and complications of its misperception has been noted more recently. Life satisfaction (LS) and self-rated health (SRH) have also been known as independent morbidity and mortality factors. The objective of this study was to evaluate the associations of perceived weight status (body image) and actual body mass index (BMI), with LS and SRH in a nationally representative sample of a pediatric population in Iran, as a country located in the Middle East and North Africa region.

METHODS

This nationwide population-based survey was conducted among 5,570 (2,784 female and 2,786 male) Iranian students, aged 10-18 years, living in urban and rural areas of 27 provinces, which were selected via multistage sampling method. Agreement between BMI and perceived weight status (underweight, about right and overweight/obesity) was assessed. Adjusted association between BMI and perceived weight status with LS and SRH was assessed using multiple logistic regressions after adjustment for potential confounders.

RESULTS

Nearly 40 % of the participants misperceived their body image. Misperception as overweight or underweight was found to be associated with lower odds for both LS and SRH [overweight SRH OR 0.796 (95 % CI 0.647-980), underweight SRH OR 0.701 (95 % CI 0.588-0.835), overweight LS OR 0.884 (95 % CI 0.718-998), underweight LS OR = 0.676 (95 % CI 0.577-0.793)], whereas the association between actual BMI with LS and SRH was not statistically significant (P value > 0.05).

CONCLUSION

A mismatch between BMI and body weight perception was found in this study. Moreover, LS and SRH were not related with BMI, but had negative association with body weight perception.

Multiple chronic medical conditions: prevalence and risk factors--results from the Singapore Mental Health Study

OBJECTIVE

The objective was to establish the prevalence and risk factors for multiple chronic medical conditions (MCMC) in the Singapore population.

METHODS

Data for the study were extracted from the Singapore Mental Health Study, a population-based, cross-sectional, epidemiological study of Singapore residents aged 18 years and above. Face-to-face interviews were completed with 6616 respondents from December 2009 to December 2010, and the survey response rate was 75.9%. The assessment of psychiatric conditions was established using version 3.0 of the WHO World Mental Health Composite International Diagnostic Interview (WMH-CIDI). A modified version of the CIDI checklist of chronic medical conditions was used to capture data on 15 chronic medical conditions which were reclassified into eight types of physical conditions.

RESULTS

A total of 25.4% of the population reported having one chronic condition, and 16.3% had MCMC. Those who were older (aged 35 years and above vs. those aged 18-34 years), economically inactive, unemployed, overweight and obese had higher odds of having MCMC. Adjusting for covariates in multinomial regression analyses, mood and alcohol use disorder (AUD) were significantly associated with higher risk of MCMC.

CONCLUSIONS

The study identified two important yet potentially modifiable risk factors for MCMC--psychiatric conditions and obesity--in the general population. Screening for mood and alcohol use disorder, as well as lifestyle interventions targeted at obesity, must be a part of disease management for MCMC.

The influence of locus of control on self-rated health in context of chronic disease: a structural equation modeling approach in a cross sectional study

BACKGROUND

Self-rated health is a robust predictor of several health outcomes, such as functional ability, health care utilization, morbidity and mortality. The purpose of this study is to investigate and explore how health locus of control and disease burden relate to self-rated health among patients at risk for cardiovascular disease.

METHODS

In 2009, 414 Swedish patients who were using statins completed a questionnaire about their health, diseases and their views on the three-dimensional health locus of control scale. The scale determines which category of health locus of control - internal, chance or powerful others - a patient most identifies with. The data was analyzed using logistic regression and a structural equation modeling approach.

RESULTS

The analyses showed positive associations between internal health locus of control and self-rated health, and a negative association between health locus of control in chance and powerful others and self-rated health. High internal health locus of control was negatively associated with the cumulative burden of diseases, while health locus of control in chance and powerful others were positively associated with burden of diseases. In addition, age and education level had indirect associations with self-rated health through health locus of control.

CONCLUSIONS

This study suggests that self-rated health is positively correlated with internal locus of control and negatively associated with high locus of control in chance and powerful others in patients at high risk for cardiovascular disease. Furthermore, disease burden seems to be negatively associated with self-rated health.