Association between obesity and high blood pressure: reporting bias related to gender and age

Effect modification of age and hypertension on cancer and prevalence of self-reported stroke - A cross-sectional study

The objective of this study was to examine the effect modification of age on the relationship between cancer and prevalence of self-reported stroke. We used cross-sectional data from the 2015-2016 iteration of the Canadian Community Health Survey. A multivariable logistic regression model was used to assess the association between cancer and self-reported stroke. Covariates were assessed for effect modification using the maximum likelihood estimation method. We analyzed 86,809 subjects; the prevalence of self-reported stroke was 1.11%. The odds ratio for the association between cancer and self-reported stroke was 1.26 (95% CI 0.98-1.61) after adjusting for age, sex, dyslipidemia, hypertension, diabetes, heart disease, education, and household income. Age and hypertension were found to be effect modifiers, and the association between cancer and self-reported stroke was stronger in younger adults and in those without hypertension. These results suggest that cancer-associated strokes may have unique underlying mechanisms compared to conventional strokes.

Relationships between Physical Activity Frequency and Self-Perceived Health, Self-Reported Depression, and Depressive Symptoms in Spanish Older Adults with Diabetes: A Cross-Sectional Study

Diabetes is one of the most prevalent noncommunicable diseases in the world. This disease can affect both physical and mental health in the population. This study analyzed the prevalence of Self-Perceived Health (SPH), self-reported depression, and depressive symptoms in comparison with the Physical Activity Frequency (PAF) reported by Spanish older adults with diabetes. A cross-sectional study was carried out with data from 2799 self-reported diabetic participants, all of whom were residents of Spain, aged 50-79 years, and included in the European Health Surveys carried out in Spain (EHIS) both in 2014 and 2020. The relationships between the variables were analysed with a chi-squared test. A z-test for independent proportions was performed to analyze differences in proportions between the sexes. A multiple binary logistic regression was carried out on the prevalence of depression. Linear regressions were performed on depressive symptoms and SPH. Dependent relationships were found between the SPH, self-reported depression, and depressive symptoms with PAF. Most of the very active participants reported a higher prevalence of self-reported depression. Physical inactivity increased the risk of depression, major depressive symptoms, and negative SPH.

Ensemble Learning for Skeleton-Based Body Mass Index Classification

In this study, we performed skeleton-based body mass index (BMI) classification by developing a unique ensemble learning method for human healthcare. Traditionally, anthropometric features, including the average length of each body part and average height, have been utilized for this kind of classification. Average values are generally calculated for all frames because the length of body parts and the subject height vary over time, as a result of the inaccuracy in pose estimation. Thus, traditionally, anthropometric features are measured over a long period. In contrast, we controlled the window used to measure anthropometric features over short/mid/long-term periods. This approach enables our proposed ensemble model to obtain robust and accurate BMI classification results. To produce final results, the proposed ensemble model utilizes multiple k-nearest neighbor classifiers trained using anthropometric features measured over several different time periods. To verify the effectiveness of the proposed model, we evaluated it using a public dataset. The simulation results demonstrate that the proposed model achieves state-of-the-art performance when compared with benchmark methods.

Stronger associations of obesity with prehypertension and hypertension in young women than in young men

OBJECTIVE

Obesity is an important risk factor for prehypertension and hypertension, and there are sex-specific differences in prevalences of obesity and hypertension. The aim of this study was to determine whether sex influences the relationships of obesity with prehypertension and hypertension.

METHODS

The participants were 28,325 Japanese men and women aged 20-39 years. Obesity was evaluated by BMI (≥ 25 kg/m) and waist-to-height ratio (WHtR ≥ 0.5). Associations of obesity with prehypertension and hypertension were compared in men and women by using odds ratio (OR) and area under the curve (AUC).

RESULTS

ORs for prehypertension and hypertension in participants with vs. participants without high BMI or WHtR were significantly higher than a reference level of 1.00 both in men and women and were significantly higher in women than in men. ORs for prehypertension and hypertension of participants with vs. participants without high BMI were 3.10 (2.84-3.38) (men) vs. 5.54 (4.80-6.40) (women) (P < 0.01) and 12.06 (10.83-13.42) (men) vs. 34.58 (26.55-45.04) (women) (P < 0.01), respectively. ORs of the interaction terms consisting of sex (male vs. female) and adiposity (high vs. not high BMI or WHtR) for prehypertension and hypertension were found to be significant. AUCs for the relationships of BMI with prehypertension and hypertension were significantly larger than a reference level of 0.500 and were significantly larger in women than in men.

CONCLUSION

The results suggest that the associations of obesity with prehypertension and hypertension are stronger in women than in men.

Comparing self-reported and measured high blood pressure and high cholesterol status using data from a large representative cohort study

OBJECTIVE

To examine the relationship between self-reported and clinical measurements for high blood pressure (HBP) and high cholesterol (HC) in a random population sample.

METHOD

A representative population sample of adults aged 18 years and over living in the north-west region of Adelaide (n=1537) were recruited to the biomedical cohort study in 2002/03. In the initial cross-sectional component of the study, self-reported HBP status and HC status were collected over the telephone. Clinical measures of blood pressure were obtained and fasting blood taken to determine cholesterol levels. In addition, data from a continuous chronic disease and risk factor surveillance system were used to assess the consistency of self-reported measures over time.

RESULT

Self-report of current HBP and HC showed >98% specificity for both, but sensitivity was low for HC (27.8%) and moderate for HBP (49.0%). Agreement between current self-report and clinical measures was moderate (kappa 0.55) for HBP and low (kappa 0.30) for HC. Demographic differences were found with younger people more likely to have lower sensitivity rates. Self-reported estimates for the surveillance system had not varied significantly over time.

CONCLUSION

Although self-reported measures are consistent over time there are major differences between the self-reported measures and the actual clinical measurements. Technical aspects associated with clinic measurements could explain some of the difference.

IMPLICATIONS

Monitoring of these broad population measures requires knowledge of the differences and limitations in population settings.

Changing prevalence of obesity in a rural community between 1977 and 2003: a multiple cross-sectional study

OBJECTIVE

To determine the changes in the prevalence of obesity in a rural community between 1977 and 2003.

STUDY DESIGN

A multiple cross-sectional study.

METHODS

The analysis was based on data from four cross-sectional surveys of adults aged 25-59 years, conducted in the town of Humboldt, Saskatchewan in 1977, 1983, 1993 and 2003. People with a body mass index (BMI) > or =30 kg/m(2) were considered to be obese.

RESULTS

Average body weight increased by 8 kg for both men and women during the study period. The increase in BMI was greater in adults aged 25-39 years compared with older age groups. The prevalence of obesity increased from 24% in 1977 to 38% in 2003 for men, and from 16% to 32% for women. The change was more pronounced from 1993 to 2003 than from 1977 to 1993, especially among younger adults. Standardized to the 2003 study population by sex, age and smoking status, the prevalence of obesity was 16.8% in 1977, 22.7% in 1983, 24.7% in 1993 and 34.5% in 2003, and was much higher than the Canadian national average (16% in 2003).

CONCLUSION

There was a dramatic increase in the prevalence of obesity in rural adults, and this was greater in younger adults. Changes in cigarette smoking did not explain the increase. There is an urgent need to identify and implement effective interventions to slow if not reverse the trend, particularly in rural populations.

Energy expenditure and physical activity in Prader-Willi syndrome: comparison with obese subjects

Prader-Willi syndrome (PWS) is a complex neurodevelopmental disorder characterized by hypotonia, suck and feeding difficulties, hypogonadism, small hands and feet, developmental delay, hyperphagia and early childhood obesity and a particular facial appearance. The obesity associated with PWS is the result of a chronic imbalance between energy intake and energy expenditure (EE) due to hyperphagia, decreased physical activity, reduced metabolic rate and an inability to vomit. EE is affected by body composition as well as exercise. Individuals with PWS have a lower lean body mass (LBM) compared with controls which may contribute to reduced basal level EE. To determine the relationship among body composition, activity levels and metabolic rates, dual energy X-ray absorptiometry (DEXA) and a whole-room respiration chamber were used to measure body composition, total EE (TEE), resting EE (REE), physical activity, and mechanical work (MW) during an 8 hr monitoring period. The chamber consisted of a live-in whole-room indirect calorimeter equipped with a force platform floor to allow simultaneous measurement of EE, physical activity, and work efficiency during spontaneous activities and standardized exercise. Participants with PWS (27 with 15q11-q13 deletion and 21 with maternal disomy 15 with an average age of 23 years) had significantly decreased TEE by 20% and reduced LBM compared to 24 obese subjects. Similarly, REE was significantly reduced by 16% in the individuals with PWS relative to the comparison subjects. Total MW performed during the 8 hr monitoring period was significantly reduced by 35% in the PWS group. The energy cost of physical activity is related to the duration, intensity and type of activity and the metabolic efficiency of the individual. After adjusting group differences in LBM by analysis of variance, TEE and REE were no longer different between the two groups. Our data indicate that there is a significant reduction of EE in individuals with PWS resulting from reduced activity but also from lower energy utilization due to reduced LBM which consists primarily of muscle.

Validation study on self-reported height, weight, and blood pressure

Self-report data were compared with actual recorded data on height, weight, and blood pressure during health examinations to check for validity. The subjects were 1,823 persons, ages 40-68 years. Pearson correlations for systolic blood pressure, diastolic blood pressure, height, weight, and Body Mass Index between data reported in 1993 and measurements made in 1991 were .63, .60, .96, .96, and .92, respectively. Pearson correlations for the same variables between the data reported in 1993 and the measurements made in 1992 were .73, .67, .97, .97, and .94, respectively. Self-reported values for height, weight, and Body Mass Index appear to be valid over years or so.

Gender-related differences in the association between socioeconomic status and self-reported diabetes

BACKGROUND

The prevalence of diabetes has been steadily increasing in Western countries. We investigated the impact of socioeconomic status (SES) on the prevalence of self-reported diabetes, and its differences between genders.

METHODS

Data for this investigation were derived from the second cycle of the National Population Health Survey conducted in 1996-1997. A total of 39 021 subjects (17 730 males and 21 291 females) >/=40 years of age who answered the question about diabetes were included in the present analysis. Educational attainment and income adequacy were used as indicators of SES. Multiple logistic regression models were constructed for men and women separately to assess the effects of SES on the prevalence of diabetes after adjustment for age, area of residence, body mass index, and physical activity.

RESULTS

and The prevalence of diabetes was 6.6% among men and 5.5% among women. The

CONCLUSIONS

prevalence increased with decreasing income category and educational attainment in both genders. The odds ratios for income and education in relation to diabetes after adjustment remained significant in women, but attained unity in men. Canadian women >/=40 years of age of low SES have a relatively high prevalence of diabetes, independent of age, area of residence, obesity, and physical inactivity.