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Wang T, Dai B, Shi H, Li H, Fan K, Zhang D, Zhou Y. Weight change across adulthood in relation to the risk of depression. Front Psychol 2023; 14:1108093. [PMID: 37621933 PMCID: PMC10446764 DOI: 10.3389/fpsyg.2023.1108093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Background Studies examining weight change patterns and depression are scarce and report inconsistent findings. This study-aimed to elucidate the association between weight change patterns and the risk of depression in a large, representative sample of US adults. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 was analyzed. Five weight change groups were categorized: stable normal, weight loss, weight gain, maximum overweight, and stable obesity. Depression was ascertained using the validated Patient Health Questionnaire (PHQ-9) and depression was defined as PHQ score ≥ 10. Results A total of 17,556 participants were included. Compared with participants who maintained normal weight, stable obesity participants had increased risks of depression across adulthood from age 25 years to 10 years before the survey (OR = 1.61, 95% CI =1.23 to 2.11), in the 10 years period before the survey (OR = 2.15, 95% CI =1.71 to 2.70), and from age 25 years to survey (OR = 1.88, 95% CI =1.44 to 2.44). Weight gain was associated with an increased risk of depression from age 25 years to 10 years before the survey (OR = 1.71, 95% CI = 1.41 to 2.04), in the 10 years period before the survey (OR = 1.73, 95% CI = 1.35 to 2.21), and for the period from age 25 years to survey (OR = 1.83, 95% CI = 1.49 to 2.24). In the stratified analyses, we found statistically significant interactions with sex. Conclusion Our study suggested that stable obesity and weight gain across adulthood were associated with increased risks of depression.
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Affiliation(s)
- Tao Wang
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, China
- Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Bingqin Dai
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
| | - Huanchen Shi
- School of Basic Medicine, Qingdao University, Qingdao, China
| | - Huawei Li
- School of Nursing, Qingdao University, Qingdao, China
| | - Kexin Fan
- School of Nursing, Qingdao University, Qingdao, China
| | - Dongfeng Zhang
- School of Public Health, Qingdao University, Qingdao, China
| | - Yunping Zhou
- School of Nursing, Qingdao University, Qingdao, China
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2
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Hellgren MI, Kitsche E, Groot-Zevert M, Lindblad U, Daka B. Association between body mass index and self-rated health: A Swedish population-based longitudinal study. Scand J Public Health 2019; 49:369-376. [PMID: 31814526 DOI: 10.1177/1403494819875012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: We aimed to investigate (a) the association between body mass index (BMI) and self-rated health (SRH) and (b) BMI's predicted value for SRH within a representative population in the Skaraborg Project. Methods: This was a longitudinal observational study. A random population of 2816 individuals were included in the study between 2002 and 2005, and a representative sample of these individuals were invited consecutively for a follow-up visit between 2012 and 2014. At follow-up, data from 1327 participants were collected concerning anthropometric variables, blood samples and validated questionnaires regarding lifestyle factors. Results: A significant inverse association was observed between BMI and SRH both at baseline and at follow-up, with all p-values for trend being ⩽0.001 in both men and women. This association was observed even after adjusting for confounders such as co-morbidity, age, sex, education, marital status and lifestyle factors. In addition, the longitudinal analyses showed that BMI at baseline was inversely associated with SRH at follow-up in both sexes (odds ratio (OR)=1.1, confidence interval (CI) 1.02-1.16, p=0.017 in men; and OR=1.1, CI 1.04-1.14, p=0.001 in women). These findings remained in participants whose weight increased (p=0.022) or was stable (p=0.004), while it was not seen in individuals who lost weight over the years (p=0.340). Conclusions: SRH is inversely associated with BMI in Swedish men and women. High BMI predicted low SRH from a longitudinal perspective, independent of co-morbidities, except for individuals who lost weight over the years. This knowledge emphasises the importance of an understanding and empathetic attitude towards these individuals.
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Affiliation(s)
- Margareta I Hellgren
- Department of Public Health and Community Medicine, Division of Family Medicine, University of Gothenburg, Sweden
| | - Emelie Kitsche
- Department of Public Health and Community Medicine, Division of Family Medicine, University of Gothenburg, Sweden
| | - Marieke Groot-Zevert
- Department of Public Health and Community Medicine, Division of Family Medicine, University of Gothenburg, Sweden.,Dimence Institute of Mental Health, The Netherlands
| | - Ulf Lindblad
- Department of Public Health and Community Medicine, Division of Family Medicine, University of Gothenburg, Sweden
| | - Bledar Daka
- Department of Public Health and Community Medicine, Division of Family Medicine, University of Gothenburg, Sweden
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3
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Williams LT, Collins CE, Morgan PJ, Hollis JL. Maintaining the Outcomes of a Successful Weight Gain Prevention Intervention in Mid-Age Women: Two Year Results from the 40-Something Randomized Control Trial. Nutrients 2019; 11:E1100. [PMID: 31108930 PMCID: PMC6567062 DOI: 10.3390/nu11051100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/07/2019] [Accepted: 05/15/2019] [Indexed: 12/19/2022] Open
Abstract
Despite the life stage of menopause being identified as a high risk for weight gain, there are few obesity prevention interventions for this target group, and no evidence on maintenance of intervention effects after intervention support is withdrawn. In the 40-Something Randomized Controlled Trial (RCT) (ACTRN12611000064909), a five-consultation health professional (dietitian and exercise physiologist) obesity prevention intervention, using motivational interviewing principles (MI) over 12 months, achieved significantly greater weight loss than a self-directed intervention (SDI) (tailored written material) in 54 non-obese (body mass index (BMI): 18.5-29.9 kg/m2), premenopausal women (44-50 years). The aim of the current paper is to report on whether the intervention effects were maintained at two years. Anthropometric, biochemical and health behavior data were collected at baseline, 12 months (end of intervention) and 24 months (end of maintenance period). Forty participants (22 = MI, 18 = SDI) who completed all measures to 12 months were invited to participate in the monitoring phase and 30 (MI = 16, SDI = 14) consented. The primary outcome of weight at 24 months was assessed using intention to treat principles (n = 54), adjusting for baseline weight. The MI group had a significantly lower weight at 24 months (64.6 kg, 95% CI: 63.2, 66.6, p = 0.015) compared with the SDI group (67.3 kg, 95% CI: 65.7, 68.8), and the secondary outcomes of percentage body fat and waist circumference were also significantly lower in the MI group. The low-intensity, health professional weight control intervention utilizing MI principles was more efficacious in maintaining a significant weight loss compared to a self-directed intervention, and both were successful in preventing obesity.
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Affiliation(s)
- Lauren T Williams
- Menzies Health Institute Queensland, Griffith University, Southport, QLD 4222, Australia.
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
- School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Jenna L Hollis
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia.
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4
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Hayes M, Baxter H, Müller-Nordhorn J, Hohls JK, Muckelbauer R. The longitudinal association between weight change and health-related quality of life in adults and children: a systematic review. Obes Rev 2017; 18:1398-1411. [PMID: 28975765 DOI: 10.1111/obr.12595] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/15/2017] [Accepted: 07/07/2017] [Indexed: 12/19/2022]
Abstract
This systematic review examined longitudinal associations between weight change (weight gain and loss) and both physical and mental aspects of health-related quality of life (HRQOL) compared with stable weight in adults and children of the general population. MEDLINE, EMBASE, PsycINFO and PubMed databases were searched. Longitudinal observational studies measuring HRQOL with six predefined instruments were synthesized according to type of association: weight change and change in HRQOL (change-on-change association) and weight change and HRQOL at follow-up (predictive association). Twenty studies of adults (n = 15) or children (n = 5) were included. Fifteen studies used the SF-12 or SF-36. Results of nine studies in adults examining the change-on-change association were combined through a tallying of 606 analyses. Weight gain was most often associated with reduced physical, but not mental HRQOL, across all baseline body mass index categories and in both men and women. Weight loss may be associated with improved physical, but not mental HRQOL, among adults with overweight and obesity. Weight gain was more strongly associated with HRQOL than weight loss, implicating a greater need for preventative strategies to tackle obesity. Results in children and for the predictive association generally reflected these findings but require further research.
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Affiliation(s)
- M Hayes
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - H Baxter
- Austin Health Sciences Library, Austin Health, Heidelberg, Victoria, Australia
| | - J Müller-Nordhorn
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J K Hohls
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - R Muckelbauer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
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5
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Coltman CE, Steele JR, McGhee DE. Breast volume is affected by body mass index but not age. ERGONOMICS 2017; 60:1576-1585. [PMID: 28532249 DOI: 10.1080/00140139.2017.1330968] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study aimed to establish normative breast volume data for women of varying ages, body masses and breast sizes, and to determine the effect of age and body mass index (BMI) on breast volume. METHODS The breast volume of 356 women (age range: 18.1-83.7 years; BMI range: 18.4-54.5 kg/m²) was measured using three-dimensional scanning in a prone position. RESULTS Breast volumes ranged from 48 to 3100 mL. Although breast volume was not significantly affected by age, it was significantly affected by BMI, with the breast volume of overweight and obese women being two-to-three times greater than women with normal BMI's. CONCLUSION It is recommended that bra cups must be designed to support the wide range and increasing magnitude of breast volumes exhibited by women. Practitioner summary: This original research provides evidence for bra designers and manufacturers on the range of breast volumes of women and the significant effect of BMI on breast volume. Bra cups need to be designed to support the wide range and increasing magnitude of breast volumes exhibited by women.
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Affiliation(s)
- Celeste E Coltman
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Julie R Steele
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
| | - Deirdre E McGhee
- a Biomechanics Research Laboratory, School of Medicine, Faculty of Science, Medicine & Health , University of Wollongong , Wollongong , Australia
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Aljadani HM, Patterson AJ, Sibbritt D, Collins CE. Diet quality and six-year risk of overweight and obesity among mid-age Australian women who were initially in the healthy weight range. Health Promot J Austr 2017; 27:29-35. [PMID: 26568282 DOI: 10.1071/he14070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/24/2015] [Indexed: 02/01/2023] Open
Abstract
Issue addressed The present study investigated the association between diet quality, measured using the Australian Recommended Food Score (ARFS), and 6-year risk of becoming overweight or obese in mid-age women from the Australian Longitudinal Study of Women's Health (ALSWH). Methods Women (n=1107) aged 47.6-55.8 years who were a healthy weight (body mass index (BMI) between ≤18.5 and <25.0kgm(-2)) at baseline and who reported valid total energy intakes were included in the study. BMI was calculated from self-reported data in 2001 and 2007. ARFS scores were calculated from data collected using the Dietary Questionnaire for Epidemiological Studies Version 2. Logistic regression was used to examine the relationship between ARFS score as a continuous variable and risk of becoming overweight or obese. Results The 6-year incidence of overweight and obesity was 18.5% and 1.1%, respectively. The mean (± s.d.) ARFS (maximum possible 74) among those who remained within the healthy weight range and those who became overweight or obese at follow-up was 35.3±8.1 and 34.3±8.8, respectively. There was no relationship between baseline ARFS and risk of becoming overweight or obese over 6 years. Women who were smokers were more likely to become overweight or obese (odds ratio 1.5; 95% confidence interval 1.11-2.09; P=0.008). Conclusions Poor diet quality was common among mid-age women of a healthy weight in the ALSWH. Higher diet quality was not associated with the risk of overweight or obesity after 6 years, yet smoking status was. So what? Better diet quality alone will not achieve maintenance of a healthy weight, but should be encouraged to improve other health outcomes.
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Affiliation(s)
- Haya M Aljadani
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Amanda J Patterson
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - David Sibbritt
- Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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7
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Bliddal M, Pottegård A, Kirkegaard H, Olsen J, Sørensen TIA, Nohr EA. Depressive symptoms in women's midlife in relation to their body weight before, during and after childbearing years. Obes Sci Pract 2016; 2:415-425. [PMID: 28090347 PMCID: PMC5192541 DOI: 10.1002/osp4.75] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/16/2016] [Accepted: 09/17/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study aimed to examine how weight and weight changes related to pregnancy were associated with depressive symptoms 11-16 years after childbirth. METHOD We followed 16,998 first-time mothers from the Danish National Birth Cohort up till 16 years after birth and estimated associations between depressive symptoms and pre-pregnancy body mass index (BMI) (kg m-2), weight changes in different time periods, and BMI-adjusted waist circumference 7 years after birth (WCBMI, cm). Depressive symptoms were estimated by the Center for Epidemiologic Studies Depression 10-item scale. Multiple logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals. RESULTS Compared with normal-weight, we found that underweight, overweight and obesity were associated with greater odds of depressive symptoms (1.29, 1.24 and 1.73, respectively). Compared with weight change ±1 BMI unit during the total follow-up period, greater odds for depressive symptoms were observed with weight loss (OR 1.14, 0.96-1.36) or gain of 2-2.99 kg m-2 (OR 1.11, 0.92-1.33) or gain of ≥3 kg m-2 (OR 1.68, 1.46-1.94). WCBMI > 2.2 cm was associated with greater odds of depressive symptoms (OR 1.16, 0.99-1.36) than waist circumference as predicted by BMI. CONCLUSION Low and high pre-pregnancy BMI, weight changes and WCBMI larger than predicted were associated with more depressive symptoms in midlife.
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Affiliation(s)
- M. Bliddal
- Institute of Clinical Research, Research Unit of Gynaecology and ObstetricsUniversity of Southern DenmarkOdenseDenmark
- Department of Gynaecology and ObstetricsOdense University HospitalOdenseDenmark
- OPEN – Odense Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - A. Pottegård
- Clinical Pharmacology, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - H. Kirkegaard
- Institute of Clinical Research, Research Unit of Gynaecology and ObstetricsUniversity of Southern DenmarkOdenseDenmark
| | - J. Olsen
- Department of Public Health, Section for EpidemiologyAarhus UniversityAarhusDenmark
| | - T. I. A. Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic ResearchUniversity of CopenhagenCopenhagenDenmark
- Institute of Preventive MedicineBispebjerg and Frederiksberg Hospitals – Part of Copenhagen University HospitalCopenhagenDenmark
- MRC Integrative Epidemiology UnitBristol UniversityBristolUK
| | - E. A. Nohr
- Institute of Clinical Research, Research Unit of Gynaecology and ObstetricsUniversity of Southern DenmarkOdenseDenmark
- Department of Gynaecology and ObstetricsOdense University HospitalOdenseDenmark
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Pan A, Kawachi I, Luo N, Manson JE, Willett WC, Hu FB, Okereke OI. Changes in body weight and health-related quality of life: 2 cohorts of US women. Am J Epidemiol 2014; 180:254-62. [PMID: 24966215 DOI: 10.1093/aje/kwu136] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Studies have shown that body weight is a determinant of health-related quality of life (HRQoL). However, few studies have examined long-term weight change with changes in HRQoL. We followed 52,682 women aged 46-71 years in the Nurses' Health Study (in 1992-2000) and 52,587 women aged 29-46 years in the Nurses' Health Study II (in 1993-2001). Body weight was self-reported, HRQoL was measured by the Medical Outcomes Study's 36-Item Short Form Health Survey, and both were updated every 4 years. The relationship between changes in weight and HRQoL scores was evaluated at 4-year intervals by using a generalized linear regression model with multivariate adjustment for baseline age, ethnicity, menopausal status, and changes in comorbidities and lifestyle factors. Weight gain of 15 lbs (1 lb = 0.45 kg) or more over a 4-year period was associated with 2.05-point lower (95% confidence interval: 2.14, 1.95) physical component scores, whereas weight loss of 15 lbs or more was associated with 0.89-point higher (95% confidence interval: 0.75, 1.03) physical component scores. Inverse associations were also found between weight change and physical function, role limitations due to physical problems, bodily pain, general health, and vitality. However, the relations of weight change with mental component scores, social functioning, mental health, and role limitations due to emotional problems were small.
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Retrospective long-term comparison of naturopathic fasting therapy and weight reduction diet in overweight patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:453407. [PMID: 25126098 PMCID: PMC4122067 DOI: 10.1155/2014/453407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 05/03/2014] [Accepted: 06/10/2014] [Indexed: 11/25/2022]
Abstract
In a follow-up study overweight and obese patients fasting according to Buchinger (modified) and a control group treated by a weight reduction diet in the context of an inpatient naturopathic complex treatment were compared using a questionnaire developed for a standardized phone interview 6.8 ± 1.1 years after inpatient treatment. During the inpatient treatment the fasting patients significantly more body weight, but at the time of the interview significantly more weight was gained again. 10.7% of the fasting patients and 31.9% of the control group lowered their weight at least 5% of their initial weight up to the interview. 42% of the fasting and 74% of the control group persistently changed their diet. The control group followed a significantly higher number of trained nutritional aspects. 21% of the fasting and 40% of the control group increased their leisure activity permanently. Continued improvement in quality of life was achieved by 16% of the fasting patients and 28% of the control group. The fasting therapy, carried out as part of the inpatient naturopathic complex treatment, turned out to be less suitable for the treatment of overweight and obesity compared to standard therapy. One likely determinant is the minor poststationary lifestyle modification.
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10
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Williams LT, Hollis JL, Collins CE, Morgan PJ. Can a relatively low-intensity intervention by health professionals prevent weight gain in mid-age women? 12-Month outcomes of the 40-Something randomised controlled trial. Nutr Diabetes 2014; 4:e116. [PMID: 24799163 PMCID: PMC4042310 DOI: 10.1038/nutd.2014.12] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 02/11/2014] [Accepted: 02/19/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Weight gain in perimenopausal women results in increased visceral adipose tissue, leading to metabolic syndrome and associated comorbidities. Despite a high prevalence of weight gain at this life stage, interventions to prevent menopausal obesity are lacking. AIM To test the effectiveness of an intervention delivered by health professionals using a motivational interviewing (MI) counselling style in preventing weight gain in non-obese (body mass index (BMI) 18.5 and 29.9 kg m(-2)) women in late premenopause. METHODS In a randomised controlled trial, 54 women (mean (s.d.) age 47.3 (1.8) years; BMI 25.1 (2.4) kg m(-2)) who had menstruated within the preceding 3 months were randomly assigned to an MI intervention (n=28) (five health professional MI counselling sessions) or a self-directed intervention (SDI) (print materials only) (n=26). The primary outcome, body weight (kg) and secondary outcomes (blood lipids, glucose, body fat %, lean mass % and waist circumference) were measured at baseline and postintervention (12 months), and intention-to-treat analysis was conducted. RESULTS Forty women completed all measures and adhered to all protocols. The weight at 12 months for the MI group of 65.6 kg (95% CI: 64.5; 66.8) was significantly different (P=0.034) from the SDI group of 67.4 kg (95% CI: 66.2; 68.6). When stratified by baseline BMI category, the MI group lost significantly more weight (-2.6 kg; 95% CI: -3.9; -1.2) than the SDI group (-0.1 kg; 95% CI: -1.2; 1.0, P=0.002) for the healthy weight women. The overweight women lost weight regardless of the intervention group, with no between-group difference (-3.5 kg; 95% CI: -6.1, -1.0 and -2.3; 95% CI: -4.1, -0.5, P=0.467). CONCLUSION This relatively low-intensity intervention, incorporating MI into health professional counselling, not only effectively prevented weight gain but also achieved significant weight loss and decreased diastolic blood pressure. Further refinements are required to optimise outcomes for overweight women.
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Affiliation(s)
- L T Williams
- 1] Nutrition and Dietetics, School of Allied Health Sciences, Faculty of Health, Griffith University, Southport, QLD, Australia [2] Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce, ACT, Australia [3] School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - J L Hollis
- 1] School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia [2] Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - C E Collins
- 1] School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia [2] Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - P J Morgan
- 1] Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia [2] School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, NSW, Australia
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Koohkan S, Schaffner D, Milliron BJ, Frey I, König D, Deibert P, Vitolins M, Berg A. The impact of a weight reduction program with and without meal-replacement on health related quality of life in middle-aged obese females. BMC Womens Health 2014; 14:45. [PMID: 24618460 PMCID: PMC3975286 DOI: 10.1186/1472-6874-14-45] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 03/05/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In addition to an increased risk for chronic illnesses, obese individuals suffer from social stigmatization and discrimination, and severely obese people may experience greater risk of impaired psychosocial and physical functioning. Lower health-related quality of life (HRQOL) has been reported among obese persons seeking intensive treatment for their disease. To aid in the treatment of obesity, meal replacements have been recommended as an effective therapeutic strategy for weight loss, particularly when consumed in the beginning of an intervention. Hence, the objective of this study was to assess the impact of two 12-month weight reduction interventions (one arm including a meal replacement) on changes in HRQOL among obese females. METHODS This controlled trial compared two versions of a standardized 12-month weight reduction intervention: the weight-reduction lifestyle program without a meal replacement (LS) versus the same lifestyle program with the addition of a soy-based meal replacement product (LSMR). 380 women (LS: n = 190, LSMR: n = 190) were matched by age, gender, and weight (51.4 ± 7.0 yrs., 35.5 ± 3.03 kg/m2). This sample of women all completed the 12-month lifestyle intervention that was part of a larger study. The lifestyle intervention included instruction on exercise/sport, psychology, nutrition, and medicine in 18 theoretical and 40 practical units. Led by a sport physiologist, participants engaged in group-based exercise sessions once or twice a week. To evaluate HRQOL, all participants completed the SF-36 questionnaire pre- and post-intervention. Anthropometric, clinical, physical performance (ergometric stress tests), and self-reported leisure time physical activity (hours/day) data were collected. RESULTS The LSMR sample showed lower baseline HRQOL scores compared to the LS sample in six of eight HRQOL dimensions, most significant in vitality and health perception (p < 0.01). After the intervention, body weight was reduced in both lifestyle intervention groups (LS: -6.6±6.6 vs. LSMR -7.6±7.9 kg), however, weight loss and HRQOL improvements were more pronounced in the LSMR sample (LSMR: seven of eight, LS: four of eight dimensions). CONCLUSIONS Our results show that HRQOL may improve among middle-aged obese females during a standardized lifestyle weight reduction program and may be enhanced by consuming a soy-based meal replacement product. TRIAL REGISTRATION ClinicalTrials.gov NCT00356785.
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Affiliation(s)
- Sadaf Koohkan
- Department of Nutrition, Institut für Sport und Sportwissenschaft der Universität Freiburg, Schwarzwaldstrasse 175, Freiburg D-79117, Germany
| | - Denise Schaffner
- Department of Rehabilitative und Präventive Sportmedizin, Medizinische Universitätsklinik Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Brandy J Milliron
- Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Ingrid Frey
- Department of Rehabilitative und Präventive Sportmedizin, Medizinische Universitätsklinik Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Daniel König
- Department of Nutrition, Institut für Sport und Sportwissenschaft der Universität Freiburg, Schwarzwaldstrasse 175, Freiburg D-79117, Germany
| | - Peter Deibert
- Department of Rehabilitative und Präventive Sportmedizin, Medizinische Universitätsklinik Freiburg, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Mara Vitolins
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Aloys Berg
- Department of Nutrition, Institut für Sport und Sportwissenschaft der Universität Freiburg, Schwarzwaldstrasse 175, Freiburg D-79117, Germany
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Aljadani HMA, Sibbritt D, Patterson A, Collins C. The Australian Recommended Food Score did not predict weight gain in middle-aged Australian women during six years of follow-up. Aust N Z J Public Health 2014; 37:322-8. [PMID: 23895474 DOI: 10.1111/1753-6405.12079] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between diet quality score, as measured by the Australian Recommended Food Score (ARFS) and six-year weight gain in middle-aged Australian women. METHODS Participants were a sub-sample of women from the Australian Longitudinal Study on Women's Health (ALSWH) who were followed up from 2001 to 2007 (n= 7,155, aged 48 to 56 years). The ARFS was derived from responses to a sub-set of questions from a food frequency questionnaire, with possible scores ranging from 0 to 74 (maximum). Absolute weight gain was calculated from the difference in self-reported weight between 2001 and 2007. Linear regression was used to test the relationship between diet score and weight change. RESULTS On average, women gained weight during follow-up (1.6 ± 6.2 kg) and had a mean baseline ARFS of 32.6 (SD 8.7) which was not optimal. There was no association between ARFS and weight change during follow-up (β= 0.016; p=0.08) in the fully adjusted model that included total energy intake, education, area of residence, baseline weight, physical activity, smoking and menopause status. CONCLUSIONS Weight gain and low ARFS were common. However, diet quality as measured by the ARFS did not predict six-year weight gain. IMPLICATIONS This lack of association may be due to limitations related to AFRS, or may be a false negative finding. Further research is warranted to evaluate the impact of promoting optimal diet quality on weight gain prospectively.
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Affiliation(s)
- Haya M A Aljadani
- School of Health Sciences, Faculty of Health, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, New South Wales, Australia
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Gomersall SR, Dobson AJ, Brown WJ. Weight Gain, Overweight, and Obesity: Determinants and Health Outcomes from the Australian Longitudinal Study on Women's Health. Curr Obes Rep 2014; 3:46-53. [PMID: 26626467 DOI: 10.1007/s13679-013-0077-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Recent estimates suggest that 35.3 % of adult Australians are overweight and a further 27.5 % are obese. The Australian Longitudinal Study on Women's Health (ALSWH) is a prospective study of women's health that commenced in Australia in 1996. The study recruited approximately 40,000 women in three birth cohorts, 1973-1978, 1946-1951 and 1921-1926, who have since been followed up approximately every three years using self-report surveys. Six surveys have been completed to date. This review aims to describe the changes in weight and weight status over time in the three ALSWH cohorts, and to review and summarise the published findings to date relating to the determinants and health consequences of weight gain, overweight and obesity. Future plans for the ALSWH include on-going surveys for all cohorts, with a seventh survey in 2013-2015, and establishment of a new cohort of women born in 1990-1995, which is currently being recruited.
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Affiliation(s)
- S R Gomersall
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, The University of Queensland, Level 5, Building 26B, Blair Drive, St Lucia, Brisbane, QLD, 4072, Australia.
| | - A J Dobson
- Centre for Longitudinal and Life Course Research, School of Population Health, The University of Queensland, Herston, Brisbane, Queensland, Australia.
| | - W J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement Studies, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
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Milder IEJ, de Hollander EL, Picavet HS, Verschuren WMM, de Groot LCPGM, Bemelmans WJE. Changes in weight and health-related quality of life. The Doetinchem Cohort Study. J Epidemiol Community Health 2014; 68:471-7. [PMID: 24385547 DOI: 10.1136/jech-2013-203127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The cross-sectional association between obesity and a lower health-related quality of life (HRQL) is clear. However, less is known about the association between changes in weight and HRQL. We examined the association between weight changes and changes in HRQL in a population-based sample of 2005 men and 2130 women aged 26-70 years. METHODS Weight was measured two or three times with 5-year intervals between 1995 and 2009, and was categorised as stable (change ≤2 kg, 40%), weight loss (19%), or weight gain 2.1-4.0 kg, 4.1-6.0 kg, or >6 kg (41%). Changes in HRQL (SF36 questionnaire, including physical and mental scales) per weight change category were compared with a stable weight using generalised estimating equations. RESULTS Weight gain was associated with declines of up to 5 points on five mainly physical scales and holds for different age categories. Especially for women, a dose-response relationship was observed, that is, larger weight gain was associated with larger declines in HRQL. Changes in HRQL for those with weight loss were small, but particularly on the mental scales, changes were in the negative direction compared to a stable weight. CONCLUSIONS Weight gain and weight loss were associated with unfavourable changes in HRQL compared with a stable weight. For weight gain, this was most pronounced on the physical scales and for weight loss, although less consistent, on the mental scales.
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Affiliation(s)
- Ivon E J Milder
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, , Bilthoven, The Netherlands
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15
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Are baby boomers booming too much? Obes Res Clin Pract 2013; 2:I-II. [PMID: 24351778 DOI: 10.1016/j.orcp.2008.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 05/08/2008] [Accepted: 05/08/2008] [Indexed: 11/21/2022]
Abstract
SUMMARY OBJECTIVE To provide a social, demographic, and health-related description of overweight and obese baby boomers (born between 1946 and 1964). METHOD Data were collected using a monthly chronic disease and risk factor surveillance system in which a representative random sample of South Australians are selected from the Electronic White Pages each month and interviewed using computer assisted telephone interviewing (CATI). RESULTS In 2006-2007, 65% of baby boomers in South Australia were overweight or obese, and 26% were obese. There were statistically significant increases in both categories between 2002 and 2007. In 2006-2007, the overweight or obese groups were significantly different on a wide range of social, demographic and health-related variables when compared to their non-overweight peers at the univariate level. In the multivariate analysis the obese group was more likely to have risk factors (high blood pressure, insufficient exercise) and chronic disease (diabetes, asthma, arthritis). They were also more likely to be in lower socio-economic areas, to be of Aboriginal or Torres Strait Islander origin and have lower levels of education. CONCLUSIONS Addressing the high rates of overweight and obesity within the baby boomers generation should be a policy priority. As this generation moves towards old age the significant associations between body mass index and chronic disease and disability promise to increase demand upon an already pressurized health system.
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Williams LT, Hollis JL, Collins CE, Morgan PJ. The 40-Something randomized controlled trial to prevent weight gain in mid-age women. BMC Public Health 2013; 13:1007. [PMID: 24156558 PMCID: PMC4016250 DOI: 10.1186/1471-2458-13-1007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 10/10/2013] [Indexed: 11/29/2022] Open
Abstract
Background Obesity prevention is a major public health priority. Despite the health risks associated with weight gain, there has been a distinct lack of research into effective interventions to prevent, rather than treat, obesity particularly at high risk life stages such as menopause in women. This paper describes the rationale for and design of a 2-year randomized controlled trial (RCT) (the 40-Something Study) aimed at testing the feasibility and efficacy of a relatively low intensity intervention designed to achieve weight control in non-obese women about to enter the menopause transition. Methods and design The study is a parallel-group RCT consisting of 12 months of intervention (Phase 1) and 12 months of monitoring (Phase 2). Non-obese pre-menopausal healthy females 44–50 years of age were screened, stratified according to Body Mass Index (BMI) category (18.5-24.9 and 25–29.9 kg/m2) and randomly assigned to one of two groups: motivational interviewing (MI) intervention (n = 28), or a self-directed intervention (SDI) (control) (n = 26). The MI intervention consisted of five consultations with health professionals (four with a Dietitian and one with an Exercise Physiologist) who applied components of MI counselling to consultations with the women over a 12 month period. The SDI was developed as a control and these participants received print materials only. Outcome measures were collected at baseline, three, 12, 18 and 24 months and included weight (primary outcome), waist circumference, body composition, blood pressure, plasma markers of metabolic syndrome risk, dietary intake, physical activity and quality of life. Analysis of covariance will be used to investigate outcomes according to intervention type and duration (comparing baseline, 12 and 24 months). Discussion The 40-Something study is the first RCT aimed at preventing menopausal weight gain in Australian women. Importantly, this paper describes the methods used to evaluate whether a relatively low intensity, health professional led intervention will achieve better weight control in pre-menopausal women than a self-directed intervention. The results will add to the scant body of literature on obesity prevention methods at an under-researched high-risk life stage, and inform the development of population-based interventions. Trial registration ACTRN12611000064909
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Affiliation(s)
- Lauren T Williams
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, 2308, Callaghan, NSW, Australia.
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de Hollander EL, Picavet HSJ, Milder IE, Verschuren WMM, Bemelmans WJE, de Groot LCPGM. The impact of long-term body mass index patterns on health-related quality of life: the Doetinchem Cohort Study. Am J Epidemiol 2013; 178:804-12. [PMID: 23820786 DOI: 10.1093/aje/kwt053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Overweight is associated with a reduced health-related quality of life (QOL), but less is known about the impact of long-term body mass index (BMI, calculated as weight (kg)/height (m)(2)) patterns on QOL in adults. In the Dutch Doetinchem Cohort Study (1989-2009) that included 1,677 men and 1,731 women aged 20-66 years, 6 BMI patterns were defined by using 4 measurements over a 15-year period: 1) persistent healthy weight (18.5-24.9, reference pattern); 2) persistent overweight (25.0-29.9); 3) persistent obesity (≥30.0); 4) developing overweight; 5) developing obesity; and 6) switching between BMI categories. For each BMI pattern, adjusted QOL (measured on a 0-100 scale) was estimated at the end of this period. The lowest QOL was observed for persistent obesity of all BMI patterns. It was 5.0 points (P = 0.02) lower for 1 mental dimension in men and 6.2-11.6 points (P < 0.05) lower for 5 (mainly physical) dimensions in women. Developing overweight or obesity scored 1.8-6.3 points (P < 0.05) lower on 2-5 (mainly physical) dimensions. Persistent overweight hardly differed from a persistent healthy weight. In women, switching between BMI categories resulted in a lower QOL on the mental dimensions. Studying long-term BMI patterns over a 15-year period showed that persistent obesity, developing overweight, and developing obesity resulted in a lower QOL-particularly on the physical dimensions-compared with a persistent healthy weight.
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Affiliation(s)
- Ellen L de Hollander
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
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Singh G, Jackson CA, Dobson A, Mishra GD. Bidirectional association between weight change and depression in mid-aged women: a population-based longitudinal study. Int J Obes (Lond) 2013; 38:591-6. [PMID: 23846452 DOI: 10.1038/ijo.2013.127] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 06/18/2013] [Accepted: 06/26/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is some evidence for a bidirectional association between obesity and depression. However, studies examining weight change and depression are scarce and report inconsistent findings. OBJECTIVE The objective was to investigate the relationship between average annual percentage weight change and depression in mid-aged women. DESIGN This was a prospective cohort study. SUBJECTS A total of 8246 women aged 45-50 years at baseline participating in the Australian Longitudinal Study on Women's Health were surveyed every 3 years over a 12-year period. Information on body mass index and depression was collected at each survey. We used regression models to investigate the effect of weight change predicting depression and vice versa, by calculating odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Weight gain was associated with an increased risk of prevalence (OR 1.39, 95% CI 1.25-1.56) and incidence (OR 1.30, 95% CI 1.14-1.49) of depression. However, in time-lagged analyses, where weight change between the two preceding surveys was used to predict incidence of depression at the current survey, no statistically significant associations with depression were found. Compared with women without depression, women with prevalent and incident depression had an increased risk of weight gain (OR 1.29, 95% CI 1.19-1.40 and OR 1.20, 95% CI 1.05-1.38, respectively). When incidence of depression was lagged with respect to weight change between the two subsequent surveys, depression remained associated with an increased risk (OR 1.19, 95% CI 1.00-1.41) of gaining weight. CONCLUSION These findings suggest that depression may cause weight gain over the next 3 years, but that weight change (loss or gain) may not lead to depression. Further research at shorter intervals, perhaps 6 monthly or yearly is needed to ascertain whether weight change is an independent predictor of depression in the shorter term.
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Affiliation(s)
- G Singh
- Centre for Longitudinal and Life Course Research, School of Population Health, University of Queensland, Herston, Queensland, Australia
| | - C A Jackson
- Centre for Longitudinal and Life Course Research, School of Population Health, University of Queensland, Herston, Queensland, Australia
| | - A Dobson
- Centre for Longitudinal and Life Course Research, School of Population Health, University of Queensland, Herston, Queensland, Australia
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, School of Population Health, University of Queensland, Herston, Queensland, Australia
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Madden CEL, Leong SL, Gray A, Horwath CC. Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutr 2012; 15:2272-9. [PMID: 22443858 PMCID: PMC10271589 DOI: 10.1017/s1368980012000882] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 02/06/2012] [Accepted: 02/10/2012] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association between eating in response to hunger and satiety signals (intuitive eating) and BMI. A second objective was to determine whether the hypothesized higher BMI in less intuitive eaters could be explained by the intake of specific foods, speed of eating or binge eating. DESIGN Cross-sectional survey. Participants were randomly selected from a nationally representative sampling frame. Eating in response to hunger and satiety signals (termed 'intuitive eating'), self-reported height and weight, frequency of binge eating, speed of eating and usual intakes of fruits, vegetables and selected high-fat and/or high-sugar foods were measured. SETTING Nationwide study, New Zealand. SUBJECTS Women (n 2500) aged 40-50 years randomly selected from New Zealand electoral rolls, including Māori rolls (66 % response rate; n 1601). RESULTS Intuitive Eating Scale (IES) scores were significantly associated with BMI in an inverse direction, after adjusting for potential confounding variables. When controlling for confounding variables, as well as potential mediators, the inverse association between intuitive eating (potential range of IES score: 21-105) and BMI was only slightly attenuated and remained statistically significant (5.1 % decrease in BMI for every 10-unit increase in intuitive eating; 95 % CI 4.2, 6.1 %; P < 0.001). The relationship between intuitive eating and BMI was partially mediated by frequency of binge eating. CONCLUSIONS Eating in response to hunger and satiety signals is strongly associated with lower BMI in mid-age women. The direction of causality needs to be investigated in longitudinal studies and randomized controlled trials.
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Affiliation(s)
- Clara EL Madden
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
| | - Sook Ling Leong
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
| | - Andrew Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Caroline C Horwath
- Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand
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20
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The effect of social class on mid-age women's weight control practices and weight gain. Appetite 2011; 56:719-25. [DOI: 10.1016/j.appet.2011.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 01/30/2011] [Accepted: 02/10/2011] [Indexed: 11/23/2022]
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Rohrer JE, Merry SP, Thacher TD, Summers MR, Alpern JD, Contino RW. Self-assessed disability and self-rated health among rural villagers in Peru: a brief report. J Rural Health 2011; 26:294-8. [PMID: 20633098 DOI: 10.1111/j.1748-0361.2010.00293.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. PURPOSE The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. METHODS A door-to-door survey of villagers residing in the Pampas Grande region in Peru, which is in the Andes Mountains, yielded complete data for 337 adults. FINDINGS Adjusting for age and gender using multiple logistic regression analysis revealed that having self-reported disabilities was inversely and independently related to good self-rated health (OR 0.48 [95% CI, 0.26-0.88]). Joint pain also was related to self-rated health (OR 0.23 [95% CI, 0.13-0.41]). CONCLUSIONS Increasing access to affordable, effective analgesics may reduce this disparity. Health agencies should consider these actions as possible planning priorities for the region.
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Affiliation(s)
- James E Rohrer
- Department of Family Medicine, Mayo Clinic-Rochester, Rochester, Minnesota 55905, USA.
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Rohrer JE, Herman DC, Merry SP, Naessens JM, Houston MS. Validity of overall self-rated health as an outcome measure in small samples: a pilot study involving a case series. J Eval Clin Pract 2009; 15:366-9. [PMID: 19335498 DOI: 10.1111/j.1365-2753.2008.01017.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE A single-item measure of overall self-rated health (SRH) commonly is used in population surveys, but has not been used in small pilot projects. The purpose of this study was to assess the validity of SRH in small samples. DESIGN We used data from a prospective, observational weight-loss project to compare change in SRH with change in body weight and physical activity (PA) (minutes) over 30 days (n = 34). Body mass index at baseline ranged from 25.5 to 50.4 (mean = 36.1, median = 34.6). SRH was self-assessed using the following question: How would you rate your health overall? Results An increase in weight was associated with a reduction in SRH (r = 0.37, P = 0.03). An increase in PA was associated with improved SRH (r = 0.39, P = 0.02). CONCLUSIONS A single-item SRH measure may be an efficient method for measuring programme outcomes, and may also be useful for comparing the relative effectiveness of different programmes in pilot projects and quality improvement studies.
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Affiliation(s)
- James E Rohrer
- Department of Family Medicine, Mayo Clinic-Rochester, Rochester, MN, USA.
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Simonsen MK, Hundrup YA, Grønbaek M, Heitmann BL. A prospective study of the association between weight changes and self-rated health. BMC WOMENS HEALTH 2008; 8:13. [PMID: 18691402 PMCID: PMC2532681 DOI: 10.1186/1472-6874-8-13] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Accepted: 08/08/2008] [Indexed: 12/02/2022]
Abstract
Background Obesity and self-rated health (SRH) are strong predictors of morbidity and mortality but their interrelation is sparsely studied. The aim of this study was to analyse the association between weight changes and changes in SRH among women. We also examined if poor SRH at baseline was associated with later weight gain. Methods The Danish Nurse Cohort Study is a prospective population study (1993–1999) and comprises 13,684 female nurses aged 44 to 69 years. Logistic regression analyses were used to examine the association between weight changes and changes in SRH. Results Women who gained weight during the study period had higher odds of reporting poorer self-rated health (Odds Ratio (OR): 1.18, 95% CI: 1.04–1.35). Weight loss among overweight women, did not result in an increase in self-rated health ratings, in fully adjusted analyses (0.96 (95% CI: 0.76–1.23). Poor self-rated health combined with normal weight at first examination was associated with higher odds of later weight gain (OR: 1.29, 95% CI: 1.10–1.51). Conclusion Weight changes may result in lower SRH. Further, poor self-rated health at baseline seems to predict an increase in weight, among women without any longstanding chronic diseases. Future obesity prevention may focus on normal weight individuals with poor SRH.
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Affiliation(s)
- Mette K Simonsen
- Research Unit for Dietary Studies, Institute of Preventive Medicine, Centre for Health and Society, Copenhagen, Denmark.
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Llaneza P, Iñarrea J, Gonzalez C, Alonso A, Arnott I, Ferrer-Barriendos J. Differences in health related quality of life in a sample of Spanish menopausal women with and without obesity. Maturitas 2007; 58:387-94. [PMID: 17997059 DOI: 10.1016/j.maturitas.2007.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 09/21/2007] [Accepted: 09/25/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate whether body mass index, abdominal obesity or fat distribution in postmenopausal women influence their quality of Life. METHODS A cross-sectional study was carried out on 250 postmenopausal women (age: 50-64 years), with intact uterus and ovaries, sexually active, and non-hormone therapy users. Various anthropometric measurements were considered and a specific health-related quality of life (HR-QoL) instrument, the Cervantes scale, was performed. RESULTS Thirty-three women were not included as they refused to participate in the study, had chronic disease such as hypertension, diabetes type 2, depression or did not answer all the scale items, so 217 patients were evaluated. According with BMI values, 34% of women were obese, 46.1% were in overweight, 19.8% were in normal weight and there were not underweight women. Any consistent relation was found between BMI and global values of HR-QoL, but obese women were diagnosed with "high level of problems" in the "psychical domain" and in the "sexuality domain". This difference in "sexuality domain" was also appreciated in women with abdominal obesity. Fat or lean mass was not correlated with HR-QoL. CONCLUSION In our study, obesity did not affect the global HR-QoL in Spanish postmenopausal women, but could have an influence on the psychical and sexual domains. Others anthropometric measurements are not associated with changes in HR-QoL. Additional research with HR-QoL specific and validated instruments and with a longitudinal design seems necessary to confirm our results.
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Affiliation(s)
- Placido Llaneza
- Central University Hospital of Asturias, C/ Celestino Villamil s/n, 33006 Oviedo, Spain.
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Rohrer JE, Merry SP, Lopez-Jimenez F, Adamson SC, Wilshusen L. A Patient-Centered Decision Rule for Referral of Patients to Weight-Loss Programs. Qual Manag Health Care 2007; 16:250-5. [PMID: 17627220 DOI: 10.1097/01.qmh.0000281061.15108.f8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The obesity epidemic threatens to shorten life expectancy and reduce the quality of life for large segments of the population. The purpose of this study was to develop a decision rule for referral to a weight-loss program on the basis of the relationship between body mass index (BMI) and self-rated overall health. METHODS We employed a patient satisfaction survey of family medicine patients treated in Mayo Clinic in Rochester, Minnesota, linked with medical record information, to test the theory that, in primary care patients, BMI exhibits an inverse and independent relationship with overall self-rated health after adjusting for age, gender, marital status, and cigarette smoking. Interviews were linked to medical records for 679 adult patients. RESULTS Adjusting for age and other confounders using multiple logistic regression analysis revealed that overweight (BMI = 25-30 kg/m(2)) was not a risk factor for poor self-rated health and only BMI above 35 kg/m(2) was significantly related to poor overall health (adjusted odds ratio = 0.33, confidence interval = 0.17-0.64, P = .0012). CONCLUSIONS Quality improvement programs should monitor whether obesity is being addressed in clinical settings. A patient-centered decision rule for addressing obesity could involve referral of patients whose BMI is above 35 kg/m(2) to weight management programs, monitoring of patients whose BMI scores are between 30 and 35 kg/m(2), and encouragement of patients whose BMI is above 25 kg/m(2) to avoid weight gain.
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Williams L, Germov J, Young A. Preventing weight gain: a population cohort study of the nature and effectiveness of mid-age women's weight control practices. Int J Obes (Lond) 2007; 31:978-86. [PMID: 17264847 DOI: 10.1038/sj.ijo.0803550] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine women's weight control practices and their effectiveness in preventing weight gain. DESIGN Retrospective cohort study of weight control practices and 2-year weight change among mid-age women participating in the Australian Longitudinal Study on Women's Health (ALSWH). SUBJECTS 11,589 Australian women (aged 47-52 years). MEASUREMENTS The prevalence and types of self-reported weight control practices used were assessed by a nine-item instrument. Two-year weight change was self-reported and adjusted for baseline body mass index (BMI) and other potential confounders. RESULTS Seventy-four per cent of the cohort (N=8556) reported actively trying to control their weight. Dietary modification was used more frequently than exercise. Two-thirds of the weight-controlling women used a combination of practices, the two most common being 'decreased food quantity, cut down on fats/sugars and exercise' (32%, baseline BMI 25.87(0.10)), and 'decreased food quantity and cut down on fats/sugars without exercise' (15.6%, baseline BMI 27.04(0.14)). Potentially health-damaging practices (smoking, laxatives, fasting) were relatively uncommon, at 7.9%. Only one combination of practices (decreased food quantity, cut down on fats/sugars, use of a commercial weight loss programme and exercise) prevented mean weight gain (-0.03 kg), whereas the mean (s.d.) weight of the cohort increased (+1.19(4.78)) over the 2-year period. CONCLUSIONS The majority of mid-age women attempting weight control used practices consistent with public health messages. Despite their efforts, the group was mostly unsuccessful in preventing weight gain. Public health authorities and health practitioners may need to make more quantitative recommendations and emphasize the importance of balancing physical activity with dietary intake to achieve successful weight control for women at this life stage.
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Affiliation(s)
- L Williams
- School of Health Sciences, The University of Newcastle, Callaghan, Australia.
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