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Salerno PRVO, Qian A, Dong W, Deo S, Nasir K, Rajagopalan S, Al-Kindi S. County-level socio-environmental factors and obesity prevalence in the United States. Diabetes Obes Metab 2024; 26:1766-1774. [PMID: 38356053 DOI: 10.1111/dom.15488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Abstract
AIMS To investigate high-risk sociodemographic and environmental determinants of health (SEDH) potentially associated with adult obesity in counties in the United States using machine-learning techniques. MATERIALS AND METHODS We performed a cross-sectional analysis of county-level adult obesity prevalence (body mass index ≥30 kg/m2) in the United States using data from the Diabetes Surveillance System 2017. We harvested 49 county-level SEDH factors that were used in a classification and regression trees (CART) model to identify county-level clusters. The CART model was validated using a 'hold-out' set of counties and variable importance was evaluated using Random Forest. RESULTS Overall, we analysed 2752 counties in the United States, identifying a national median (interquartile range) obesity prevalence of 34.1% (30.2%, 37.7%). The CART method identified 11 clusters with a 60.8% relative increase in prevalence across the spectrum. Additionally, seven key SEDH variables were identified by CART to guide the categorization of clusters, including Physically Inactive (%), Diabetes (%), Severe Housing Problems (%), Food Insecurity (%), Uninsured (%), Population over 65 years (%) and Non-Hispanic Black (%). CONCLUSION There is significant county-level geographical variation in obesity prevalence in the United States, which can in part be explained by complex SEDH factors. The use of machine-learning techniques to analyse these factors can provide valuable insights into the importance of these upstream determinants of obesity and, therefore, aid in the development of geo-specific strategic interventions and optimize resource allocation to help battle the obesity pandemic.
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Affiliation(s)
- Pedro R V O Salerno
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center & Case Western Reserve University, Cleveland, Ohio, USA
| | - Alice Qian
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Weichuan Dong
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Salil Deo
- Surgical Services, Louis Stokes VA Medical Center, and Case Western Reserve University, Cleveland, Ohio, USA
| | - Khurram Nasir
- Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center & Case Western Reserve University, Cleveland, Ohio, USA
| | - Sadeer Al-Kindi
- Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
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Pinheiro LCHT, Rossi M, dos Santos CAF, Oliveira LVF, Vencio S, de Paula Vieira R, Juliano Y, Armond J, Silva CHM, Fonseca AL, França CN, Bachi ALL. Prevalence of associations among sarcopenia, obesity, and metabolic syndrome in Brazilian older adults. Front Med (Lausanne) 2023; 10:1206545. [PMID: 37746072 PMCID: PMC10514480 DOI: 10.3389/fmed.2023.1206545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background Although aging is a process associated with the development of obesity, metabolic syndrome (MetS), and sarcopenia, the prevalence of these conditions in older adults from São Paulo, Brazil, is unclear. Methods Therefore, the current study aimed to investigate the prevalence of obesity, sarcopenia, and MetS, both separately and together, in a community-based sample of older adults from São Paulo, Brazil. Data from the medical records of 418 older adults of both genders, aged 60 years or older (mean age 69.3 ± 6.5 years), who were not physically active, were used to conduct this retrospective cross-sectional study. Anthropometric variables were used to determine both body mass index (BMI) and Conicity index (C index). Sarcopenia and MetS were defined according to the criteria of the European Working Group on Sarcopenia in Older People and by the Brazilian Society of Endocrinology and Metabolism, respectively. Results Based on BMI, the group of older men (n = 91) showed a predominance of adequate weight (n = 49) and the group of older women (n = 327) showed a predominance of obesity (n = 181). In association with obesity, while only the group of older women presented with sarcopenia (n = 5), 52 older women and 9 older men presented with MetS, and two older women presented with sarcopenia + MetS [prevalence ratio = 0.0385, 95% CI (0.007;0.1924)]. Based on the C index, 58 older women and 11 older men presented with MetS, while the occurrence of sarcopenia or MetS + sarcopenia was found in 32 and 5 older women, respectively [prevalence ratio = 0.0910, 95% CI (0.037;0.2241)]. Discussion Our results suggest that obesity, as measured by BMI or the C Index, was more closely associated with the occurrence of MetS than sarcopenia, regardless of gender, and also that sarcopenic obesity was only found in the group of older women. Additionally, the prevalence ratio of obesity, sarcopenia, and MetS evidenced using the C index was 2.3 times higher than the values found using the BMI classification.
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Affiliation(s)
| | - Marcelo Rossi
- Post-graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Carlos André Freitas dos Santos
- Discipline of Geriatrics and Gerontology, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Postgraduate Program in Translational Medicine, Department of Medicine, Paulista School of Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Luis Vicente Franco Oliveira
- Human Movement and Rehabilitation Post Graduation Program, Evangelical University of Goiás (UniEVANGELICA), Anápolis, Brazil
| | - Sergio Vencio
- Institute of Pharmaceutical Sciences, Goiania, Brazil
| | - Rodolfo de Paula Vieira
- Human Movement and Rehabilitation Post Graduation Program, Evangelical University of Goiás (UniEVANGELICA), Anápolis, Brazil
- Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, Brazil
- Post-graduation Program in Science of Human and Rehabilitation, Federal University of São Paulo (UNIFESP), Santos, Brazil
| | - Yara Juliano
- Post-graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Jane Armond
- Post-graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo, Brazil
| | - Carlos Hassel Mendes Silva
- Human Movement and Rehabilitation Post Graduation Program, Evangelical University of Goiás (UniEVANGELICA), Anápolis, Brazil
| | - Adriano Luís Fonseca
- Human Movement and Rehabilitation Post Graduation Program, Evangelical University of Goiás (UniEVANGELICA), Anápolis, Brazil
| | - Carolina Nunes França
- Post-graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo, Brazil
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Cullin JM. Biological normalcy and body fat: Obesity prevalence, fat stigma, and allostatic load among late adolescents and young adults. Am J Biol Anthropol 2023. [PMID: 37096804 DOI: 10.1002/ajpa.24752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 03/17/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVES Biological normalcy provides a framework to assess tensions between clinical definitions of "normal," statistical norms, and normative beliefs. A prevailing cultural belief is obesity directly causes poor health, but research has demonstrated consequences of fat stigma. Previous research linked fat stigma and allostatic load (AL) in adults, but this has not been demonstrated in youth, and the role of obesity prevalence is unknown. This study assesses the relationship between fat stigma and AL among youth from counties varying by obesity prevalence. MATERIALS AND METHODS Undergraduates from 38 counties across the US state of Indiana (n = 175) were recruited. Fat stigma was measured using the brief stigmatizing situations inventory (SSI). AL was calculated using eight biomarkers representing cardiovascular, metabolic, and immune function. Poisson regression assessed relationships of interest and adjusted for potential confounding. An interaction term and stratified analyses were used to assess moderation. RESULTS SSI was not statistically associated with obesity prevalence (RR = 0.96, p = 0.173) but did statistically significantly predict AL (RR = 1.019, p = 0.045) when adjusting for confounders. Obesity prevalence moderated the relationship between SSI and AL (RR = 0.993, p = 0.001). DISCUSSION Results suggest that fat stigma, regardless of body fat percentage, is associated with physiologic wear and tear on the late adolescent body, and that exposure to obesity during earlier adolescence moderates this relationship. Those most at risk for high AL reported high fat stigma and lived in counties with relatively low obesity prevalence during earlier adolescence, suggesting vulnerability to fat stigma may be heightened where obesity is less common.
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Affiliation(s)
- Jennifer M Cullin
- Department of Anthropology, Indiana University, Bloomington, Indiana, USA
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Pou SA, Wirtz Baker JM, Aballay LR. [Obesity epidemic: current evidence, challenges and future directions]. Medicina (B Aires) 2023; 83:283-289. [PMID: 37094198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
The obesity epidemic is a phenomenon that has been widely studied in recent decades but is still incompletely understood, and its control is far from the desirable level in view of the increasing prevalence figures observed worldwide. This paper conducts a narrative review with the aim of providing updated evidence on the global obesity epidemic, and particularly on the situation in Latin America and Argentina, identifying the main challenges and future directions for addressing this public health problem. It first describes the current burden and increasing trends in the prevalence of obesity, in the overall population and by population groups, and its possible association with genetic and epigenetic aspects. It also summarizes the direct and indirect socioeconomic consequences of this epidemic, as well as recent strategies and initiatives focused on obesity prevention, with special attention to those reported as the most efficient in the Latin American context. This review identified some pending challenges in the region, the integrated approach to the double burden of malnutrition and the growing childhood overweight; and it points out some emerging approaches, such as the syndemic approach, as potentially useful to understand and address this complex problem in the current context. In conclusion, it highlights the importance of implementing renewed, more efficient and evidence-based strategies to control the growing prevalence of obesity, which would also impact on the burden of related chronic diseases, and thus on the economy and well-being of Latin American societies.
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Affiliation(s)
- Sonia A Pou
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Facultad de Ciencias Médicas, CONICET, Universidad Nacional de Córdoba, Argentina. E-mail:
- Centro de Investigaciones en Nutrición Humana (CenINH), Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | - Julia M Wirtz Baker
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Facultad de Ciencias Médicas, CONICET, Universidad Nacional de Córdoba, Argentina
- Centro de Investigaciones en Nutrición Humana (CenINH), Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
| | - Laura R Aballay
- Centro de Investigaciones en Nutrición Humana (CenINH), Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina
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Parkinson M, Thompson J. An exploration of the challenges of providing person-centred care for older care home residents with obesity. Health Soc Care Community 2022; 30:e1112-e1122. [PMID: 34268838 DOI: 10.1111/hsc.13519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 05/27/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study was to explore care home staff's views on the prevalence of obesity in older people and how well prepared they were for any rise in applications for placements. Thematic analysis was used to analyse focus group interview data collected from seven care homes/33 participants in N.E. England. Findings revealed rises in demand by older people with obesity for care home admittance, consistent with rising prevalence of obesity in this demographic nationally. Findings also highlight implications of rising prevalence of obesity in older people, particularly care home staff's ability to deliver person-centred care (PCC) and the importance of appropriate support/recognition of this as an emergent issue to be addressed at a higher executive level and by health/social care authorities. Ways of ensuring PCC are discussed. Given continuing trends towards rising prevalence of obesity in this population, the findings possess broader translational potential.
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Affiliation(s)
- Mark Parkinson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
- Fuse, Centre for Translational Research in Public Health-a UK Clinical Research Collaboration Centre for Translational Research in Public Health & NIHR School for Public Health Research (SPHR) Centre of Excellence, Newcastle, UK
| | - Juliana Thompson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
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Foo O, Hiu S, Teare D, Syed AA, Razvi S. A global country-level analysis of the relationship between obesity and COVID-19 cases and mortality. Diabetes Obes Metab 2021; 23:2697-2706. [PMID: 34402152 PMCID: PMC8444639 DOI: 10.1111/dom.14523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 12/20/2022]
Abstract
AIM To assess the association of country-level obesity prevalence with COVID-19 case and mortality rates, to evaluate the impact of obesity prevalence on worldwide variation. METHODS Data on COVID-19 prevalence and mortality, country-specific governmental actions, socioeconomic, demographic, and healthcare capacity factors were extracted from publicly available sources. Multivariable negative binomial regression was used to assess the independent association of obesity with COVID-19 case and mortality rates. RESULTS Across 168 countries for which data were available, higher obesity prevalence was associated with increased COVID-19 mortality and prevalence rates. For every 1% increase in obesity prevalence, the mortality rate was increased by 8.3% (incidence rate ratio [IRR] 1.083, 95% confidence interval [CI] 1.048-1.119; P < 0.001) and the case rate was higher by 6.6% (IRR 1.066, 95% CI 1.035-1.099; P < 0.001). Additionally, higher median population age, greater female ratio, higher Human Development Index (HDI), lower population density, and lower hospital bed availability were all significantly associated with higher COVID-19 mortality rate. In addition, stricter governmental actions, higher HDI and lower mean annual temperature were significantly associated with higher COVID-19 case rate. CONCLUSION These findings demonstrate that obesity prevalence is a significant and potentially modifiable risk factor of increased COVID-19 national caseload and mortality. Future research to study whether weight loss improves COVID-19 outcomes is urgently required.
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Affiliation(s)
- Oliver Foo
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Shaun Hiu
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Dawn Teare
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | | | - Salman Razvi
- Translational and Clinical Research InstituteNewcastle UniversityNewcastle upon TyneUK
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Yamada G, Castillo-Salgado C, Jones-Smith JC, Moulton LH. Obesity prediction by modelling BMI distributions: application to national survey data from Mexico, Colombia and Peru, 1988-2014. Int J Epidemiol 2021; 49:824-833. [PMID: 31665300 DOI: 10.1093/ije/dyz195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The prediction of future obesity patterns is crucial for effective strategic planning. However, disproportionally changing body mass index (BMI) distributions pose particular challenges. Flexible modelling of the shape of BMI distributions may improve prediction performance. METHODS We used data from repeated national health surveys conducted in Mexico, Colombia and Peru at four or five time points between 1988 and 2014. Data from all surveys except the last survey were used to construct prediction models for three obesity indicators (median BMI, overweight/obesity prevalence and obesity prevalence) for the time of the last survey. We assessed their performance using predicted curves, absolute prediction errors and comparison of actual and predicted distributions. With one method, we modelled the shape of BMI distributions assuming BMI follows a Box-Cox Power Exponential (BCPE) distribution, whose parameters were modelled as a function of interval or nominal 5-year age groups, time and their interaction terms. In a second method, we modelled each of the obesity indicators directly as a function of the same covariates using quantile and logistic regression. RESULTS The BCPE model with interval age groups yielded the best prediction performance in predicting obesity prevalence. Average absolute prediction errors across all age groups were 4.3 percentage points (95% percentile interval: 1.9, 7.5), 2.5 (1.2, 6.1) and 1.7 (1.0, 9.3), with data from Mexico, Colombia and Peru, respectively. This superiority was weak or none for overweight/obesity prevalence and median BMI. CONCLUSION The BCPE model performed better for prediction of the extremes of BMI distribution, possibly by incorporating its shape more precisely.
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Affiliation(s)
- Goro Yamada
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, Room 717D, Philadelphia, PA 19104, USA. E-mail:
| | - Carlos Castillo-Salgado
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Jessica C Jones-Smith
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.,Department of Health Services/Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA
| | - Lawrence H Moulton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Venkatrao M, Nagarathna R, Majumdar V, Patil SS, Rathi S, Nagendra H. Prevalence of Obesity in India and Its Neurological Implications: A Multifactor Analysis of a Nationwide Cross-Sectional Study. Ann Neurosci 2020; 27:153-161. [PMID: 34556954 PMCID: PMC8455012 DOI: 10.1177/0972753120987465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND India is undergoing a rapid epidemiological transition, from underweight to overweight/obese population. Obesity is a major risk factor in type 2 diabetes and cardiovascular diseases, and is also implicated as a factor in neurological diseases such as Alzheimer's disease. A robust, pan-Indian estimate of obesity is not yet available. PURPOSE This study estimates the pan-Indian prevalence of obesity, stratified across nonmodifiable (age and gender) and modifiable (education and physical activity levels) factors, and across zones and urban/rural. METHODOLOGY Data for 1,00,531 adults from a nationwide randomized cluster sample survey (Niyantrita Madhumeha Bharata 2017, phase 1) were analyzed. Obesity was determined using body mass index, and cross-tabulations were calculated across zones, age, gender, education, physical activity, and area. To determine statistical significance, t-tests were used. The odds of obesity within each category of the various factors were calculated using binary logistic regression. RESULTS Prevalence of obesity in India is 40.3%. Zonal variations were seen as follows: south highest at 46.51% and east lowest at 32.96%. Obesity was higher among women than men (41.88% vs. 38.67%), urban than rural (44.17% vs. 36.08%), and over 40 than under 40 (45.81% vs. 34.58%). More education implied a higher obesity (44.6% college vs. 38% uneducated), as did lowered physical activity (43.71% inactive vs. 32.56% vigorously active). The odds ratio for physical activity was 3.83, stronger than age (1.58), education (1.4), urban (1.3), and gender (1.2). CONCLUSION Obesity levels in India are very high, across all zones. The odds of being obese increases with age, and is higher among women and among urban dwellers. Obesity is the highest among aging urban men and women who are college educated and are sedentary. Physical activity and aging are the strongest determinants of obesity. Given the high cost of obesity in terms of type 2 diabetes, cardiovascular diseases, and Alzheimer's disease, urgent public health measures are necessary to reduce its impact.
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Affiliation(s)
- Murali Venkatrao
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Raghuram Nagarathna
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Vijaya Majumdar
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Suchitra S. Patil
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Sunanda Rathi
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
| | - Hongasandra Nagendra
- Division of Yoga and Life Sciences, SVYASA University, Prashanti Kutiram, Jigani, Bengaluru, Karnataka, India
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Rudolf M, Perera R, Swanston D, Burberry J, Roberts K, Jebb S. Observational analysis of disparities in obesity in children in the UK: Has Leeds bucked the trend? Pediatr Obes 2019; 14:e12529. [PMID: 31022330 PMCID: PMC6767538 DOI: 10.1111/ijpo.12529] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/01/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND The prevalence of obesity in childhood is of high concern, especially in deprived populations. We explored trends in obesity following the introduction of a citywide strategy focused on preschool children. METHODS Analysis of obesity prevalence using the National Child Measurement Programme 2009 to 2017 for primary-school children in Leeds using 5-year aggregated data for Leeds, comparable cities, and England as a whole. RESULTS Prevalence of obesity in Leeds for school entry children fell significantly (9.4% to 8.8%), whilst comparable cities (CC) and England as a whole showed no change (comparison of trends: P < 0.001 and P < 0.001). The reduction in Leeds was primarily in the most deprived (11.5% to 10.5%; trend comparison CC: P < 0.001, Eng: P < 0.001), but also amongst the affluent (6.8% to 6.0%; trend comparison CC: P = 0.087, Eng: P = 0.012). Prevalence in older children in Leeds was unchanged whilst it increased for comparable cities and England (trend comparison CC: P < 0.001, Eng: P < 0.001). In the deprived, obesity increased: Leeds by 1.4%; CC 1.3%, England 1% (trend comparison Eng: P = 0.004). In the affluent, obesity prevalence reduced more in Leeds than elsewhere: 2% in Leeds, 0.8% in CC, and 0.7% in England (trend comparison CC: P < 0.001, Eng: P ≤ 0.001). CONCLUSIONS There has been a notable decrease in the prevalence of obesity especially amongst the most disadvantaged children at entry to primary school in Leeds. How this was achieved merits in-depth consideration.
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Affiliation(s)
- Mary Rudolf
- Department of Population Health, Azrieli Faculty of MedicineBar Ilan UniversitySafedIsrael
| | - Rafael Perera
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | | | - Janice Burberry
- Public Health (Children and Families) Adults and Health DirectorateLeedsUK
| | | | - Susan Jebb
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
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Rouse H, Goudie A, Rettiganti M, Leath K, Riser Q, Thompson J. Prevalence, Patterns, and Predictors: A Statewide Longitudinal Study of Childhood Obesity. J Sch Health 2019; 89:237-245. [PMID: 30740717 DOI: 10.1111/josh.12741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 06/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND We examined prevalence, incidence, and trajectory of obesity from kindergarten through grade 8 in one of the first states to implement annual surveillance. METHODS Participants included 16,414 children enrolled in kindergarten in Arkansas in 2004 with complete body mass index (BMI) measurements in kindergarten and eighth grade. Repeated measures of weight status were entered in multiple linear and logistic regression models with demographics and family poverty status. RESULTS The prevalence of obesity (BMI ≥ 95th percentile) was lowest in kindergarten (14.9%), with subsequent incidence rates consistent at 4%. Prevalence and incidence peaked in eighth grade (24.5% and 4.9%, respectively), with 33.8% of children measuring obese at least once by eighth grade. Kindergarten obesity was a significant predictor of eighth grade obesity (odds ratio, 17.5; 95% confidence interval, 15.8-19.3). We found statistically significant 3-way interactions for sex, race, and time, suggesting unique patterns for Hispanic boys and black girls. CONCLUSIONS Our study documents unique longitudinal patterns of obesity from kindergarten through eighth grade that expand our understanding of risk. It demonstrates the value of public school health systems that collect routine administrative data about student BMI that is integrated with education records to foster program and policy discussions.
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Affiliation(s)
- Heather Rouse
- Assistant Professor, , Iowa State University, 2360 Palmer, Ames, IA 50011
| | - Anthony Goudie
- Associate Professor, , University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202
| | - Mallik Rettiganti
- Assistant Professor, , University of Arkansas for Medical Sciences, 13 Children's Way, Little Rock, AR 72202
| | - Katherine Leath
- Program Administrator for Health Literacy Services and Communication, , UAMS Center for Health Literacy, 5800 W 10th Street, Suite 502, Little Rock, AR 72204
| | - Quentin Riser
- NSF Graduate Research Fellow, , Iowa State University, 1089 Lebaron, Ames, IA 50011
| | - Joseph Thompson
- Director, , Arkansas Center for Health Improvement, 1401 West Capitol Avenue Suite 300, Little Rock, AR 72201
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Strugnell C, Orellana L, Hayward J, Millar L, Swinburn B, Allender S. Active (Opt-In) Consent Underestimates Mean BMI-z and the Prevalence of Overweight and Obesity Compared to Passive (Opt-Out) Consent. Evidence from the Healthy Together Victoria and Childhood Obesity Study. Int J Environ Res Public Health 2018; 15:ijerph15040747. [PMID: 29652831 PMCID: PMC5923789 DOI: 10.3390/ijerph15040747] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 12/21/2022]
Abstract
Background: Tracking population trends in childhood obesity and identifying target areas for prevention requires accurate prevalence data. This study quantified the magnitude of non-participation bias for mean Body Mass Index-z scores and overweight/obesity prevalence associated with low (opt-in) compared to high (opt-out) participation consent methodologies. Methods: Data arose from all Local Government Areas (LGAs) participating in the Healthy Together Victoria Childhood Obesity Study, Australia. Primary schools were randomly selected in 2013 and 2014 and all Grades 4 and 6 students (aged approx. 9-12 years) were invited to participate via opt-in consent (2013) and opt-out consent (2014). For the opt-in wave N = 38 schools (recruitment rate (RR) 24.3%) and N = 856 students participated (RR 36.3%). For the opt-out wave N = 47 schools (RR 32%) and N = 2557 students participated (RR 86.4%). OUTCOMES differences between opt-in and opt-out sample estimates (bias) for mean BMI-z, prevalence of overweight/obesity and obesity (alone). Standardized bias (Std bias) estimates defined as bias/standard error are reported for BMI-z. Results: The results demonstrate strong evidence of non-participation bias for mean BMI-z overall (Std bias = -4.5, p < 0.0001) and for girls (Std bias = -5.4, p < 0.0001), but not for boys (Std bias = -1.1, p = 0.15). The opt-in strategy underestimated the overall population prevalence of overweight/obesity and obesity by -5.4 and -4.5 percentage points respectively (p < 0.001 for both). Significant underestimation was seen in girls, but not for boys. Conclusions: Opt-in consent underestimated prevalence of childhood obesity, particularly in girls. Prevalence, monitoring and community intervention studies on childhood obesity should move to opt-out consent processes for better scientific outcomes.
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Affiliation(s)
- Claudia Strugnell
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.
| | - Liliana Orellana
- Biostatistics Unit, Deakin University, Geelong, VIC 3220, Australia.
| | - Joshua Hayward
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.
| | - Lynne Millar
- Australian Health Policy Collaboration, Victoria University, Melbourne, VIC 8001, Australia.
- Australian Institute of Musculoskeletal Science, The University of Melbourne and Western Health, St Albans, VIC 3021, Australia.
| | - Boyd Swinburn
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.
- School of Population Health, University of Auckland, Auckland 1142, New Zealand.
| | - Steven Allender
- Global Obesity Centre, Centre for Population Health Research, Deakin University, 1 Gheringhap Street, Geelong, VIC 3220, Australia.
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George J, Klika AK, Navale SM, Newman JM, Barsoum WK, Higuera CA. Obesity Epidemic: Is Its Impact on Total Joint Arthroplasty Underestimated? An Analysis of National Trends. Clin Orthop Relat Res 2017; 475:1798-1806. [PMID: 28054327 PMCID: PMC5449322 DOI: 10.1007/s11999-016-5222-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is a well-established risk factor for total joint arthroplasty (TJA) and a number of complications including prosthetic joint infection. The annual changes in the prevalence of obesity among primary, revision, and infected TJA has not been studied at a national level. Given the higher costs of complications of TJA, it is important to understand the association of obesity with the annual trends of revision and infected TJA. QUESTIONS/PURPOSES (1) Is the prevalence of obesity increasing among patients undergoing THA/TKA? (2) Is the prevalence of obesity increasing among patients undergoing revision THA/TKA? (3) Is the prevalence of obesity increasing among patients with infected THA/TKA? METHODS Annual volumes of primary, revision, and infected THA and TKA from 1998 to 2011 were obtained from the Nationwide Inpatient Sample. Using mathematical equations, the prevalence of obesity was estimated from relative risks and national obesity prevalence. National obesity prevalence was obtained from public health sources and the relative risk estimates were obtained from previously published meta-analyses and population-based studies. Annual prevalence of obesity was obtained by dividing the number of obese primary/revision/infected procedures in each year by the total number of corresponding procedures in that year. Annual changes in the prevalence of obesity were analyzed using linear regression. RESULTS The prevalence of obesity is increasing among patients undergoing THA (1998: 60,264 of 154,337 [39%], 2011: 160,241 of 305,755 [52%], increase of 1.05%/year [confidence interval {CI}, 0.95%-1.15%], p < 0.001) and TKA (1998: 143,681 of 251,309 [57%], 2011: 448,712 of 644,243 [70%], increase of 0.97%/year [CI, 0.87%-1.07%], p < 0.001). There was an increasing prevalence of obesity with THA revisions (1998: 16,322 of 34,139 [48%], 2011: 33,304 of 54,453 [61%], increase of 1.04%/year [CI, 0.94%-1.15%], p < 0.001) and in TKA revisions (1998: 16,837 of 26,539 [63%], 2011: 52,151 of 69,632 [75%], increase of 0.89%/year [CI, 0.79%-0.99%], p < 0.001). There was an increasing prevalence of obesity with THA infections (1998: 2068 of 3018 [69%], 2011: 6856 of 8687 [79%], increase of 0.80%/year [CI, 0.71%-0.89%], p < 0.001) and in TKA infections (1998: 3563 of 4684 [76%], 2011: 14,178 of 16,774 [85%], increase of 0.65%/year [CI, 0.57%-0.73%], p < 0.001). CONCLUSIONS The prevalence of obesity has increased in patients undergoing primary, revision, and infected TJA in United States. The obesity epidemic appears to be related to the growing trends of revision and infection after TJA. With the obesity rates expected to grow further, the revision and infection burden associated with obesity may increase in the future. LEVEL OF EVIDENCE Level II, prognostic study.
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Affiliation(s)
- Jaiben George
- 0000 0001 0675 4725grid.239578.2Department of Orthopedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A40, Cleveland, OH 44195 USA
| | - Alison K. Klika
- 0000 0001 0675 4725grid.239578.2Department of Orthopedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A40, Cleveland, OH 44195 USA
| | - Suparna M. Navale
- 0000 0001 2164 3847grid.67105.35Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH USA
| | - Jared M. Newman
- 0000 0001 0675 4725grid.239578.2Department of Orthopedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A40, Cleveland, OH 44195 USA
| | - Wael K. Barsoum
- 0000 0001 0675 4725grid.239578.2Department of Orthopedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A40, Cleveland, OH 44195 USA
| | - Carlos A. Higuera
- 0000 0001 0675 4725grid.239578.2Department of Orthopedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A40, Cleveland, OH 44195 USA
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Kolahdooz F, Sadeghirad B, Corriveau A, Sharma S. Prevalence of overweight and obesity among indigenous populations in Canada: A systematic review and meta-analysis. Crit Rev Food Sci Nutr 2017; 57:1316-1327. [PMID: 26566086 DOI: 10.1080/10408398.2014.913003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Previous studies on overweight and obesity among indigenous peoples in Canada have been inconclusive. A systematic review was conducted on the prevalence of overweight and obesity among Canadian indigenous populations. Major bibliographic databases were searched for relevant studies published between January 1990 and June 2013. We reviewed 594 abstracts and included 41 studies in the meta-analyses. Using the heterogeneity test (Cochrane Q) results, the overall prevalence was estimated using fixed- or random-effects model. Nonadults (<18 years) had a pooled prevalence of overweight and obesity at 29.8% (95% CI: 25.2-34.4) and 26.5% (95% CI: 21.8-31.3), respectively. The pooled prevalence of overweight and obesity among adults were 29.7% (95% CI: 28.2-31.2) and 36.6% (95% CI: 32.9-40.2), respectively. Adult males had higher overweight prevalence than females (34.6% vs. 26.6%), but lower obesity prevalence (31.6% vs. 40.6%). Nonadult girls had higher prevalence than boys [overweight: 27.6%; 95% CI: 22.6-32.7 vs. 24.7%; 95% CI: 19.0-30.5; obesity: 28.6%; 95% CI: 20.3-36.9 vs. 25.1%; 95% CI: 13.8-36.4]. Nonadult Inuit had the highest overweight and lowest obesity prevalence. Although Inuit adult had the lowest prevalence of overweight (28.7%; 95% CI: 27.3-30.2) and obesity (32.3%; 95% CI: 25.5-39.1), it was relatively high. This study highlights the need for nutritional intervention programs for obesity prevention among indigenous populations in Canada.
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Affiliation(s)
- Fariba Kolahdooz
- a Indigenous and Global Health Research Group , Department of Medicine , University of Alberta , Edmonton, Alberta , Canada
| | - Behnam Sadeghirad
- b Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences , Kerman , Iran
| | - André Corriveau
- c Office of the Chief Public Health Officer , Department of Health and Social Services , Government of the Northwest Territories , Yellowknife , Northwest Territories , Canada
| | - Sangita Sharma
- a Indigenous and Global Health Research Group , Department of Medicine , University of Alberta , Edmonton, Alberta , Canada
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Mattar A, Carlston D, Sariol G, Yu T, Almustafa A, Melton GB, Ahmed A. The prevalence of obesity documentation in Primary Care Electronic Medical Records. Are we acknowledging the problem? Appl Clin Inform 2017; 8:67-79. [PMID: 28119990 DOI: 10.4338/aci-2016-07-ra-0115] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/22/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. METHOD This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015. International Classification of Diseases, Ninth Revision, (ICD-9) codes were used to identify obesity documentation in the EMR problem list. Univariate and multivariate logistic regression analyses were used. RESULTS Out of 10,540, a total of 3,868 patients were included in the study. 2,003 (52%) patients met the criteria for obesity (BMI ≥ 30.0); however, only 112 (5.6%) patient records included obesity in the problem list. Moreover, in a multivariate analysis, in addition to age and gender, morbid obesity and cumulative number of comorbidities were significantly associated with obesity documentation, OR=1.6 and OR=1.3, respectively, with 95% CI [1.4, 1.9] and [1.0, 1.7], respectively. For those with obesity documentation, exercise counseling was provided more often than diet counselling. CONCLUSION Based on EHR documentation, obesity is under coded and generally not identified as a significant problem in primary care. Physicians are more likely to document obesity in the patient record for those with higher BMI scores who are morbidly obese. Moreover, physicians more frequently provide exercise than diet counseling for the documented obese.
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Affiliation(s)
| | | | | | | | | | | | - Adil Ahmed
- Adil Ahmed, 1301 Third Street, Suite 200, Wichita Falls, TX 76301, E-Mail: , Phone: 507-269-1799
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Myers CA, Slack T, Martin CK, Broyles ST, Heymsfield SB. Regional disparities in obesity prevalence in the United States: A spatial regime analysis. Obesity (Silver Spring) 2015; 23:481-7. [PMID: 25521074 PMCID: PMC4310761 DOI: 10.1002/oby.20963] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/16/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Significant clusters of high- and low-obesity counties have been demonstrated across the United States (US). This study examined regional disparities in obesity prevalence and differences in the related structural characteristics across regions of the US. METHODS Drawing on model-based estimates from the Centers for Disease Control and Prevention, regional differences in county-level adult obesity prevalence (percent of the adult population [≥ 20 years] that was obese [BMI ≥ 30 kg/m(2) ] within a county, 2009) were assessed with a LISA (Local Indicators of Spatial Association) analysis to identify geographic concentrations of high and low obesity levels. Regional regime analysis was utilized to identify factors that were differentially associated with obesity prevalence between regions of the US. RESULTS High- and low-obesity county clusters and the effect of a number of county-level characteristics on obesity prevalence differed significantly by region. These included the positive effect of African American populations in the South, the negative effect of Hispanic populations in the Northeast, and the positive effect of unemployed workers in the Midwest and West. CONCLUSIONS Our findings suggest the need for public health policies and interventions that account for different regional characteristics underlying obesity prevalence variation across the US.
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Affiliation(s)
- Candice A. Myers
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Tim Slack
- Department of Sociology, Louisiana State University, Baton Rouge, LA, 70803, USA
| | - Corby K. Martin
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
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16
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Thomas DM, Weedermann M, Fuemmeler BF, Martin CK, Dhurandhar NV, Bredlau C, Heymsfield SB, Ravussin E, Bouchard C. Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends. Obesity (Silver Spring) 2014; 22:590-7. [PMID: 23804487 PMCID: PMC3842399 DOI: 10.1002/oby.20520] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 05/27/2013] [Indexed: 12/04/2022]
Abstract
OBJECTIVE Obesity prevalence in the United States appears to be leveling, but the reasons behind the plateau remain unknown. Mechanistic insights can be provided from a mathematical model. The objective of this study is to model known multiple population parameters associated with changes in body mass index (BMI) classes and to establish conditions under which obesity prevalence will plateau. DESIGN AND METHODS A differential equation system was developed that predicts population-wide obesity prevalence trends. The model considers both social and nonsocial influences on weight gain, incorporates other known parameters affecting obesity trends, and allows for country specific population growth. RESULTS The dynamic model predicts that: obesity prevalence is a function of birthrate and the probability of being born in an obesogenic environment; obesity prevalence will plateau independent of current prevention strategies; and the US prevalence of overweight, obesity, and extreme obesity will plateau by about 2030 at 28%, 32%, and 9% respectively. CONCLUSIONS The US prevalence of obesity is stabilizing and will plateau, independent of current preventative strategies. This trend has important implications in accurately evaluating the impact of various anti-obesity strategies aimed at reducing obesity prevalence.
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Affiliation(s)
- Diana M. Thomas
- Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ
| | | | | | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
| | - Nikhil V. Dhurandhar
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
| | - Carl Bredlau
- Center for Quantitative Obesity Research, Montclair State University, Montclair, NJ
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
| | - Claude Bouchard
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA
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Abstract
Levels of overweight and obesity across low- and middle-income countries (LMIC) have approached levels found in higher-income countries. This is particularly true in the Middle East and North Africa and in Latin America and the Caribbean. Using nationally representative samples of women aged 19-49, n = 815,609, this paper documents the annualized rate of increase of overweight from the first survey in early 1990 to the last survey in the present millennium. Overweight increases ranged from 0.31% per year to 0.92% per year for Latin America and the Caribbean and for the Middle East and North Africa, respectively. For a sample of eight countries, using quantile regression, we further demonstrate that mean body mass index (BMI) at the 95th percentile has increased significantly across all regions, representing predicted weight increases of 5-10 kg. Furthermore we highlight a major new concern in LMICs, documenting waist circumference increases of 2-4 cm at the same BMI (e.g. 25) over an 18-year period. In sum, this paper indicates growing potential for increased cardiometabolic problems linked with a large rightward shift in the BMI distribution and increased waist circumference at each BMI level.
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Affiliation(s)
- B M Popkin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Lahti-Koski M, Harald K, Saarni SE, Peltonen M, Männistö S. Changes in body mass index and measures of abdominal obesity in Finnish adults between 1992 and 2007, the National FINRISK Study. Clin Obes 2012; 2:57-63. [PMID: 25586048 DOI: 10.1111/j.1758-8111.2012.00035.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED What is already known about this subject • Recent obesity trends across the world in adults are mixed, varying from showing signs of levelling off to a continuously increasing prevalence. • Secular trends in body mass index (BMI) and waist circumference may vary by sex and age. • Relying exclusively on BMI data may lead to underestimate the obesity epidemic. What this study adds • Adverse trends in obesity indicators have continued in Finland in the 2000s. • In older men, BMI remained quite stable and in older women BMI has decreased since 1997. • Steep upward trends in abdominal obesity (waist circumference and waist-to-height ratio, WHtR) have taken place in both men and women and in all age groups, especially during the past 10 years. • The impact of BMI adjustment on trends in abdominal obesity varied by age such that increases in BMI-adjusted waist circumference and WHtR were more prominent in older age groups. SUMMARY Signs that obesity trends will level off at the turn of the 21st century have been reported. In these studies, however, the definition of obesity has been based only on body mass index (BMI). We investigated obesity trends among Finnish adults over recent years by using BMI, waist circumference and waist-to-height ratio as indicators for obesity. Data were derived from the national FINRISK surveys, which are cross-sectional population surveys conducted at 5-year intervals between 1992 and 2007. Altogether, 20 551 randomly selected men and women aged 25-64 years participated in health examinations, where weight, height, and waist and hip circumferences were measured by trained nurses. Mean BMI increased in younger men and women (aged 25-44 years) between 1992 and 2007, whereas in older men, BMI remained quite stable and in older women BMI has decreased since 1997. Nevertheless, mean waist circumference and waist-to-height ratio increased in both men and women over the 15-year period. The upward trends took place in all age groups, especially during the past 10 years. Adverse trends in obesity indicators have continued in Finland in the 2000s. In particular, concerns are related to steep upward trends in abdominal obesity.
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Affiliation(s)
- M Lahti-Koski
- Finnish Heart Association, Helsinki, FinlandNational Institute for Health and Welfare (THL), Helsinki, FinlandDepartment of Psychiatry, Health Center, City of Helsinki, Helsinki, Finland
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Anyanwu GE, Ekezie J, Danborno B, Ugochukwu AI. Impact of education on obesity and blood pressure in developing countries: A study on the Ibos of Nigeria. N Am J Med Sci 2010; 2:320-4. [PMID: 22558581 PMCID: PMC3341639 DOI: 10.4297/najms.2010.2320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Increase in the prevalence of hypertension, obesity and obesity related diseases has become significant cause of disability and premature death in both developing and newly developed countries, with over bearing demand on national health budgets. AIM To evaluate the impact of various levels of education on obesity and blood pressure. MATERIALS AND METHOD 325 male and 254 female Nigerians of ages 20-80 years of the Ibo ethnicity through random sampling, were selected for this study. The participants were broken into three major groups based on their educational levels; primary, secondary and tertiary levels. systolic and diastolic blood pressure (SBP & DBP) levels, body mass index (BMI), waist hip ratio (WHR), waist height ratio (WHtR), waist circumference (WC),various skin fold thicknesses, and other anthropometric parameters were measured. RESULT For all the indicators of subcutaneous fat, general obesity, and central obesity, largest mean deposition was noted to be highest in the lowest education group and least in the highest education group. Mean blood pressure parameters were also highest in the least education group. While fat deposition was noted to be highest in all the females of all the groups, the males showed larger mean BP values. Education was noted to have a significant inverse relationship with most of the fat indicators and blood pressure parameters and cardiovascular disease risk highest in the least education groups. CONCLUSION Education showed a significant impact on obesity and blood pressure and could be one of the major tools to reduce the high prevalence of obesity, hypertension and other obesity associated diseases.
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Affiliation(s)
- Godson Emeka Anyanwu
- Department of Anatomy, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Jervase Ekezie
- Department of Prosthesis and Orthopaedics Technology, Federal University of Technology Owerri, Imos, Nigeria
| | - Barnabas Danborno
- Department of Anatomy, Faculty of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Anthony Ikemefuna Ugochukwu
- Department of Anatomy/Surgery, College of Medicine, Enugu State University of Science and Technology Enugu, Enugu State, Nigeria
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Abstract
BACKGROUND Obesity is associated with reduced quality of life, development of serious chronic conditions such as heart disease and diabetes, increased medical care costs, and premature death. Environmental effects, especially feeding habits may cause hyperinsulinemia and obesity. A Healthy People 2010 objective is to reduce the proportion of adults who are obese to 15%. MATERIALS AND METHODS This cross-sectional study was conducted on 1647 persons in a sample representing Gaziantep, Turkey. Over the selected 329 houses, 310 houses were reached (94.2%) and data about 1315 related persons was collected. The body mass index (BMI) shows the relationship between the weight and the height of people, calculated by the ratio of mass by kg over the square value of height measure. In statistical analyses chi-square, student's t-test and logistic regression analysis were used. RESULTS The mean BMI increased with time for both sex, whereas decreased for 60+ age group. The fastest increase for both sex was seen while transition from 18 year to 19-29 age groups occurred. Another increase in women was in 30-39 age group; BMI=25.08+/-4.39 in 19-29 ages whilst BMI=29.02+/-5.79 in 30-39 ages. The increases in both sex in other age groups were not as much as in this group. CONCLUSION Obesity is not only a problem in the Gaziantep but is also a major health concern in Europe and other regions of the world. As an accepted method against obesity, life-style changes should be put into use from childhood supported in school and family life.
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Affiliation(s)
- Birgul Ozcirpici
- Department of Public Health, Gaziantep University, Faculty of Medicine, Sahinbey, Gaziantep, Turkey
| | - Ferhat Coskun
- Department of Public Health, Gaziantep University, Faculty of Medicine, Sahinbey, Gaziantep, Turkey
| | - Saime Sahınoz
- Department of Public Health, Gaziantep University, Faculty of Medicine, Sahinbey, Gaziantep, Turkey
| | - Servet Ozgur
- Department of Public Health, Gaziantep University, Faculty of Medicine, Sahinbey, Gaziantep, Turkey
| | - Ali Ihsan Bozkurt
- Department of Public Health, Pamukkale University, Faculty of Medicine, Denizli, Turkey
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