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Socioeconomic position and risk of short-term weight gain: Prospective study of 14,619 middle-aged men and women
Lisa R Purslow, Elizabeth H Young, Nicholas J Wareham, Nita Forouhi, Eric J Brunner, Robert N Luben, Ailsa A Welch, Kay-Tee Khaw, Shelia A Bingham, Manjinder S Sandhu
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-112
Abstract: We analysed data on 14,619 middle-aged men and women (aged between 40–75 at baseline) with repeated objective measures of weight and height at baseline (1993–1997) and follow up (1998–2000).During follow up 5,064 people gained more than 2.5 kg. Compared with the highest social class, individuals in the lowest social class had around a 30% greater risk of gaining more than 2.5 kg (OR 1.29; 95% CI 1.11–1.51; p for trend = 0.002). This association remained statistically significant following adjustment for sex, age, baseline BMI, smoking, and follow up time (OR 1.25; CI 1.07–1.46; p for trend <0.001). We also found no material difference between unadjusted models and those including all confounders and potential mediators.Individuals of low socioeconomic position are at greatest risk of gaining weight during middle age, which is not explained by classical correlates of socioeconomic position and risk factors for obesity.Across the UK there has been a rapid increase in the prevalence of obesity in recent decades [1]. Since obesity is associated with a greater risk of morbidity and mortality [2], identifying the determinants of weight gain and obesity is fundamental to the development of preventative strategies at the individual and societal level. Social inequalities in health are well recognised, and several studies suggest that adverse socioeconomic position is associated with obesity [3-5]. However, the association between socioeconomic position in middle age and risk of subsequent, short-term weight gain is unknown [5]. Additionally, few studies have attempted to investigate the mechanisms underlying the associations between socioeconomic position and weight gain [5,6]. We therefore investigated this association in a prospective population based study of 14,619 middle-aged men and women.We used data from the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk cohort. The study was approved by the Norfolk Health District Ethics Committee and f
Is There a Reversal in the Effect of Obesity on Mortality in Old Age?  [PDF]
Jiska Cohen-Mansfield,Rotem Perach
Journal of Aging Research , 2011, DOI: 10.4061/2011/765071
Abstract: Studies of obesity and its relationship with mortality risk in older persons have yielded conflicting results. We aimed to examine the age-related associations between obesity and mortality in older persons. Data were drawn from the Cross-Sectional and Longitudinal Aging Study (CALAS), a national survey of a random sample of older Jewish persons in Israel conducted during 1989–1992. Analyses included 1369 self-respondent participants aged 75–94 from the Cross-Sectional and Longitudinal Aging Study (CALAS). Mortality data at 20-year followup were recorded from the Israeli National Population Registry. Obesity was significantly predictive of higher mortality for persons aged 75–84, but from age 85 onwards, obesity had a protective effect on mortality albeit at a nonsignificant level. Being underweight was consistently predictive of mortality. Findings suggest that the common emphasis on avoiding obesity may not apply to those advancing towards old-old age, at least as far as mortality is concerned. 1. Introduction Increased obesity rates comprise a major public health concern over the world [1, 2]. While obesity was associated with increased mortality risk for young and middle-aged adults [3, 4], studies of older persons have yielded conflicting results. Some indicate higher mortality rates for obese older persons [4–6], while others found no such associations [7–9] or evidence for a reversed relationship, that is, linking decreased mortality with higher Body Mass Index (BMI) values [9–13]. Studies of the relationship between obesity and mortality among older persons suggest the impact of obesity varies according to age. In a study of persons aged 44–101 with 23 years of followup, obesity increased mortality only among persons under 75 years of age [5]. Similarly, a study of adults aged 30 and over with a 12-year followup found higher mortality rates for obese younger persons, but not for those aged 75 and over [14]. In line with that, higher BMI was associated with lower mortality among persons aged 70–88 [9], among older persons aged 70 and older [12], and among persons aged 75–89 [10]. This paper addresses the following question: what are the age-related associations between obesity and mortality in older persons? Accordingly, we examine the impact of obesity on mortality in persons who survived to old-old age, that is, persons over 75 years of age. 2. Methods and Procedures 2.1. Participants and Procedure The sample was part of the Cross-Sectional and Longitudinal Aging Study (CALAS). The CALAS conducted a multidimensional assessment of a random
CVD and obesity in transitional Syria: a perspective from the Middle East  [cached]
Barakat H,Barakat H,Baaj MK
Vascular Health and Risk Management , 2012,
Abstract: Hani Barakat1, Hanniya Barakat1, Mohamad K Baaj21Kalamoon Private University Medical School, Deir Attieh, Syria; 2Aleppo University Medical School, Aleppo, SyriaPurpose: Syria is caught in the middle of a disruptive nutritional transition. Its healthcare system is distracted by challenges and successes in other areas while neglecting to address the onslaught of Syria's cardiovascular disease (CVD) epidemic. Despite the official viewpoint touting improvement in health indicators, current trends jeopardize population health, and several surveys in the Syrian population signal the epidemic spreading far and wide. The goal is to counteract the indifference towards obesity as a threat to Syrian's health, as the country is slowly becoming a leader in CVD mortality globally.Methods: PubMed, World Health Organization, and official government websites were searched for primary surveys in Syria related to CVD morbidity, mortality, and risk factors. Inclusion criteria ensured that results maximized relevance while producing comparable studies. Statistical analysis was applied to detect the most common risk factor and significant differences in risk factor prevalence and CVD rates.Results: Obesity remained the prevailing CVD risk factor except in older Syrian men, where smoking and hypertension were more common. CVD mortality was more common in males due to coronary disease, while stroke dominated female mortality. The young workforce is especially impacted, with 50% of CVD mortality occurring before age 65 years and an 81% prevalence of obesity in women over 45 years.Conclusion: Syria can overcome its slow response to the CVD epidemic and curb further deterioration by reducing obesity and, thus, inheritance and clustering of risk factors. This can be achieved via multilayered awareness and intensive parental and familial involvement. Extinguishing the CVD epidemic is readily achievable as demonstrated in other countries.Keywords: Syria, CVD, obesity, risk factors
The Effect of Age and NT-proBNP on the Association of Central Obesity with 6-Years Cardiovascular Mortality of Middle-Aged and Elderly Diabetic People: The Population-Based Casale Monferrato Study  [PDF]
Graziella Bruno, Federica Barutta, Andrea Landi, Paolo Cavallo Perin, Gabriella Gruden
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0096076
Abstract: Background Among people with type 2 diabetes the relationship between central obesity and cardiovascular mortality has not been definitely assessed. Moreover, NT-proBNP is negatively associated with central obesity, but no study has examined their combined effect on survival. We have examined these issues in a well-characterized population-based cohort. Methods and Findings Survival data of 2272 diabetic people recruited in 2000 who had no other chronic disease have been updated to 31 December 2006. NT-proBNP was measured in a subgroup of 1690 patients. Cox proportional hazards modeling was employed to estimate the independent associations between cardiovascular and all-cause mortality and waist circumference. Mean age was 67.9 years, 49.3% were men. Both age and NT-proBNP were negatively correlated with waist circumference (r = ?0.11, p<0.001 and r = ?0.07, p = 0.002). Out of 2272 subjects, 520 deaths (221 for CV mortality) occurred during a median follow-up of 5.4 years. Central obesity was not associated with CV mortality (hazard ratio, HR, adjusted for age, sex, diabetes duration, 1.14, 95% CI 0.86–1.52). NTproBNP was a negative confounder and age a strong modifier of this relationship (p for interaction<0.001): age<70 years, fully adjusted model HR = 3.52 (1.17–10.57) and age ≥70 years, HR = 0.80 (0.46–1.40). Respective HRs for all-cause mortality were 1.86 (1.03–3.32) and 0.73 (0.51–1.04). Conclusions In diabetic people aged 70 years and lower, central obesity was independently associated with increased cardiovascular mortality, independently of the negative effect of NT-proBNP. In contrast, no effect on 6-years survival was evident in diabetic people who have yet survived up to 70 years.
CVD and obesity in transitional Syria: a perspective from the Middle East
Barakat H, Barakat H, Baaj MK
Vascular Health and Risk Management , 2012, DOI: http://dx.doi.org/10.2147/VHRM.S28691
Abstract: nd obesity in transitional Syria: a perspective from the Middle East Review (1621) Total Article Views Authors: Barakat H, Barakat H, Baaj MK Published Date March 2012 Volume 2012:8 Pages 145 - 150 DOI: http://dx.doi.org/10.2147/VHRM.S28691 Received: 30 November 2011 Accepted: 16 January 2012 Published: 07 March 2012 Hani Barakat1, Hanniya Barakat1, Mohamad K Baaj2 1Kalamoon Private University Medical School, Deir Attieh, Syria; 2Aleppo University Medical School, Aleppo, Syria Purpose: Syria is caught in the middle of a disruptive nutritional transition. Its healthcare system is distracted by challenges and successes in other areas while neglecting to address the onslaught of Syria's cardiovascular disease (CVD) epidemic. Despite the official viewpoint touting improvement in health indicators, current trends jeopardize population health, and several surveys in the Syrian population signal the epidemic spreading far and wide. The goal is to counteract the indifference towards obesity as a threat to Syrian's health, as the country is slowly becoming a leader in CVD mortality globally. Methods: PubMed, World Health Organization, and official government websites were searched for primary surveys in Syria related to CVD morbidity, mortality, and risk factors. Inclusion criteria ensured that results maximized relevance while producing comparable studies. Statistical analysis was applied to detect the most common risk factor and significant differences in risk factor prevalence and CVD rates. Results: Obesity remained the prevailing CVD risk factor except in older Syrian men, where smoking and hypertension were more common. CVD mortality was more common in males due to coronary disease, while stroke dominated female mortality. The young workforce is especially impacted, with 50% of CVD mortality occurring before age 65 years and an 81% prevalence of obesity in women over 45 years. Conclusion: Syria can overcome its slow response to the CVD epidemic and curb further deterioration by reducing obesity and, thus, inheritance and clustering of risk factors. This can be achieved via multilayered awareness and intensive parental and familial involvement. Extinguishing the CVD epidemic is readily achievable as demonstrated in other countries.
Urine Bisphenol-A Level in Relation to Obesity and Overweight in School-Age Children  [PDF]
De-Kun Li, Maohua Miao, ZhiJun Zhou, Chunhua Wu, Huijing Shi, Xiaoqin Liu, Siqi Wang, Wei Yuan
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0065399
Abstract: Bisphenol-A (BPA) is a potential endocrine disruptor impacting metabolic processes and increasing the risk of obesity. To determine whether urine BPA level is associated with overweight/obesity in school-age children, we examined 1,326 students in grades 4–12 from three schools (one elementary, one middle, and one high school) in Shanghai. More than 98% of eligible students participated. Total urine BPA concentration was measured and anthropometric measures were taken by trained research staff. Information on risk factors for childhood obesity was collected for potential confounders. Age- and gender-specific weight greater than 90th percentile of the underlying population was the outcome measure. After adjustment for potential confounders, a higher urine BPA level (≥2 μg/L), at the level corresponding to the median urine BPA level in the U.S. population, was associated with more than two-fold increased risk of having weight >90th percentile among girls aged 9–12 (adjusted odds ratio (aOR) = 2.32, 95% confidence interval: 1.15–4.65). The association showed a dose-response relationship with increasing urine BPA level associated with further increased risk of overweight (p = 0.006 for trend test). Other anthropometric measures of obesity showed similar results. The same association was not observed among boys. This gender difference of BPA effect was consistent with findings from experimental studies and previous epidemiological studies. Our study suggests that BPA could be a potential new environmental obesogen. Widespread exposure to BPA in the human population may also be contributing to the worldwide obesity epidemic.
Risk of obesity in immigrants compared with Swedes in two deprived neighbourhoods
Johan Faskunger, Ulf Eriksson, Sven-Erik Johansson, Kristina Sundquist, Jan Sundquist
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-304
Abstract: Height and weight, waist circumference and body fat percentage were objectively measured in a random sample (n = 289). Sociodemographic data were obtained through a survey. Established cut-offs were used to determine obesity. Country of birth was categorized as Swedish, Other European, and Middle Eastern. Odds ratios were estimated by unconditional logistic regression.One third of the sample was classified as obese overall, with 39.0% of women being abdominally obese. After adjusting for age, we found higher odds of obesity in Middle Eastern women than in Swedish women regardless of outcome with odds ratios ranging between 2.74 and 5.53. Men of other European origin had higher odds of BMI obesity than Swedish men. Most associations between country of birth and obesity remained in the full model.This study demonstrates the magnitude of the obesity problem and the need for prevention programmes targeting native and immigrant adults in deprived neighbourhoods in Sweden. The initiatives should also focus on particular groups, e.g. immigrant women and those experiencing economic difficulties. Further studies are needed on behavioural and environmental factors influencing the risk of obesity in residents settled in deprived neighbourhoods.Obesity is rapidly increasing worldwide and contributes to chronic diseases and increased risks of morbidity, disability and mortality [1,2] It is estimated that 30–80% of adults in the European region are overweight or obese, with approximately 150 million individuals being obese [1] and resulting in 1 million deaths and 12 million life-years of ill-health annually [3]. Likewise, several studies show that the prevalence of obesity has increased dramatically in Sweden [4-8]. For example, Swedish national data based on self-reported height and weight (body mass index, BMI) indicate that BMI obesity doubled from 5 to 10% between 1980 and 2005 [8]. Another national study concluded that the prevalence of BMI obesity increased from 8.8 to 11.
Obesity and the risk of diabetes mellitus in middle-aged Japanese men.
Seki A,Takigawa T,Ito T,Fukuoka E
Acta Medica Okayama , 2002,
Abstract: The morbidity of diabetes mellitus is increasing gradually in Japanese populations. It is important to clarify the risk factors of diabetes in Japanese populations in order to take adequate measures against the increasing morbidity of diabetes. In order to evaluate the link between past and concurrent obesity and diabetes in middle-aged Japanese men, we conducted a worksite-based historical cohort study in Okayama, Japan in 1999. Annual health examination data of middle-aged male workers in a worksite were collected. The relative risks of past and concurrent obesity for developing diabetes were calculated. Subjects with a past history of obesity at between 40 and 50 years of age had a significantly higher risk of developing diabetes by age 55 than did subjects in the normal weight group. These results suggest that, in order to prevent diabetes in middle-aged Japanese men, health guidance for normal weight maintenance should be provided not only for middle-aged men, but also for men under age 40.
Abdominal obesity in Japanese-Brazilians: which measure is best for predicting all-cause and cardiovascular mortality?
Bevilacqua, Marselle Rodrigues;Gimeno, Suely Godoy Agostinho;
Cadernos de Saúde Pública , 2011, DOI: 10.1590/S0102-311X2011001000012
Abstract: this study aimed to verify which anthropometric measure of abdominal obesity was the best predictor of all-cause and cardiovascular mortality in japanese-brazilians. the study followed 1,581 subjects for 14 years. socio-demographic, lifestyle, metabolic, and anthropometric data were collected. the dependent variable was vital status (alive or dead) at the end of the study, and the independent variable was presence of abdominal obesity according to different baseline measures. the mortality rate was estimated, and poisson regression was used to obtain mortality rate ratios with abdominal obesity, adjusted simultaneously for the other variables. the mortality rate was 10.68/thousand person-years. male gender, age > 60 years, and arterial hypertension were independent risk factors for mortality. the results indicate that prevalence of abdominal obesity was high among japanese-brazilians, and that waist/hip ratio was the measure with the greatest capacity to predict mortality (especially cardiovascular mortality) in this group.
Effect of the Mediterranean Diet on BMI in Middle-Aged Hispanic Women with Pre-Obesity and Obesity Central Washington State  [PDF]
Eloy Espinoza
International Journal of Clinical Medicine (IJCM) , 2019, DOI: 10.4236/ijcm.2019.106029
Abstract: Background: Conclusive evidence has yet to emerge regarding the effectiveness and applicability of the Mediterranean diet on middle-aged Hispanic women, the largest female minority group in the United States who is at-risk of metabolic disorders. Objective: The aim of this study is to evaluate the effect of the Mediterranean diet (MED) on the BMI in middle-aged Hispanic women with pre-obesity and obesity in Central Washington State. Design: A prospective study was performed to determine the effect of Mediterranean diet on the BMI of 67 Hispanic women with pre-obesity and obesity between 45 to 65 years of age in Central Washington State. The study was carried out for eight weeks. Dietary adherence was monitored to ensure consistent results. Results: The proportion of Hispanic women who reported a reduction in BMI was 94%, with a decrease in mean BMI after eight weeks of 2.8 (95% CI: 2.5 to 3.0) and P = 0.02, with an odds ratio of 2.6. Multiple linear regression analysis was used to adjust for age, education, physical activity, and smoking. Conclusion: The reduction in BMI demonstrates that the Mediterranean diet can be a promising, culturally appropriate therapy to address the obesity epidemic that is prevalent among Hispanic women.
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