Determinants of obesity in transition economies: The case of Russia

This paper examines human obesity, measured as weight and body mass index (BMI), and its determinants in Russia. Obesity increased dramatically during transition from a planned to a market economy, by 38%. We determine the factors contributing to rising obesity using individual level data from the Russia Longitudinal Monitoring Survey for 1994 and 2004. We find a strong positive effect of diet/caloric intake and a strong negative effect of smoking on weight and BMI. Gender, education, and income are other major determinants of obesity. Our analysis provides information on dietary patterns and other determinants of obesity in Russia which is essential for formulation and implementation of effective policies designed to reduce the problem and improve the health of the population.     

Portrayals of canine obesity in English-language newspapers and in leading veterinary journals, 2000-2009: implications for animal welfare organizations and veterinarians as public educators

In industrialized societies, more than 1 in 3 dogs and people currently qualify as overweight or obese. Experts in public health expect both these figures to rise. Although clinical treatment remains important, so are public perceptions and social norms. This article presents a thematic analysis of English-language mass media coverage on canine obesity from 2000 through 2009 and compares these results with a thematic analysis of articles on canine obesity in leading veterinary journals during the same time period. Drawing on Giddens's theory of structuration, this study identified articles that emphasized individual agency, environmental structure, or both as contributors to canine obesity. Comparisons with weight-related health problems in human populations were virtually absent from the veterinary sample. Although such comparisons were almost always present in the media sample, quotations from veterinarians and other spokespeople for the welfare of nonhuman animals emphasized the agency of individual caregivers (owners) over structural influences. Now that weight gain and obesity have been established as a pressing animal welfare problem, these results suggest a need for research and for interventions, such as media advocacy, that emphasize intersections between animal-owner agency, socioenvironmental determinants, and connections between animal welfare and human health.     

Portrayals of Canine Obesity in English-Language Newspapers and in Leading Veterinary Journals, 2000–2009: Implications for Animal Welfare Organizations and Veterinarians as Public Educators

In industrialized societies, more than 1 in 3 dogs and people currently qualify as overweight or obese. Experts in public health expect both these figures to rise. Although clinical treatment remains important, so are public perceptions and social norms. This article presents a thematic analysis of English-language mass media coverage on canine obesity from 2000 through 2009 and compares these results with a thematic analysis of articles on canine obesity in leading veterinary journals during the same time period. Drawing on Giddens's theory of structuration, this study identified articles that emphasized individual agency, environmental structure, or both as contributors to canine obesity. Comparisons with weight-related health problems in human populations were virtually absent from the veterinary sample. Although such comparisons were almost always present in the media sample, quotations from veterinarians and other spokespeople for the welfare of nonhuman animals emphasized the agency of individual caregivers (owners) over structural influences. Now that weight gain and obesity have been established as a pressing animal welfare problem, these results suggest a need for research and for interventions, such as media advocacy, that emphasize intersections between animal-owner agency, socioenvironmental determinants, and connections between animal welfare and human health.     

Acknowledging Individual Responsibility while Emphasizing Social Determinants in Narratives to Promote Obesity-Reducing Public Policy: A Randomized Experiment

This study tests whether policy narratives designed to increase support for obesity-reducing public policies should explicitly acknowledge individual responsibility while emphasizing social, physical, and economic (social) determinants of obesity. We use a web-based, randomized experiment with a nationally representative sample of American adults (n = 718) to test hypotheses derived from theory and research on narrative persuasion. Respondents exposed to narratives that acknowledged individual responsibility while emphasizing obesity’s social determinants were less likely to engage in counterargument and felt more empathy for the story’s main character than those exposed to a message that did not acknowledge individual responsibility. Counterarguing and affective empathy fully mediated the relationship between message condition and support for policies to reduce rates of obesity. Failure to acknowledge individual responsibility in narratives emphasizing social determinants of obesity may undermine the persuasiveness of policy narratives. Omitting information about individual responsibility, a strongly-held American value, invites the public to engage in counterargument about the narratives and reduces feelings of empathy for a character that experiences the challenges and benefits of social determinants of obesity.     

Obesity and its socioeconomic determinants in Iran

ObjectiveTo investigate the socioeconomic inequality of obesity and its determinants in Iran.MethodsData was from Iran's surveillance system for risk factors of non-communicable diseases which was conducted on 89,400 individuals aged 15–64 years in 2005. Principal component analysis was used to create a new variable for defining socioeconomic status of participants. We assessed inequality by calculating a slop index of inequality and concentration index for obesity. Oaxaca-Blinder decomposition analysis was used to determine the determinants of inequality.ResultsThe slop index of inequality and concentration index for obesity was −13.1 (95% Confidence Intervals [CI]: −16.3 to −9.8) percentage points and −0.123, respectively. The level of inequality varied widely between different provinces in Iran and was more severe in women and urban population. Obesity persisted in 20.2% (95% CI: 19.4–20.9) of the low-socioeconomic group and 11.0% (95% CI: 10.5–11.6) of the high-socioeconomic group. More than 90% of this gap was due to differences of independent variables (mainly age, gender and marital status) in two socioeconomic status groups.ConclusionsA pro-rich inequality existed in the obesity in Iran. Older age, female gender and rural residency contributed most to the economic inequality of obesity.     

Peer effects of obesity on child body composition

This study investigates whether peer obesity is a driver of individual weight changes in public school children and whether the impact of peer effects changes as children age. Quantifying peer effects is important for understanding the social determinants of obesity and for planning effective school wellness policies. However, the extant empirical research on peer effects is limited due to difficulties in separating causal influences from confounding factors. This study overcomes some of these difficulties by using a within-school, across-cohort empirical design to separate confounding factors at the individual, school and school-grade level for over one million public school children. The results show that increases a one standard deviation increase in average classmate body mass index (BMI) leads to a modest but meaningful increase of 0.395 standard deviation increase in a child's own BMI. Peer-effects are highest (0.813) for children in Kindergarten and decline with age. These findings suggest that the critical time for school-grade level intervention may be in the earliest ages of childhood development.     

Neighborhood Socioeconomic Status in Relation to 10‐Year Weight Gain in the Black Women's Health Study

We prospectively assessed the association of neighborhood socioeconomic status (SES) with 10‐year weight change and with incident obesity among 48,359 women in the Black Women's Health Study (BWHS). Lower neighborhood SES was significantly associated with 10‐year weight gain after adjustment for individual SES and behavioral variables, such as physical activity and caloric intake. Low neighborhood SES was also associated with increased incidence of obesity during 10 years of follow‐up among women of normal weight at baseline (BMI <25 kg/m²). The associations were most evident among BWHS participants who had graduated from college. These prospective data suggest that lower neighborhood SES contributes to overweight and obesity in African‐American women.     

Determinants affecting physical activity levels in animal models

Weight control is dependent on energy balance. Reduced energy expenditure (EE) associated with decreased physical activity is suggested to be a major underlying cause in the increasing prevalence of weight gain and obesity. Therefore, a better understanding of the biological determinants involved in the regulation of physical activity is essential. To facilitate interpretation in humans, it is helpful to consider the evidence from animal studies. This review focuses on animal studies examining the biological determinants influencing activity and potential implications to human. It appears that physical activity is influenced by a number of parameters. However, regardless of the parameter involved, body weight appears to play an underlying role in the regulation of activity. Furthermore, the regulation of activity associated with body weight appears to occur only after the animal achieves a critical weight. This suggests that activity levels are a consequence rather than a contributor to weight control. However, the existence of an inverse weight-activity relationship remains inconclusive. Confounding the results are the multifactorial nature of physical activity and the lack of appropriate measuring devices. Furthermore, many determinants of body weight are closely interlocked, making it difficult to determine whether a single, combination, or interaction of factors is important for the regulation of activity. For example, diet-induced obesity, aging, lesions to the ventral medial hypothalamus, and genetics all produce hypoactivity. Providing a better understanding of the biological determinants involved in the regulation of activity has important implications for the development of strategies for the prevention of weight gain leading to obesity and subsequent morbidity and mortality in the human population.     

Willingness to pay for obesity prevention

The purpose of this paper is to estimate consumers’ willingness to pay (WTP) and investigate factors that affect participation in therapy to reduce weight or prevent obesity. As for the decision to participate in obesity prevention therapy, the results show that the price charged for therapy is the key factor. Furthermore, the gender, education, income, the concern that work achievement is affected by obesity, and health condition variables are found to be important and significant determinants of the decision to participate in the therapy. The average willingness to pay for obesity reduction therapy which could reduce weight by 5 kg in 3 months is estimated to be NT$12,531 (US$362) among the sample respondents. The results of the profile analysis suggest that obese females with high education, high income, who think that obesity affects work achievement, and who have tried to control their weight are the most likely to be willing to pay the greatest amount for the weight-reduction therapy.     

Genes and the intergenerational transmission of BMI and obesity

This paper compares the strength of intergenerational transmission of body mass index (BMI) and obesity in a sample of adoptees relative to a matched sample of biological children with similar observable characteristics. We find that BMI and obesity are strongly correlated among biological parent-child pairs, but there are no significant intergenerational associations in these health traits among adoptive parent-child pairs. The intergenerational elasticity of BMI for children to their parents is 0.2 in the matched biological sample, but indistinguishable from zero for adopted children with a standard error more than three times as large as the coefficient. Under reasonable assumptions, these findings indicate that the intergenerational transmission of BMI and obesity occurs primarily through genetic mechanisms. Additional analyses of transmission rates by parental gender and among step-parents and step-children support this conclusion. The role of determinants of BMI and obesity in the household environment in relation to our findings is discussed. Given the negative consequences of obesity on earnings and other economic measures, our results suggest that the genetic transmission of weight problems contributes substantially to intergenerational persistence in economic outcomes.     

Overweight People Have Low Levels of Implicit Weight Bias,but Overweight Nations Have High Levels of Implicit Weight Bias

Although a greater degree of personal obesity is associated with weaker negativity toward overweight people on both explicit (i.e., self-report) and implicit (i.e., indirect behavioral) measures, overweight people still prefer thin people on average. We investigated whether the national and cultural context – particularly the national prevalence of obesity – predicts attitudes toward overweight people independent of personal identity and weight status. Data were collected from a total sample of 338,121 citizens from 71 nations in 22 different languages on the Project Implicit website (https://implicit.harvard.edu/) between May 2006 and October 2010. We investigated the relationship of the explicit and implicit weight bias with the obesity both at the individual (i.e., across individuals) and national (i.e., across nations) level. Explicit weight bias was assessed with self-reported preference between overweight and thin people; implicit weight bias was measured with the Implicit Association Test (IAT). The national estimates of explicit and implicit weight bias were obtained by averaging the individual scores for each nation. Obesity at the individual level was defined as Body Mass Index (BMI) scores, whereas obesity at the national level was defined as three national weight indicators (national BMI, national percentage of overweight and underweight people) obtained from publicly available databases. Across individuals, greater degree of obesity was associated with weaker implicit negativity toward overweight people compared to thin people. Across nations, in contrast, a greater degree of national obesity was associated with stronger implicit negativity toward overweight people compared to thin people. This result indicates a different relationship between obesity and implicit weight bias at the individual and national levels.     

What Should I Eat and Why? The Environmental,Genetic, and Behavioral Determinants of Food Choice: Summary from a Pennington Scientific Symposium

This review details the proceedings of a Pennington Biomedical scientific symposium titled, “What Should I Eat and Why? The Environmental, Genetic, and Behavioral Determinants of Food Choice.” The symposium was designed to review the literature about energy homeostasis, particularly related to food choice and feeding behaviors, from psychology to physiology. This review discusses the intrinsic determinants of food choice, including biological mechanisms (genetics), peripheral and central signals, brain correlates, and the potential role of the microbiome. This review also address the extrinsic determinants (environment) of food choice within our physical and social environments. Finally, this review reports the current treatment practices for the clinical management of eating‐induced overweight and obesity. An improved understanding of these determinants will inform best practices for the clinical treatment and prevention of obesity. Strategies paired with systemic shifts in our public health policies and changes in our “obesogenic” environment will be most effective at attenuating the obesity epidemic.     

Genetics of human obesity

We present the knowledge acquired in the field of the genetics of human obesity. The molecular approach proved to be powerful to define new syndromes associated to obesity. The pivotal role of leptin and melanocortin pathways were recognized but in rare obesity cases. In the commoner form of obesities, a multitude of polymorphisms located in genes and candidate regions participate in an individual susceptibility to weight gain in a permissive environment. The effects are often uncertain and the results not always confirmed. It is now necessary to integrate data of various origins (environment, genotype, expression) to clarify the domain.     

Exploring the Potential of a School Impact on Pupil Weight Status: Exploratory Factor Analysis and Repeat Cross-Sectional Study of the National Child Measurement Programme

Schools are common sites for obesity prevention interventions. Although many theories suggest that the school context influences weight status, there has been little empirical research. The objective of this study was to explore whether features of the school context were consistently and meaningfully associated with pupil weight status (overweight or obese). Exploratory factor analysis of routinely collected data on 319 primary schools in Devon, England, was used to identify possible school-based contextual factors. Repeated cross-sectional multilevel analysis of five years (2006/07-2010/11) of data from the National Child Measurement Programme was then used to test for consistent and meaningful associations. Four school-based contextual factors were derived which ranked schools according to deprivation, location, resource and prioritisation of physical activity. None of which were meaningfully and consistently associated with pupil weight status, across the five years. The lack of consistent associations between the factors and pupil weight status suggests that the school context is not inherently obesogenic. In contrast, incorporating findings from education research indicates that schools may be equalising weight status, and obesity prevention research, policy and practice might need to address what is happening outside schools and particularly during the school holidays.     

Use of complementary and alternative therapies by overweight and obese adults

Objective: Obesity is associated with higher health‐care costs due, in part, to higher use of traditional health care. Few data are available on the relationship between obesity and the use of complementary and alternative medicine (CAM). Methods and Procedures: We analyzed data on CAM use from the 2002 National Health Interview Survey (NHIS) Alternative Medicine Supplement (n = 31,044). We compared the use of CAM overall, within the past 12 months, between normal weight (BMI from 18 to <25), overweight (from 25 to <30), mildly obese (from 30 to <35), moderately obese (from 35 to <40), and extremely obese (>40) adults. For the primary analysis, our multivariable model was adjusted for sociodemographic factors, insurance status, medical conditions, and health behaviors. We performed additional analyses to explore the association of BMI and the use of seven CAM modalities. Results: We found that adults with obesity have lower prevalence of use of yoga therapy, and similar prevalence of use of several CAM modalities, including relaxation techniques, natural herbs, massage, chiropractic medicine, tai chi, and acupuncture, compared to normal‐weight individuals. After adjustment for sociodemographic factors, insurance status, medical conditions, and health behaviors, adults with obesity were generally less likely to use most individual CAM modalities, although the magnitude of these differences were quite modest in many cases. Discussion: Even though adults with obesity have a greater illness burden and higher utilization of traditional medical care, adults with higher BMIs were no more likely to use each of the individual CAM therapies studied. Additional research is needed to improve our understanding of CAM use by adults with obesity.     

Stress and dental asymmetry in a population of Japanese children

We studied the significance of the magnitude of fluctuating dental asymmetry in 489 Japanese children by regression analysis. The search was for the predictability of asymmetry from levels of five factors assumed to be relevant parameters of prenatal stress. The five factors were derived by principal components analysis to simplify the interrelationships between birth weight, gestational age, maternal age, parity, sex, year of birth, socioeconomic status, and F, the coefficient of inbreeding. Only the regression of asymmetry on a factor representing a secular effect related to sex ratio was statistically significant; however, the relationship was too small to be biologically meaningful. The significance of individual asymmetry is thus equivocal, and this is discussed in terms of the meaning of asymmetry vis à vis overall fitness and developmental homeostasis. We conclude that experimental research will be necessary to elucidate not only the determinants of dental asymmetry but the relationship between these determinants and mortality and morbidity.     

Dietary behaviors as associated factors for overweight and obesity in a sample of adolescents from Aquitaine, France

This study aimed to identify dietary behaviors that might be considered as associated factors for overweight or obesity among French adolescents. Forty-nine of the 536 middle and high schools in Aquitaine (southwest of France) were invited to take part in the study. For each school, participating adolescents were selected using stratification by grade. A self-report questionnaire, including information about sex, age, dietary behaviors, physical and sedentary activities, and parental socioeconomic status (SES), was filled in by adolescents during class. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task Force. Multivariate analysis (logistic regression) was used to identify independent dietary factors associated with overweight including obesity and obesity alone (adjustment on sex, age, parental SES, and weight status and adolescents' sedentary activity). In addition to parental SES and weight status and adolescents' sedentary activity, some dietary behaviors are also independently and significantly associated with a higher prevalence of overweight including obesity: absence (OR 1.43, 0.91–2.23) or rare (OR 1.57, 1.23–2.01) breakfast intake (p?<?0.01) and absence (OR 5.03, 3.19–7.92) or rare (OR 1.90, 1.46–2.47) light afternoon meal intake (p?<?0.001). All variables were also significantly and independently associated with obesity alone. This study shows that socioeconomic factors and individual behaviors are associated with overweight or obesity. These results confirm the importance to carry out multifaceted educational actions among adolescents, by promoting physical activity and healthy food choices in order to prevent overweight and promote healthy lifestyle behaviors.     

Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9

Background

Parental obesity is a predominant risk factor for childhood obesity. Family factors including socio-economic status (SES) play a role in determining parent weight. It is essential to unpick how shared family factors impact on child weight. This study aims to investigate the association between measured parent weight status, familial socio-economic factors and the risk of childhood obesity at age 9.

Methodology/Principal Findings

Cross sectional analysis of the first wave (2008) of the Growing Up in Ireland (GUI) study. GUI is a nationally representative study of 9-year-old children (N = 8,568). Schools were selected from the national total (response rate 82%) and age eligible children (response rate 57%) were invited to participate. Children and their parents had height and weight measurements taken using standard methods. Data were reweighted to account for the sampling design. Childhood overweight and obesity prevalence were calculated using International Obesity Taskforce definitions. Multinomial logistic regression examined the association between parent weight status, indicators of SES and child weight. Overall, 25% of children were either overweight (19.3%) or obese (6.6%). Parental obesity was a significant predictor of child obesity. Of children with normal weight parents, 14.4% were overweight or obese whereas 46.2% of children with obese parents were overweight or obese. Maternal education and household class were more consistently associated with a child being in a higher body mass index category than household income. Adjusted regression indicated that female gender, one parent family type, lower maternal education, lower household class and a heavier parent weight status significantly increased the odds of childhood obesity.

Conclusions/Significance

Parental weight appears to be the most influential factor driving the childhood obesity epidemic in Ireland and is an independent predictor of child obesity across SES groups. Due to the high prevalence of obesity in parents and children, population based interventions are required.     

Role of hereditary factors in weight loss and its maintenance

The prevalence of obesity is increasing worldwide at an alarming rate in both developed and developing countries. Obesity is a chronic complex disease of multifactorial origin resulting from a long-term positive energy balance, in which both genetic and environmental factors are involved. Genetically prone individuals are the first to accumulate fat in the present obesogenic environment. Obesity increases the risks of type 2 diabetes, hypertension, cardiovascular disease, dyslipidemia, arthritis, and several cancers and reduces the average life expectancy. Implementation of effective strategies in prevention and management of obesity should become an important target in health care systems. Weight changes throughout life depend on the interaction of behavioral, genetic and environmental factors. Weight loss in response to weight management shows a wide range of interindividual variation which is largely influenced by genetic determinants. The strong control of weight loss by genotype was confirmed by twin and family studies. Recently, special attention has been paid to nutritional, hormonal, psychobehavioral and genetic factors which can predict the response to weight reduction programme. In this article currently available data on the role of obesity candidate gene polymorphisms in weight loss and maintenance are reviewed. It is believed that an elucidation of the genetic component in the prognosis of weight management could assist in the development of more effective and individually tailored therapeutic strategies.     

Effect of a weight management program on the determinants and prevalence of metabolic syndrome

Objective: As prevalence of obesity and metabolic syndrome (met synd) rises, establishing effective, community‐based treatments is imperative. Our investigation sought to evaluate and report the effect of a weight management program on the prevalence and determinants of met synd, and the effect of participation level. Methods and Procedures: Between 10 July 2001 and 17 November 2005, 339 of 574 individuals enrolled in and completed our 6‐month weight management program at the McConnell Heart Health Center in Columbus, Ohio. One hundred and sixty completers met our inclusion criteria for our retrospective analysis: (i) non diabetic, (ii) complete outcomes, (iii) no program participation in the previous 6 months. Met synd status was determined using AHA/NHLBI criteria. Blood pressure criterion was modified to a history of hypertension or current antihypertension medication use. Participation level was dichotomized as high participators (HP) and low participators (LP) using the number of center visits. Results: The entire cohort showed significant reductions in BMI, waist circumference and met synd prevalence (51–39%). The met synd group had significant improvements in high‐density lipoprotein (HDL), triglycerides, and glucose. Compared with LP, HP had a significant reduction in the prevalence of met synd and significantly greater improvement in the anthropometric, HDL and triglyceride determinants of met synd. Discussion: This weight management program had a positive effect on determinants and prevalence of met synd. High participation levels were associated with significantly greater improvements in the anthropometric variables, HDL, triglycerides, met synd determinants, and reduction of met synd prevalence.