Prevalence of gallstones and gallbladder disease in Canadian Micmac Indian women.

The prevalence of gallstones and gallbladder disease was studied between October 1973 and June 1976 in Canadian Micmac Indian women aged 15 to 50 years in an inland rural community near Shubenacadie, NS. Of 132 women at risk 98 underwent cholecystography, 6 had a history of cholecystectomy (verified from hospital records) and 3 had cholecystectomy because of cholecystitis during the 3 years of the study. Of the 17 abnormal cholecystograms 10 showed radiolucent gallstones, and repeated studies documented gallstones in 6 of the 7 radiographs on which the gallbladder was not visualized. The prevalence of gallstones was found to be 211/1000, and that of gallbladder disease, 240/1000. The peak prevalence was at 30 to 39 years of age. The women with gallbladder disease were significantly more obese and of greater parity than those without gallbladder disease even when age was controlled. The Micmac Indian women of Nova Scotia appear to be at a much higher risk for the development of cholesterol gallstones and gallbladder disease than Caucasian women in Framingham, Massachusetts.     

Nutrient intake and meal patterns of Micmac indian and Caucasian women in Shubenacadie,NS.

North American Indians have a higher morbidity from gallbladder disease, diabetes mellitus and obesity than other North Americans; this may result from their food intake. Nutrient intake and meal patterns were compared in 120 Micmac Indian and 115 Caucasian women in Shubenacadie, NS. Findings were compared with the Canadian Dietary Standard (CDS) and the Nutrition Canada national and Indian survey reports. The diet of Indian women had higher carbohydrate, lower protein and lower fibre content than that of Caucasian women, who derived a higher percentage of energy from protein and had a higher intake of vitamin A, niacin and ascorbic acid. Overnight fast was longer among Indian women. A high percentage of all women studied reported diets that did not reach the CDS for total energy intake in kilocalories or for calcium, iron, vitamin A, thiamin or riboflavin.     

Dietary Adequacies among South African Adults in Rural KwaZulu-Natal

Background

Food quality, determined by micronutrient content, is a stronger determinant of nutritional status than food quantity. Health concerns resulting from the co-existence of over-nutrition and under-nutrition in low income populations in South Africa have been fully recognized in the last two decades. This study aimed to further investigate dietary adequacy amongst adults in rural KwaZulu-Natal, by determining daily energy and nutrient intakes, and identifying the degree of satisfaction of dietary requirements.

Methods

Cross-sectional study assessing dietary adequacy from 24-hour dietary recalls of randomly selected 136 adults in Empangeni, KwaZulu-Natal, South Africa.

Results

Results are presented for men (n = 52) and women (n = 84) 19–50 and >50 years old. Mean energy intake was greatest in women >50 years (2852 kcal/day) and exceeded Dietary Reference Intake’s for both men and women, regardless of age. Mean daily energy intake from carbohydrates was 69% for men and 67% for women, above the Dietary Reference Intake range of 45–65%. Sodium was also consumed in excess, and the Dietary Reference Intakes of vitamins A, B12, C, D, and E, calcium, zinc and pantothenic acid were not met by the majority of the population.

Conclusion

Despite mandatory fortification of staple South African foods, micronutrient inadequacies are evident among adults in rural South African communities. Given the excess caloric intake and the rising prevalence of obesity and other non-communicable diseases in South Africa, a focus on diet quality may be a more effective approach to influence micronutrient status than a focus on diet quantity.     

Prevalence of Pre‐obesity and Obesity in Urban Adult Mexicans in Comparison with Other Large Surveys

Objective: 1. To estimate the prevalence of pre‐obesity and obesity in a 1992 to 1993 national survey of the Mexican urban adult population. 2. To compare our findings with other national surveys and with data for Mexican Americans. Research Methods and Procedures: The national representative sample of the Mexican urban adult population included 8462 women and 5929 men aged 20 to 69 years from 417 towns of >2500 people. Body mass index (BMI), calculated from measured weight and height, was classified using the World Health Organization categories of underweight (BMI < 18.5 kg/m²), normal weight (BMI 18.5 to 24.9 kg/m²), pre‐obesity (PreOB = BMI 25 to 29.9 kg/m²) and obesity (OB = BMI 30+ kg/m²). Estimates for Mexican Americans were calculated from U.S. survey data. Results: Overall, 38% of the Mexican urban adult population were classified as pre‐obese and 21% as obese. Men had a higher prevalence of pre‐obesity than women did at all ages, but women had higher values of obesity. Both pre‐obesity and obesity increased with age up to the age range brackets of 40 to 49 or 50 to 59 years for both men and women. Both pre‐obesity and obesity prevalence estimates were remarkably similar to data for Mexican Americans from 1982 through 1984. Comparison with other large surveys showed that countries differed more in the prevalence of obesity than of pre‐obesity, leading to differences in the PreOB/OB ratio, and that countries also differed in the gender ratio (female/male) for both pre‐obesity and obesity. Discussion: Pre‐obesity and obesity were high in our population and increased with age. Our approach of characterizing large surveys by PreOB/OB and gender ratios appeared promising.     

Prevalence of Overweight and Obesity in Elderly People in Spain

Objective: To estimate the prevalence of obesity and overweight in the older adult population in Spain by sex, age, and educational level. Research Methods and Procedures: A cross‐sectional study was carried out in 2001 in a sample of 4009 persons representative of the noninstitutionalized population ≥60 years of age. Anthropometric measurements (BMI and waist circumference) were obtained using standardized techniques and equipment. Overweight was considered at a BMI of 25 to 29.9 kg/m² and obesity at a BMI of ≥30 kg/m². Central obesity was considered at a waist circumference of >102 cm in men and >88 cm in women. Results: The mean BMI was 28.2 kg/m² in men and 29.3 kg/m² in women. The prevalence of overweight and obesity in men was 49% and 31.5%, respectively. The corresponding percentages in women were 39.8% and 40.8%. The prevalence of obesity was higher in persons with no education than in those with third level education (i.e., university studies), especially among women (41.8% vs. 17.5%). The prevalence of central obesity was 48.4% in men and 78.4% in women. Differences by educational level were seen in only women, in whom the prevalence of central obesity was 80.9% in those with no education and 59% in those with third‐level education. Discussion: The prevalence of overweight and obesity in the Spanish adult elderly population is very high. Some other populations show similar prevalences, especially in Mediterranean countries. Socioeconomic conditions in Spain during the years these cohorts were born may partly explain the high‐frequency of obesity.     

Risk ratios for obesity in families of obese African-American and Caucasian women

We examined age- and sex-standardized risk ratios (SRRs) in matched samples of 1,185 families of obese African-American and Caucasian women. Familial risk ratios increased with body mass index (BMI) of proband and BMI thresholds of relative. Ratios were higher in Caucasian than African-American families, apparently because Caucasian probands were more extreme relative to their population mean. Risk ratios for moderate obesity (BMI >/= 30) were around 2 for African-Americans and were a little higher in Caucasians. Ratios for extreme obesity (BMI >/= 40) ranged from 3 to 5 in African-Americans and from about 5 to 9 in Caucasians. Thin relatives were rare in families of both races. Risk ratios appear high enough in both racial groups to facilitate the identification of quantitative trait loci underlying common obesity phenotypes. The high population prevalence of obesity in African-American women will require particularly high selection thresholds to achieve risk ratios comparable to those for Caucasians. The scarcity of thin siblings in both groups will greatly increase the effort required in sample recruitment for discordant pair designs.     

Prevalence of Night Eating in Obese and Nonobese Twins

The aim of this study was to assess the prevalence of night eating (NE) and associated symptoms in a population‐based sample of Swedish twins. A total of 21,741 individuals aged 20–47 years completed a questionnaire in 2005/2006. NE was defined as ≥25% of daily food intake after the evening meal and/or awakening at least once per week with eating episodes. The prevalence of NE was 4.6% in men and 3.4% in women. Among obese men and women, the prevalence was 8.4 and 7.5%, respectively. Men and women with NE had 3.4 and 3.6 times higher risk of binge eating compared to individuals without NE. The risk of sleep‐related problems was 1.6–3.4 times higher in men and 2.5–3.3 times higher in women with NE compared to those without NE. This epidemiological study has estimated the prevalence of NE in a twin population. It revealed that NE is 2.5 and 2.8 times more common in obese men and women compared to normal weight men and women. Furthermore that NE is associated with binge eating and sleep‐related problems.     

Tuberculosis

Obesity--defined by a body mass index above 30 kg per m2--is a major problem for affluent nations. Its prevalence is higher in North America than in Europe--between 9% and 12% of the population. Reduced energy expenditure from exercise or metabolism or both may be an important contributory factor in the development of obesity because of a failure to reduce food intake sufficiently to maintain energy balance. A high ratio of abdominal circumference relative to gluteal circumference carries a twofold or greater risk of heart attack, stroke, hypertension, diabetes mellitus, gallbladder disease, and death. The effect of increased quantities of abdominal fat is greater than that of a similar increase in total body fat on the risks of ill health associated with obesity. Genetic factors appear to contribute about 25% to its etiology.     

Prevalence of Uncomplicated Obesity in an Italian Obese Population

Objective: The existence of healthy obese subjects has been suggested but not clearly reported. We sought to address the prevalence of uncomplicated obesity and adverse risk factors in a large Italian obese population. Research Methods and Procedures: This was a cross‐sectional study of a population of consecutive Italian obese subjects. We studied 681 obese subjects (514 women and 167 men), with a mean age of 41.1 ± 13.9 years (range, 16 to 77 years), mean BMI of 40.2 ± 7.6 kg/m² (range, 30 to 89.8 kg/m²), and a history of obesity for 20.5 ± 7 years (range, 10.5 to 30 years). Anthropometric, metabolic, cardiac, and obesity‐related risk factors were evaluated. Results: The prevalence of uncomplicated subjects was 27.5%, independent of BMI and duration of obesity. The youngest group of obese subjects showed a higher, but not statistically significantly higher, prevalence of uncomplicated obesity. No statistical difference for the prevalence of impaired fasting glucose, glucose intolerance, high triglycerides, high total cholesterol, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol among BMI categories (from mild to extremely severe obesity degree) was found. Obese subjects with BMI >50 kg/m² showed a higher prevalence of high blood pressure only when they were compared with the group with a BMI of 30 to 35 kg/m² (p < 0.01). Obese subjects with BMI >40 kg/m² showed a higher prevalence of hyperinsulinemia than subjects with BMI 30 to 35 kg/m² (p < 0.01). Discussion: This study shows that a substantial part of an Italian obese population has uncomplicated obesity, and the prevalence of adverse risk factors in this sample is unexpectedly low and partially independent of obesity degree. Uncomplicated obesity could represent a well‐defined clinical entity.     

The Potential Impact of a 20% Tax on Sugar-Sweetened Beverages on Obesity in South African Adults: A Mathematical Model

Background/Objectives

The prevalence of obesity in South Africa has risen sharply, as has the consumption of sugar-sweetened beverages (SSBs). Research shows that consumption of SSBs leads to weight gain in both adults and children, and reducing SSBs will significantly impact the prevalence of obesity and its related diseases. We estimated the effect of a 20% tax on SSBs on the prevalence of and obesity among adults in South Africa.

Methods

A mathematical simulation model was constructed to estimate the effect of a 20% SSB tax on the prevalence of obesity. We used consumption data from the 2012 SA National Health and Nutrition Examination Survey and a previous meta-analysis of studies on own- and cross-price elasticities of SSBs to estimate the shift in daily energy consumption expected of increased prices of SSBs, and energy balance equations to estimate shifts in body mass index. The population distribution of BMI by age and sex was modelled by fitting measured data from the SA National Income Dynamics Survey 2012 to the lognormal distribution and shifting the mean values. Uncertainty was assessed with Monte Carlo simulations.

Results

A 20% tax is predicted to reduce energy intake by about 36kJ per day (95% CI: 9-68kJ). Obesity is projected to reduce by 3.8% (95% CI: 0.6%–7.1%) in men and 2.4% (95% CI: 0.4%–4.4%) in women. The number of obese adults would decrease by over 220 000 (95% CI: 24 197–411 759).

Conclusions

Taxing SSBs could impact the burden of obesity in South Africa particularly in young adults, as one component of a multi-faceted effort to prevent obesity.     

Macronutrients and obesity: Revisiting the calories in,calories out framework

Recent clinical research has studied weight responses to varying diet composition, but the contribution of changes in macronutrient intake and physical activity to rising population weight remains controversial. Research on the economics of obesity typically assumes a “calories in, calories out” framework, but a weight production model separating caloric intake into carbohydrates, fat, and protein, has not been explored in an economic framework. To estimate the contributions of changes in macronutrient intake and physical activity to changes in population weight, we conducted dynamic time series and structural VAR analyses of U.S. data between 1974 and 2006 and a panel analysis of 164 countries between 2001 and 2010. Findings from all analyses suggest that increases in carbohydrates are most strongly and positively associated with increases in obesity prevalence even when controlling for changes in total caloric intake and occupation-related physical activity. Our structural VAR results suggest that, on the margin, a 1% increase in carbohydrates intake yields a 1.01 point increase in obesity prevalence over 5 years while an equal percent increase in fat intake decreases obesity prevalence by 0.24 points.     

Meal Frequency and Childhood Obesity

Objective: Previous studies have demonstrated an inverse association between meal frequency and the prevalence of obesity in adulthood. The aim of this study was to assess the relationship between meal frequency and childhood obesity. Research Methods and Procedures: Stature and weight of 4370 German children ages 5 to 6 years were determined in six Bavarian (Germany) public health offices during the obligatory school entry health examination in 2001/2002. An extensive questionnaire on risk factors for obesity was answered by their parents. Obesity was defined according to sex‐ and age‐specific BMI cut‐off points proposed by the International Obesity Task Force. The main exposure was daily meal frequency. Results: The prevalence of obesity decreased by number of daily meals: three or fewer meals, 4.2% [95% confidence interval (CI), 2.8 to 6.1]; four meals, 2.8% (95% CI, 2.1 to 3.7); and 5 or more meals, 1.7% (95% CI, 1.2 to 2.4). These effects could not be explained by confounding due to a wide range of constitutional, sociodemographic, and lifestyle factors. The adjusted odds ratios for obesity were 0.73 (95% CI, 0.44 to 1.21) for four meals and 0.51 (95% CI, 0.29 to 0.89) for five or more meals. Additional analyses pointed to a higher energy intake in nibblers compared with gorgers. Discussion: A protective effect of an increased daily meal frequency on obesity in children was observed and appeared to be independent of other risk factors for childhood obesity. A modulation of the response of hormones such as insulin might be instrumental.     

Daily fat consumption by the population of Warsaw]

Fat intake with the diet has been assessed within screening Pol-MONICA--Warsaw Project in randomly selected sample of Warsaw inhabitants aged between 35 and 64 years. Altogether 2571 individuals have been screened. Fat intake in daily diet has been estimated by the 24-hour recall technique. In men, fat intake covered 38.4% of the total energy supply with the diet whereas in female population - 37.7%. Mean contribution of SFA and P/S ratio in both sex groups have been 15.8% and 0.285, respectively. Daily cholesterol intake has been 641 mg (224 mg/1000 kcal) in male and 456 mg (227/1000 kcal) in female population. These values did not change significantly with the age of the screened individuals. Such a diet may be considered atherogenic.     

Eating Frequency is Associated With Energy Intake but Not Obesity in Midlife Women

Midlife women tend to gain weight with age, thus increasing risk of chronic disease. The purpose of this study was to examine associations between overweight/obesity and behavioral factors, including eating frequency, in a cross‐sectional national sample of midlife women (n = 1,099) (mean age = 49.7 years, and BMI = 27.7 kg/m²). Eating behaviors and food and nutrient intakes were based on a mailed 1‐day food record. BMI was calculated from self‐reported height and weight, and level of physical activity was assessed by self‐reported questionnaire. After exclusion of low‐energy reporters (32% of sample), eating frequency was not associated with overweight/obesity (P > 0.05) and was not different between BMI groups (normal, 5.21 ± 1.79; overweight, 5.16 ± 1.74; obese, 5.12 ± 1.68, P = 0.769). Adjusted logistic regression showed that eating frequency, snacking frequency, breakfast consumption, eating after 10 pm and consuming meals with children or other adults were not significantly associated with overweight/obesity. Total energy intake increased as eating frequency increased in all BMI groups, however, obese women had greater energy intake compared to normal weight women who consumed the same number of meals and snacks. Intake of fruit and vegetables, whole grains, dietary fiber, dairy, and added sugars also increased as eating frequency increased. While eating frequency was not associated with overweight/obesity, it was associated with energy intake. Thus, addressing total energy intake rather than eating frequency may be more appropriate to prevent weight gain among midlife women.     

Polymorphisms of the FTO gene are associated with variation in energy intake, but not energy expenditure

The FTO gene has significant polymorphic variation associated with obesity, but its function is unknown. We screened a population of 150 whites (103F/47M) resident in NE Scotland, United Kingdom, for variants of the FTO gene and linked these to phenotypic variation in their energy expenditure (basal metabolic rate (BMR) and maximal oxygen consumption VO(2)max) and energy intake. There was no significant association between the FTO genotype and BMR or VO(2)max. The FTO genotype was significantly associated (P = 0.024) with variation in energy intake, with average daily intake being 9.0 MJ for the wild-type TT genotype and 10.2 and 9.5 MJ for the "at risk" AT and AA genotypes, respectively. Adjusting intake for BMR did not remove the significance (P = 0.043). FTO genotype probably affects obesity via effects on food intake rather than energy expenditure.     

Chronotype and energy intake timing in relation to changes in anthropometrics: a 7-year follow-up study in adults

Individuals with a later preference for the daily activities (evening types) tend to have unhealthier behaviors, which could increase their risk for obesity when compared those with an earlier preference (morning types). Furthermore, later food intake timing, another behavior more characteristic of evening types, has been associated with obesity. However, chronotype differences in the long-term weight change and the role of chronotype in the association between energy intake timing and obesity risk are not clear. To study this we first examined the independent associations of chronotype and energy intake timing with anthropometric changes and then whether chronotype modified the association between energy intake timing and obesity risk. Our data included 1097 Finns from DILGOM (DIetary Lifestyle and Genetic Determinants of Obesity and Metabolic syndrome) 2007 (baseline) and 2014 (follow-up) and from Findiet 2007. Chronotype was assessed with a shortened version of Horne and Östberg’s morningness–eveningness questionnaire. Energy intake timing (as percentages of the total energy intake in the morning/evening) was assessed with 48-h dietary recalls. Weight, body mass index (BMI), and waist circumference were based on measured and self-reported values. Analysis of co-variance and multivariable logistic regression models were used for statistical analyses. Evening typed women had greater weight gain (+ 2.3 kg vs. + 0.3 kg, P = 0.016) and increase in BMI (0.7 kg/m² vs. ?0.1 kg/m², P = 0.024) than morning typed women. After excluding participants with depression, these associations attenuated to non-significant. Compared to participants whose energy intake was proportionally lowest during evening, those with proportionally highest energy intake during evening were more likely with obesity (BMI≥ 30 kg/m²) after follow-up (OR 1.97, 95% CI 1.21–3.21, Ptrend = 0.042). Participants’ chronotype did not modify this association (Pinteract = 0.95). In conclusion, our findings indicated that evening energy intake may play a role in obesity regardless of the chronotype. Furthermore, evening typed women were more prone to increases in their anthropometrics, which seem to be at least partly explained by depression. Further studies of this topic are warranted.     

Calcium in the diet of selected groups of people]

Calcium-content was determined in 23,557 daily food rations of the individuals fed individually or in sets of food or meals prepared in various institutions (3,298) in 1975-1987. Calcium deficit in daily food of girls and adult women has ranged from 50% to 6.2% in comparison with daily intakes recommended in Poland. Mean content of calcium per 1000 kcal ranged from 191.6 mg to 276.2 mg in 24 of the analysed meals. Calcium deficit amounted to 14-37.4% in 20 out of 24 analysed daily meals for boys and men. Calcium content in the remaining daily food rations was equal or even higher than the Polish daily intake recommendation. A mean calcium content per 1000 kcal ranged from 211.6 mg to 342.1 mg. These results suggest, that the daily calcium intake in several groups of the general population is to low, especially in women. Authors suggest, that such a low calcium intake in the diet increases the risk of osteoporosis, and intoxications with lead and cadmium salts, especially in children.     

Nutritional status of adolescents in the context of the Moroccan nutritional transition: the role of parental education

In Morocco, the beginning of the nutritional transition is closely linked to social and economic transformations and changes in behaviour and traditional lifestyles. The objective of this study is to describe the current pattern of food consumption and the nutritional status of adolescents in the province of Ouarzazate and its association with parents' educational level. The sample comprises 327 high school students from Ouarzazate: 135 (41.3%) boys and 192 (58.7%) girls (age range 15-20 years). For both boys and girls, the results show lower height and BMI z-scores than the WHO reference values. Adolescents whose parents have a low educational level have lower height/age and BMI/age z-scores than those whose fathers have a high educational level. No differences are observed in total daily energy intake depending on fathers' educational level, but the energy provided by lipids is higher in adolescents whose fathers have a high educational background. The quality of fats consumed (MUFA+PUFA/SFA) is better among those boys whose fathers have low education, but no differences are observed for girls. The process of nutritional transition is not uniform in the sample, but depends on the socioeconomic characteristics of population groups, which include, among others, accessibility of certain food, differences in habits and lifestyles related to energy expenditure, and higher prevalence of overweight and obesity in more favoured groups.     

Trends in pre-pregnancy obesity in nine states, 1993-2003

Objective: Pre‐pregnancy obesity poses risks to both pregnant women and their infants. This study used a large population‐based data source to examine trends, from 1993 through 2003, in the prevalence of pre‐pregnancy obesity among women who delivered live infants. Research Methods and Procedures: Data from the Pregnancy Risk Assessment Monitoring System in nine states were analyzed for trends in pre‐pregnancy obesity (BMI > 29.0 kg/m²) overall and by maternal demographic and behavioral characteristics. Pre‐pregnancy BMI was calculated from self‐reported weight and height on questionnaires administered after delivery, and demographic characteristics were taken from linked birth certificates. The sample of 66,221 births was weighted to adjust for survey design, non‐coverage, and non‐response, and it is representative of all women delivering a live birth in each particular state. The sampled births represented 18.5% of all births in the United States. Results: Pre‐pregnancy obesity increased 69.3% during the study period, from 13.0% in 1993 to 1994 to 22.0% in 2002 to 2003. The percentage increase ranged from 45% to 105% for individual states. Subgroups of women with the highest prevalence of obesity in 2002 to 2003 were those who were 20 to 29 years of age, black, had three or more children, had a high school education, enrolled in Women, Infants, and Children, or were non‐smokers. However, all subgroups of women examined experienced at least a 43% increase in pre‐pregnancy obesity over this time period. Discussion: The prevalence of pre‐pregnancy obesity is increasing among women in these nine states, and this trend has important implications for all stages of reproductive health care.     

Prevalence of obesity and correlations with lifestyle and dietary factors in Chinese men

Objective: To estimate the age‐adjusted prevalence of general and centralized obesity among Chinese men living in urban Shanghai. Methods and Procedures: A cross‐sectional study was conducted in 61,582 Chinese men aged 40–75. BMI (kg/m²) was used to measure overweight (23 ≤ BMI < 27.4) and obesity (BMI ≥ 27.5) based on the World Health Organization (WHO) recommended criteria for Asians. Waist‐to‐hip ratio (WHR) was used to measure moderate (75th ≤ WHR < 90th percentile) and severe (WHR ≥ 90th percentile) centralized obesity. Results: The average BMI and WHR were 23.7 kg/m² and 0.90, respectively. The prevalence of overweight was 48.6% and obesity was 10.5%. The prevalence of general and centralized obesity was higher in men with high income or who were retired, tea drinkers, or nonusers of ginseng than their counterparts. Men with high education had a higher prevalence of overweight and centralized obesity, but had a lower prevalence of obesity and severe centralized obesity compared to those with less education. Current smokers or alcohol drinkers had a lower prevalence of general obesity but higher prevalence of centralized obesity than nonsmokers or nondrinkers of alcohol. Ex‐smokers and ex‐alcohol drinkers had a higher prevalence of general and centralized obesity compared to nonsmokers and nondrinkers of alcohol. Prevalence of obesity was associated with high energy intake and less daily physical activity. Discussion: The prevalence of obesity among Chinese men in urban Shanghai was lower than that observed in Western countries but higher than that in other Asian countries, and the prevalence of general and centralized obesity differed by demographic, lifestyle, and dietary factors.