Overweight and Obesity: Prediction by Silhouettes in Young Adults

The present study analyzes the prevalence of overweight/obesity in a sample of young adults from the University of the Basque Country (Spain), and tests the efficiency of the silhouettes to predict overweight/obesity. This cross‐sectional study was conducted in a sample of volunteer university students from the University of the Basque Country (356 men and 745 women, age: 18–33 years), who came to the Physical Anthropology laboratory where a standardized questionnaire was administered and anthropometric measurements were taken by a well‐trained anthropometrist. Height and weight were obtained. BMI was calculated as weight/height² (kg/m²) and it was used as a reference method. Using a questionnaire, based on the standard figural stimuli, subjects were asked to choose the silhouette which was closest to his/her usual appearance (current body size). The accuracy of the Williamson et al.'s silhouettes as an overweight‐obesity indicator was analyzed by gender‐specific receiver operating curve (ROC). The cutoff figure to distinguish between nonoverweight and overweight‐obese individuals corresponded to number 7 in men and 6 in women. These cutoff values matched optimal sensitivity and specificity, with few nonoverweight subjects selecting silhouettes bigger than 7 in the case of men or 6 for women. In conclusion, the figural stimuli allows the identification of populations at overweight/obesity risk with the simple use of silhouettes, at least in this rank of age, where the overweight and obesity are yet little frequent.     

Childhood and Young Adult Overweight/Obesity and Incidence of Depression in the SUN Project

This study included 11,825 participants of a Spanish dynamic prospective cohort based on former students from University of Navarra, registered professionals from some Spanish provinces, and university graduates from other associations, followed‐up for 6.1 years. We aimed to assess the association between childhood or young adult overweight/obesity and the risk of depression. Participants were asked to select which of nine figures most closely represented their body shape at ages 5 and 20 years. Childhood and young adult overweight/obesity was defined as those cases in which participants reported body shape corresponding to the figures 6–9 (more obese categories) at age 5 or 20, respectively. A subject was classified as incident case of depression if he/she was initially free of depression and reported physician‐made diagnosis of depression and/or the use of antidepressant medication in at least one of biannual follow‐up questionnaires. The association between childhood and young adult overweight/obesity and incidence of depression was estimated by multiple‐adjusted hazard ratio (HR) and its 95% confidence interval (95% CI). Overweight/obesity at age 5 years predicted an increased risk for adult depression (HR = 1.50, 95% CI = 1.06–2.12), and a stronger association was observed at age 20 years ((HR = 2.22, 95% CI = 1.22–4.08), (subjects younger than 30 years at recruitment were excluded from this last analysis)). Childhood or young adult overweight/obesity was associated with elevated risk of adult depression. These results, if causal and confirmed in other prospective studies, support treating childhood and young adult overweight/obesity as part of comprehensive adult depression prevention efforts.     

Birth Weight,Growth and Feeding Pattern in Early Infancy Predict Overweight/Obesity Status at Two Years of Age: A Birth Cohort Study of Chinese Infants

Objectives

To investigate the early determinants of overweight and obesity status at age two years.

Methods

A total of 1098 healthy neonates (563 boys and 535 girls) were involved in this community-based prospective study in China. Data on body weight and length were collected at birth, the 3^rd and 24^th month. A self-administered questionnaire was used to collect data on social demography and feeding patterns of children, etc. Three multivariable logistic regression models were employed to make various comparisons of weight status, i.e., model 1 (obesity vs. non-obesity), model 2 (combined overweight and obesity vs. normal weight, and model 3 (obesity, overweight and normal weight).

Results

Prevalences of overweight/obesity (95^th >BMI ≥85^th p and BMI ≥95^th p, referring to WHO BMI standards) at 2 years of age are 15.8%/11.2% for boys and 12.9%/9.0% for girls, respectively. Being born with macrosomia (OR: 1.80–1.88), relatively greater BMI increment in the first 3 months (OR: 1.15–1.16) and bottle emptying by encouragement at age two (OR: 1.30–1.57) were found in all three models to be significant risk factors for higher BMI status at 2 years. Pre-pregnancy maternal BMI (OR: 1.09–1.12), paternal BMI (OR: 1.06), and mixed breastfeeding (OR: 1.54–1.57) or formula feeding (OR: 1.90–1.93) in the first month were identified as significant in models 2 and 3. Child-initiated bottle emptying at age two was observed to increase the risk of obesity by 1.31 times but only in model 1.

Conclusion

Fetal and early postnatal growth and feeding pattern appear to have significant impacts on early childhood overweight and obesity status independent of parental BMI. Policy-based and multidisciplinary approaches to promote breastfeeding and enhancement of feeding skills of care takers may be promising intervention strategies.     

Associations of Fat Distribution and Obesity with Hypertension in a Bi‐ethnic Population: The ARIC Study

Objective: To examine associations of hypertension with obesity and fat distribution among African American and white men and women. Research Methods and Procedures: The analysis sample included 15,063 African American and white men and women between the ages of 45 and 64 years who were participants in the 1987 through 1989 examination of the Atherosclerosis Risk in Communities Study (ARIC). Odds ratios and adjusted prevalences of hypertension were calculated across sexspecific quintiles of body mass index (BMI), waist‐to‐hip ratio (WHR), waist circumference, and waist‐to‐height ratio (waist/height) and adjusted for age, research center, smoking, education, physical activity, alcohol consumption, hormone replacement therapy, and menopausal status. Results: The prevalence of hypertension was higher among African Americans than whites. In the lowest quintile of BMI, 41% of African American women and 43% of African American men had hypertension compared with 14% of white women and 19% of white men. Elevated BMI, WHR, waist circumference, and waist/height were associated with increased odds of hypertension in African American and white men and women. In women, but not in men, there were significant interactions between ethnicity and the anthropometric variables studied here. The direction of the interaction indicated larger odds ratios for hypertension with increasing levels of anthropometric indices in white compared with African American women. Discussion: Obesity and abdominal fat preponderance were associated with increased prevalence of hypertension in African American and white men and women. Associations were similar among African American and white men, but obesity and fat patterning were less strongly associated with hypertension in African American than in white women.     

Early Risk Factors of Overweight Developmental Trajectories during Middle Childhood

Background

Research is needed to identify early life risk factors associated with different developmental paths leading to overweight by adolescence.

Objectives

To model heterogeneity in overweight development during middle childhood and identify factors associated with differing overweight trajectories.

Methods

Data was drawn from the Quebec Longitudinal Study of Child Development (QLSCD; 1998-2010). Trained research assistants measured height and weight according to a standardized protocol and conducted yearly home interviews with the child’s caregiver (mother in 98% of cases). Information on several putative early life risk factors for the development of overweight were obtained, including factors related to the child’s perinatal, early behavioral family and social environment. Group-based trajectories of the probability of overweight (6-12 years) were identified with a semiparametric method (n=1678). Logistic regression analyses were used to identify early risk factors (5 months- 5 years) associated with each trajectory.

Results

Three trajectories of overweight were identified: “early-onset overweight” (11.0 %), “late-onset overweight” (16.6%) and “never overweight” (72.5%). Multinomial analyses indicated that children in the early and late-onset group, compared to the never overweight group, had 3 common types of risk factors: parental overweight, preschool overweight history, and large size for gestational age. Maternal overprotection (OR= 1.12, CI: 1.01-1.25), short nighttime sleep duration (OR=1.66, CI: 1.07-2.57), and immigrant status (OR=2.01, CI: 1.05-3.84) were factors specific to the early-onset group. Finally, family food insufficiency (OR=1.81, CI: 1.00-3.28) was weakly associated with membership in the late-onset trajectory group.

Conclusions

The development of overweight in childhood follows two different trajectories, which have common and distinct risk factors that could be the target of early preventive interventions.     

The High Prevalence of Overweight and Obesity in Mexican Children

Objective: To establish the prevalence of overweight and obesity in Mexican children 10 to 17 years of age according to the percentiles from both the Centers of Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF). Research Methods and Procedures: Heights and weights were measured in children from nationally representative, randomly chosen households in the Mexican National Health Survey 2000. The study population consisted of 7862 boys and 8947 girls, 10 to 17 years of age. Measurements used were the percentage of children in the corresponding BMI categories for overweight and obesity specified by the CDC and the IOTF BMI percentiles. Results: The children were short, with mean Z scores for height by age varying from ? 0.62 ± 1.26 to ?1.12 ± 1.06 in boys and from ?0.45 ± 1.25 to ?1.19 ± 1.12 in girls. CDC‐based overweight prevalences varied by age from 10.8% to 16.1% in boys and 14.3% to 19.1% in girls, with obesity prevalences from 9.2% to 14.7% in boys and 6.8% to 10.6% in girls; these prevalences did not relate to stunting. IOTF‐based excess weight prevalences were similar, with higher overweight rates (boys, 15.4% to 18.8%; girls, 18.4% to 22.3%) but lower obesity rates (boys, 6.1% to 9%; girls, 5.9% to 8.2%). Discussion: Mexican children have one‐half the overweight/obesity prevalences of U.S. Mexican‐American children; however, there are higher rates in Northern Mexico, which is closer to the U.S. These escalating rates of excess weight demand new prevention, as well as management, policies.     

Minimum Wage and Overweight and Obesity in Adult Women: A Multilevel Analysis of Low and Middle Income Countries

Objectives

To describe the relationship between minimum wage and overweight and obesity across countries at different levels of development.

Methods

A cross-sectional analysis of 27 countries with data on the legislated minimum wage level linked to socio-demographic and anthropometry data of non-pregnant 190,892 adult women (24–49 y) from the Demographic and Health Survey. We used multilevel logistic regression models to condition on country- and individual-level potential confounders, and post-estimation of average marginal effects to calculate the adjusted prevalence difference.

Results

We found the association between minimum wage and overweight/obesity was independent of individual-level SES and confounders, and showed a reversed pattern by country development stage. The adjusted overweight/obesity prevalence difference in low-income countries was an average increase of about 0.1 percentage points (PD 0.075 [0.065, 0.084]), and an average decrease of 0.01 percentage points in middle-income countries (PD -0.014 [-0.019, -0.009]). The adjusted obesity prevalence difference in low-income countries was an average increase of 0.03 percentage points (PD 0.032 [0.021, 0.042]) and an average decrease of 0.03 percentage points in middle-income countries (PD -0.032 [-0.036, -0.027]).

Conclusion

This is among the first studies to examine the potential impact of improved wages on an important precursor of non-communicable diseases globally. Among countries with a modest level of economic development, higher minimum wage was associated with lower levels of obesity.

Research Highlights

• Many economic factors are known to influence overweight and obesity, yet evidence on policy-related determinants is scant.
• We examined national minimum wage levels and measured overweight/obesity using multilevel models for 27 developing countries.
• We found a weak but significant lower probability of being overweight or obese associated with higher levels of minimum wage in more developed countries, and a small increase in prevalence in the least developed countries.
• Results suggested a potential societal effect of minimum wage on overweight and obesity that should be examined longitudinally to determine its potential as a structural intervention.

     

Epidemiology of Overweight and Obesity in a Greek Adult Population: the ATTICA Study

Objective: To evaluate the status of overweight and obesity in a Greek random sample. Research Methods and Procedures: From 2001 to 2002, 1514 men (20 to 87 years old) and 1528 women (20 to 89 years old) were enrolled into the study. Among several sociodemographic, lifestyle, and bioclinical factors, anthropometric characteristics were also recorded. Overweight and obesity were defined according to the World Health Organization classification. Results: The prevalences of overweight and obesity were 53% and 20% in men and 31% and 15% in women (p for gender differences < 0.05). The age‐adjusted peak prevalence of obesity was observed in men older than 40 years old and women between 50 and 59 years old (Bonferonni α < 0.001). Central obesity prevailed in 36% of men and 43% of women (p for gender differences < 0.001). Obesity varied from 10% in rural to 25% in urban areas, but this difference was explained mainly by differences in occupational status (p = 0.9). Moreover, obese and overweight participants were older, less educated, more frequently sedentary, consumed higher quantities of alcoholic beverages, and were devoted to an unhealthier diet as compared with those of normal weight (all p < 0.05). A positive association was also observed between BMI and diastolic and systolic blood pressures, total cholesterol, triglycerides, and glucose levels (all p < 0.001). Discussion: Overweight and obesity seem to be a great health problem in the Greek population, especially in middle‐aged and older adults. Unfavorable lifestyle habits, low education, and the classical cardiovascular risk factors were associated with the prevalence of these health conditions.     

长沙市开福区小学生超重和肥胖现况调查

目的:了解长沙市开福区小学生超重、肥胖情况,为小学生单纯性肥胖的防治工作提供科学依据.方法:随机抽取长沙市开福区7-12周岁小学生4140名,按照体重指数(BMI)法判定出超重和肥胖.结果:长沙市开福区儿童超重及肥胖检出率分别为9.76%和7.39%.其中,男女生超重检出率分别为12.31%和6.84%,肥胖检出率分别为9.37%和5.13%,男生超重和肥胖检出率均显著高于女生.结论:长沙市开福区小学生超重和肥胖的发生率在国内处于高水平,男童肥胖的发展趋势较为突出,提示及早预防和控制儿童肥胖的重要性.     

Overweight,Obesity and Weight Control

Evidence is cited showing that overweight is a health hazard, but that this is primarily true only when the excess weight is due to an excess accumulation of adipose tissue. Diagnosis of frank obesity should be established by a careful interpretation of height-weight tables and of all other pertinent data. Although many factors play an etiologic role, obesity can occur only when caloric intake exceeds caloric output, and can be obviated only when this imbalance is reversed. Therefore prevention of weight gain, which should receive increasing attention, and also satisfactory weight loss, both require that caloric output be increased through added physical activity and that caloric intake be decreased through diminished consumption. Success depends on recognizing the fallacy of all misleading misinformation, and on establishing permanent habits of regular exercise and of moderation in eating and drinking. Suggestions are made that can be effective guidelines to a commonsense program of weight control.     

Differing Patterns of Overweight and Obesity among Black Men and Women in Cape Town: The CRIBSA Study

Objectives

To ascertain the prevalence and determinants of overweight/obesity in the 25–74-year-old urban black population of Cape Town and examine the changes between 1990 and 2008/09.

Methods

In 2008/09, a representative cross-sectional sample, stratified for age and sex, was randomly selected from the same townships sampled in 1990. Data were collected by questionnaires, clinical measurements and biochemical analyses. Gender-specific linear regression models evaluated the associations with overweight/obesity.

Results

There were 1099 participants, 392 men and 707 women (response rate 86%) in 2008/09. Mean body mass index (BMI) and waist circumference (WC) were 23.7 kg/m² (95% confidence interval (CI): 23.1–24.2) and 84.2 cm (95% CI: 82.8–85.6) in men, and 33.0 kg/m² (95% CI: 32.3–33.7) and 96.8 cm (95% CI: 95.5–98.1) in women. Prevalence of BMI ≥25 kg/m² and raised WC were 28.9% (95% CI: 24.1–34.3) and 20.1% (95% CI: 15.9–24.9) in men, and 82.8% (95% CI: 79.3–85.9) and 86.0% (95% CI: 82.9–88.6) in women. Among 25–64-year-olds, BMI ≥25 kg/m² decreased between 1990 (37.3%, 95% CI: 31.7–43.1) and 2008/09 (27.7%, 95% CI: 22.7–33.4) in men but increased from 72.7% (95% CI: 67.6–77.2) to 82.6% (95% CI: 78.8–85.8) in women. In the regression models for men and women, higher BMI was directly associated with increasing age, wealth, hypertension and diabetes but inversely related to daily smoking. Also significantly associated with rising BMI were raised low-density lipoprotein cholesterol and being employed compared to unemployed in men, and having >7 years of education in women.

Conclusions

Overweight/obesity, particularly in urban black women, requires urgent action because of the associations with cardiovascular disease risk factors and their serious consequences.     

The Relationship Between Serum Copper and Overweight/Obesity: a Meta-analysis

Biological Trace Element Research - The relationship between serum copper (Cu) level and overweight/obesity remains controversial. The purpose of this meta-analysis is to evaluate the relationship....     

The Role of Overweight and Obesity in Calcium Oxalate Stone Formation

Objective: The aim of the study was to assess the influence of overweight and obesity on the risk of calcium oxalate stone formation. Research Methods and Procedures: BMI, 24‐hour urine, and serum parameters were evaluated in idiopathic calcium oxalate stone formers (363 men and 164 women) without medical or dietetic pretreatment. Results: Overweight and obesity were present in 59.2% of the men and in 43.9% of the women in the study population. Multiple linear regression analysis revealed a significant positive relationship between BMI and urinary uric acid, sodium, ammonium, and phosphate excretion and an inverse correlation between BMI and urinary pH in both men and women, whereas BMI was associated with urinary oxalate excretion only among women and with urinary calcium excretion only among men. Serum uric acid and creatinine concentrations were correlated with BMI in both genders. Because no association was established between BMI and urinary volume, magnesium, and citrate excretion, inhibitors of calcium oxalate stone formation, the risk of stone formation increased significantly with increasing BMI among both men and women with urolithiasis (p = 0.015). The risk of calcium oxalate stone formation, median number of stone episodes, and frequency of diet‐related diseases were highest in overweight and obese men. Discussion: Overweight and obesity are strongly associated with an elevated risk of stone formation in both genders due to an increased urinary excretion of promoters but not inhibitors of calcium oxalate stone formation. Overweight and obese men are more prone to stone formation than overweight women.     

Intrinsic Brain Connectivity Related to Age in Young and Middle Aged Adults

Age-related variations in resting state connectivity of the human brain were examined from young adulthood through middle age. A voxel-based network measure, degree, was used to assess age-related differences in tissue connectivity throughout the brain. Increases in connectivity with age were found in paralimbic cortical and subcortical regions. Decreases in connectivity were found in cortical regions, including visual areas and the default mode network. These findings differ from those of recent developmental studies examining earlier growth trajectories, and are consistent with known changes in cognitive function and emotional processing during mature aging. The results support and extend previous findings that relied on a priori definitions of regions of interest for their analyses. This approach of applying a voxel-based measure to examine the functional connectivity of individual tissue elements over time, without the need for a priori region of interest definitions, provides an important new tool in brain science.     

Early Vascular Aging in Young and Middle-Aged Ischemic Stroke Patients: The Norwegian Stroke in the Young Study

Background

Ischemic stroke survivors have high risk of cardiovascular morbidity and mortality even at young age, suggesting that early arterial aging is common among such patients.

Methods

We measured aortic stiffness by carotid-femoral pulse wave velocity (PWV) in 205 patients (69% men) aged 15–60 years with acute ischemic stroke in the prospective Norwegian Stroke in the Young Study. High for age carotid-femoral PWV was identified in the reference normogram.

Results

Patients were on average 49±10 years old, 34% had a history of hypertension and 37% had metabolic syndrome (MetS). In the total study population, higher PWV was associated with history of hypertension (β = 0.18), higher age (β = 0.34), systolic blood pressure (BP) (β = 0.28) and serum creatinine (β = 0.18) and lower high-density lipoprotein (HDL) cholesterol (β = –0.10, all p<0.01) in multivariate linear regression analysis (multiple R² = 0.42, p<0.001). High for age PWV was found in 18% of patients. In univariate analyses, known hypertension was associated with a 6-fold, MetS with a 4-fold and presence of carotid plaque with a 3.7-fold higher risk for high for age PWV (all p<0.01). In multiple logistic regression analysis higher systolic BP (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.02–1.06; p<0.01), history of hypertension (OR 3.59; 95% CI 1.52–8.51; p<0.01), low HDL cholesterol (OR 3.03; 95% CI 1.00–9.09; p = 0.05) and higher serum creatinine (OR 1.04; 95% CI 1.01–1.06; p<0.01) were associated with high for age PWV.

Conclusions

Higher PWV is common in younger and middle-aged ischemic stroke patients and associated with a clustering of classical cardiovascular risk factors.ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01597453","term_id":"NCT01597453"}}NCT01597453     

Overweight,Obesity, and Blood Pressure: The Effects of Modest Weight Reduction

Several large epidemiological studies have shown an association between body mass index and blood pressure in normal weight and overweight patients. Weight gain in adult life especially seems to be an important risk factor for the development of hypertension. Weight loss has been recommended for the obese hypertensive patient and has been shown to be the most effective nonpharmacological treatment approach. However, long‐term results of weight loss programs are disappointing with people often regaining most of the weight initially lost. In recent years, a modest weight loss, defined as a weight loss of 5% to 10% of baseline weight, has received increasing attention as a new treatment strategy for overweight and obese patients. A more gradual and moderate weight loss is more likely to be maintained over a longer period of time. Several studies have confirmed the blood pressure‐lowering effect of a modest weight loss in both hypertensive and nonhypertensive patients. A modest weight loss can normalize blood pressure levels even without reaching ideal weight. In patients taking antihypertensive medication, a modest weight loss has been shown to lower or even discontinue the need for antihypertensive medication. In patients with high normal blood pressure, a modest weight loss can prevent the onset of frank hypertension. The blood pressure‐lowering effect of weight loss is most likely a result of an improvement in insulin sensitivity and a decrease in sympathetic nervous system activity and occurs independent of salt restriction. In conclusion, a modest weight loss that can be maintained over a longer period of time is a valuable treatment goal in hypertensive patients.     

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.