Prevalence of Helicobacter pylori Infection and Identification of Risk Factors in Rural and Urban Beijing, China

Background:  The prevalence of Helicobacter pylori is higher in developing countries such as China. The aim of this study was to investigate the prevalence of H. pylori in one rural and one urban region of Beijing, China.
Materials and Methods:  Healthy individuals in rural Pinggu and urban Haidian voluntarily participated in this study. The diagnosis of H. pylori infection was reached using the ¹³C-urea breath test. Associations between H. pylori and sex, age, living area (i.e. rural vs urban), education level, smoking, and alcohol consumption were evaluated.
Results:  Of the 1232 included subjects, 54.7% of tested individuals residing in Pinggu and 41.3% in Haidian were positive for H. pylori . In urban region, more individuals were negative for H. pylori (429 of 731), whereas in the rural region, more individuals were positive for H. pylori ( p <  .05). Univariate analysis identified geographic area and lower education and annual income as significant factors associated with H. pylori . Men in rural areas were more likely than women in rural areas to be infected, and both men and women in the rural area were more likely to be positive for H. pylori than men and women in the urban area (all p  < .05).
Conclusions:  H. pylori infection is common in both rural and urban regions of Beijing. Residing in a rural area, having a lower family income, and lower education level are significant risk factors associated with infection.     

Lead,Cadmium and Zinc in Hair Samples: Relationship with Dietary Habits and Urban Environment

This study was performed in order to analyze the relationships between hair zinc, lead, and cadmium with the kind of diet consumed (by recall of the diet consumed the previous 14 days), living area (urban or rural), tobacco smoking, and body mass index (BMI) among 419 individuals of the Canary Archipelago. Median values and interquartile range were 43 μg/g (18.50–132.50) for zinc, 4.09 μg/g (2.19–8.38) for lead, and 0.128 μg/g (0.05–0.30) for cadmium. We observed that hair zinc was markedly elevated among those consuming fish more frequently and, to a lesser amount, among those who consumed meat frequently, among those living in urban areas, and among those with BMI over 25 kg/m², keeping a significant relationship with BMI. Hair lead was also higher among fish consumers, showed a trend to higher values among inhabitants of urban areas, and was lower among obese individuals. Hair cadmium was higher among those who consumed less vegetables and fruits. By multivariate analysis, introducing the variables meat, fish, and vegetable consumption, urban/rural; sex; age; and BMI values, we observed that fish consumption (beta?=?0.15) was the only variable independently associated to higher zinc levels; fish consumption (beta?=?0.15) and meat consumption (beta?=?0.17) were related to high cadmium levels, whereas meat consumption was significantly associated to higher hair lead levels (beta?=?0.15). Therefore, we conclude that hair zinc, cadmium, and lead seem to depend more heavily on dietary habits than on tobacco consumption or living in rural or urban areas.     

Increasing modularity when downscaling networks from species to individuals

Downscaling networks from species to individuals is a useful approach to incorporate inter‐individual variation and to investigate whether topology of species‐based networks results from processes acting at the scale of individuals, such as foraging behaviour. Here, we analyzed pollen‐transport networks at two scales, i.e. pollinator species–plant species (sp–sp) and pollinator individuals–plant species (i–sp), and assessed whether modularity – a prevalent pattern in most pollination networks – is consistent across both scales. To test this we use three different algorithms developed for the calculation of modularity (unipartite, bipartite and weighted bipartite modularity) and compare the results obtained. Downscaling networks revealed a higher modular structure in i–sp networks than in sp–sp networks, regardless of the modular metric used. Using a null model approach, we show that modularity at the individual scale is originated by the existence of a high heterogeneity and specialization in the partition of pollen resources among conspecific individuals, a pattern which obviously cannot be observed at the species level. Modules in i–sp networks consisted of individuals sometimes neither taxonomically nor functionally related, but sharing common pollen resources at different moments of the flowering season. Interestingly, conspecific individuals may belong to different modules. Both plant and insect phenologies were important drivers of the modularity detected in individual‐based networks, even determining the topological roles of nodes in the networks. A temporal turnover of modules was identified, i.e. modules of individuals assembled and disassembled over time as species modify their foraging choices throughout the flowering season adjusting to ecological conditions. Downscaling from species to individual‐based networks is a promising approach to study the interplay among structural patterns and processes at different, but interdependent organizational levels.     

Appropriateness Criteria for Bariatric Surgery: Beyond the NIH Guidelines

Careful selection of bariatric patients is critical for successful outcomes. In 1991, the NIH first established patient selection guidelines; however, some surgeons operate on individuals outside of these criteria, i.e., extreme age groups. We developed appropriateness criteria for the spectrum of patient characteristics including age, BMI, and severity of eight obesity‐related comorbidities. Candidate criteria were developed using combinations of patient characteristics including BMI: ≥40 kg/m², 35–39, 32–34, 30–31, <30; age: 12–18, 19–55, 56–64, 65+ years old; and comorbidities: prediabetes, diabetes, hypertension, dyslipidemia, sleep apnea, venous stasis disease, chronic joint pain, and gastroesophageal reflux (plus severity level). Criteria were formally validated on their appropriateness of whether the benefits of surgery clearly outweighed the risks, by an expert panel using the RAND/UCLA modified Delphi method. Nearly all comorbidity severity criteria for patients with BMI ≥40 kg/m² or BMI = 35–39 kg/m² in intermediate age groups were found to be appropriate for surgery. In contrast, patients in the extreme age categories were considered appropriate surgical candidates under fewer conditions, primarily the more severe comorbidities, such as diabetes and hypertension. For patients with a BMI of 32–34, only the most severe category of diabetes (Hgb A1c >9, on maximal medical therapy), is an appropriate criterion for those aged 19–64, whereas many mild to moderate severity comorbidity categories are “inappropriate.” There is overwhelming agreement among the panelists that the current evidence does not support performing bariatric surgery in lower BMI individuals (BMI <32). This is the first development of appropriateness criteria for bariatric surgery that includes severity categories of comorbidities. Only for the most severe degrees of comorbidities were adolescent and elderly patients deemed appropriate for surgery. Patient selection for bariatric procedures should include consideration of both patient age and comorbidity severity.     

Family Income Affects Children’s Altruistic Behavior in the Dictator Game

This study aimed to examine how family income and social distance influence young rural Chinese children’s altruistic behavior in the dictator game (DG). A total of 469 four-year-old children from eight rural areas in China, including many children left behind by parents who had migrated to urban areas for work, played the DG. Stickers comprised the resource, while recipients in the game were assumed to be either their friends or strangers, with the social distance (i.e., strangers compared to friends) as a between-subjects variable. Children donated significantly more stickers to their friends than to strangers. Moreover, children from lower income families donated more stickers than children from higher income families. However, no gender and parental migrant status differences in children’s prosocial behaviors were evident in this sample. Findings of this study suggest that children’s altruistic behaviours to peers are influenced by family characteristics since preschool age. The probable influence of local socialization practices on development and the possible adaptive significance were discussed.     

The extent of overweight index in children and adolescents from Cracow,Poland (1971–2000)

Obesity indices describe the percentage of overweight and obese children in a given population but they do not show the extent to which the norms have been exceeded. The aim of this work was to determine the extent of overweight index (EOW), suggested by Jolliffe, 2004a, Jolliffe, 2004b, by examining children and adolescents from Cracow in order to obtain information on overweight and obesity prevalence and on the amounts by which the BMI age- and sex-specific norms are exceeded, emphasising usefulness of EOW in population studies.The study material comprises three randomly selected groups, representative for Cracow: (1) measured in 1971 which includes 4090 individuals of both sexes and aged 7–19 years, (2) measured in 1983 with 6542 individuals aged 3–19 years and (3) measured in 2000 with 4524 boys and girls aged 3–19 years. The EOW index of overweight is a mean relative deviation from BMI threshold, assuming that for values lower than the threshold ones, the deviation amounts to zero.The EOW index values in boys increased from 0.9 in 1971 up to 2.2 in 2000 i.e. by 144%, indicating an increase of both prevalence of overweight and obesity and an increase of the amount by which the limits of overweight are exceeded. In girls the index also increased, though less dramatically, from 0.7 in 1971 to 1.5 in 2000 i.e. by 114%.An analysis of the results showed that the increasing prevalence of overweight and obesity in children and adolescents is accompanied by an increase of the amount by which the BMI threshold values are exceeded.     

Overweight and poor? On the relationship between income and the body mass index

Contrary to conventional wisdom, NHANES data indicate that the poor have never had a statistically significant higher prevalence of overweight status at any time in the last 35 years. Despite this empirical evidence, the view that the poor are less healthy in terms of excess accumulation of fat persists. This paper provides evidence that conventional wisdom is reflecting important differences in the relationship between income and the body mass index. The first finding is based on distribution-sensitive measures of overweight which indicates that the severity of overweight has been higher for the poor than the nonpoor throughout the last 35 years. The second finding is from a newly introduced estimator, unconditional quantile regression (UQR), which provides a measure of the income-gradient in BMI at different points on the unconditional BMI distribution. The UQR estimator indicates that the strongest relationship between income and BMI is observed at the tails of the distribution. There is a statistically significant negative income gradient in BMI at the obesity threshold and some evidence of a positive gradient at the underweight threshold. Both of these UQR estimates imply that for those at the tails of the BMI distribution, increases in income are correlated with healthier BMI values.     

School level contextual factors are associated with the weight status of adolescent males and females

Objective: To determine whether school context influences the BMI of adolescent males and females. Methods and Procedures: Our sample was 17,007 adolescents (aged 12–19) from the National Longitudinal Study of Adolescent Health (Add Health). We used gender‐stratified multilevel modeling to examine the contribution of schools to the overall variance in adolescent BMIs, calculated from self‐reported weight and height. We then examined the associations of individual attributes with BMI after controlling for the average BMI of the school and the association of two school‐level variables with BMI. Results: Participants attended schools that were segregated by race/ethnicity and socioeconomic status (SES). In females, when controlling only for individual‐level attributes, individual household income was inversely associated (β = ?0.043, P = 0.01) while Hispanic (β = 0.89, P < 0.001) and black (β = 1.61, P < 0.001) race/ethnicity were positively associated with BMI. In males, Hispanic (β = 0.67, P < 0.001) race/ethnicity was positively associated with BMI; there was no difference in the BMIs of blacks compared with whites (β = 0.24, P = 0.085). After controlling for the school racial/ethnic makeup and the school level median household income, the relationship between individual race/ethnicity and BMI was attenuated in both male and female adolescents. Higher school level median household income was associated with lower individual BMIs in adolescent girls (γ = ?0.37, P < 0.001) and boys (γ = ?0.29, P < 0.001) suggesting a contextual effect of the school. Discussion: Male and female adolescents attending schools with higher median household incomes have on average lower BMIs. Resources available to or cultural norms within schools may constitute critical mechanisms through which schools impact the BMI of their students.     

Decomposing adult obesity trends in China (1991–2011)

Using data from the China Health and Nutrition Survey, this study analyses two decades (1991–2011) of change in adult obesity in China with a focus on whether rising obesity rates result from all population cohorts becoming more obese across time (intra-cohort change) or recent cohorts being more obese than their earlier counterparts (inter-cohort change or cohort replacement). To do so, we decompose changes in the body mass index (BMI), waist circumference (WC), general obesity and abdominal obesity of adults aged 20+ using both Firebaugh’s linear decomposition and Das Gupta’s non-linear technique. Our analysis not only reveals significant increases in both general and abdominal obesity (8.1 and 32 percentage points, respectively) in the two decades studied but shows that the rising means in all four measures are mostly attributable to intra-cohort change. In fact, contrary to findings for the U.S., inter-cohort change for the Chinese sample is actually negative, implying that cohort replacement attenuates intra-cohort change over time. Given that intra-cohort change is the central force for the increase in BMI, WC and obesity with individual increases in obesity widely distributed across all cohorts and age groups over time, policy interventions should focus more broadly on all age groups and birth cohorts.     

Associations between household income,height, and BMI in contemporary US schoolchildren

This paper evaluates the association between income and physical development in a nationally representative sample of contemporary US schoolchildren followed from kindergarten to eighth grade (average ages of 6–14). A generalized linear mixed modeling framework is used to evaluate height and body mass index (BMI) as both levels and annualized growth in a pooled sample. Contemporary US schoolchildren show income variation in height that is significant but modest at around .1 cm (in kindergarten) to .4 cm (eighth grade) increases per doubling of income. An exception is found for Hispanic children who show faster height velocity associated with higher income through childhood yielding a 1.0 cm increase per doubling of income by the eighth grade. All groups except black males show a negative relationship between income and BMI that becomes stronger with age with an average .8 kg/m² lower BMI per doubling of income by the eighth grade. These results are robust to the inclusion of baseline anthropometric controls. The analysis suggests that higher-income US schoolchildren enter mid-adolescence as taller but with lower proportional body mass relative to their lower-income counterparts.     

Determining Parameters of the Numerical Response

The numerical response, the change in specific growth rate with food concentration, is a fundamental component of many aquatic microbial studies. Accurately and precisely determining the parameters of this response is essential to obtain useful data for both aut- and synecological studies. In this work we emphasize four points that are often ignored in designing numerical response experiments: (1) the inclusion of subthreshold concentrations (i.e., where growth rate is negative) in the experimental design; (2) an appropriate allocation of effort, i.e., the superiority of choosing more individual prey concentrations rather than replicating fewer; (3) the potential superiority of replicating experiments rather than simply replicating treatment in a single experiment; and (4) the placement of most measurements near the lower end of the concentration gradient, well below the asymptote, possibly following a geometric progression. We illustrate the first point by examining a small subset of published data on planktonic oligotrich ciliates and then, using a Monte Carlo simulation, rigorously evaluate the experimental design, supporting the remaining points.     

Density dependence in forests is stronger in tropical and subtropical climates among closely related species

Density dependence has long been considered an important mechanism for species coexistence in forests. Density‐dependent processes can be important mechanisms driving differences in species diversity across latitudes. Here we examined the decline in strength of density dependence with increasing latitude, and particularly how density dependence affected both conspecifics and heterospecifics. Conspecific individuals within a species were predominantly aggregated at the three different latitudes of the three study sites in China. The percentage of aggregated species declined with increasing spatial scale and growth stages, which confirmed the overall importance of density dependence. Compared with a latitudinal gradient, the intensity of aggregation in the most northerly temperate (Changbaishan) plot was significantly higher than that in the tropical (Bawangling) or subtropical (Heishiding) plots. This showed that the strength of density dependence among conspecific individuals at low latitudes was stronger than that for high latitudes. We found that the more closely related species were more spatially adjacent in the temperate plot, while the opposite was true in the tropical and subtropical plots at most scales. After calculating the recruitment probability of all species of mature trees, we found that 19 of the 32 species in the tropical plot and 7 of the 12 species in the subtropical plot were less likely to recruit near closely related species. In the northern temperate plot, only one species demonstrated this phenomenon. These results therefore suggest that latitudinal variation in the intensity of negative density‐dependent recruitment resulting from specialist natural enemies (the Janzen–Connell hypothesis) may contribute to the latitudinal gradient of diversity in trees. The strength of density dependence at low latitudes was stronger than at high latitudes, regardless of whether this dependence was measured between only conspecific individuals or between individuals of closely related species.     

Dietary and Environmental Correlates of Obesity in a Population Study in China

The patterns and correlates of obesity in China were studied in two panels of a nationwide longitudinal survey conducted in 1989 and 1991 (the China Health and Nutrition Survey). Among the Chinese adults, dietary energy and fat intakes were positively and significantly associated with the Body Mass Index (BMI). Household income and physical activity level were also significantly associated with BMI. Urban residence and higher in come were associated with lower energy intake, higher fat intake, and lower physical activity level compared to rural residence and other income categories. This paper documents an important emerging health problem: the increasing problem of obesity that has been observed in many lower-income countries during the last several decades.     

How does body mass index affect economic growth? A comparative analysis of countries by levels of economic development

The WHO views obesity as a significant risk to population health. Evidence suggests that obesity reduces labor-market attachment, worker productivity, and earnings. This link at the micro level may translate into adverse effects on economic growth at the macro level. Few studies have evaluated how body mass index impacts economic growth across and within countries. This sparse evidence base reflects the lack of consistent data across a broad spectrum of countries and timespan, as well as the empirical difficulties in bypassing endogeneity bias relating to unobserved selection and potential reverse causality between bodyweight and GDP. We address both of these challenges by first assembling a comprehensive panel of data spanning 116 countries over 25 years (1984–2008), and then presenting, to the best of our knowledge, the first empirical study of economic growth and obesiy correcting for endogeneity. Our GMM estimates indicate that, in developed countries, a higher level of BMI has direct negative effects on economic growth in a fully saturated model that controls for levels of human capital. In particular, we predict that the increase in BMI over the time period of analysis may have reduced potential economic growth over this period by between 3.5–5.8 percentage points.     

Obesity in China: The Differential Impacts of Covariates Along the BMI Distribution

Growing prosperity and changing diets have contributed to a surge in obesity prevalence in China. Previous research has investigated the relationships between BMI and several socioeconomic, diet‐related, and health‐related variables in China. This study proposes that such relationships are likely to differ along the conditional BMI distribution, and seeks to investigate such quantile‐dependent variation in effects. Special attention is paid to how variables affect the upper tail of the conditional BMI distribution where overweight and obesity concerns are more acute. Quantile regressions (QRs) and ordinary least squares (OLS) regressions are estimated. The sample consists of 3,407 adult individuals aged 20–45 who participated in the China Health and Nutrition Survey (CHNS), 2006. Substantial cross quantile variation is observed in the relationships between several key variables and BMI. The QR shows that the relationship between energy intake and BMI is largely insignificant in the lower and middle quantiles, whereas the upper quantiles show a positive and significant effect substantially larger than predicted by the least squares regression and by previous studies. This implies that a food‐based strategy aimed at limiting energy intake can be an effective way to fight obesity in China. The negative association between smoking and BMI, on the other hand, is found largely to hold only in the lower and middle quantiles, with the upper tail relatively unaffected by smoking status. Thus, smoking cessation policies may not exacerbate obesity.     

Income deprivation and mental well-being: The role of non-cognitive skills

We show that the positive relation between income deprivation and mental health is affected by an individual's non-cognitive skills. Income deprivation is operationalized as the Yitzhaki index, i.e., as a function of the sum of income differences between an individual and others in her reference group who are more affluent. Non-cognitive skills are extracted from a Locus of Control questionnaire and the Big Five Inventory, a self-report measurement of an individual in regard to five aspects of personality: conscientiousness, neuroticism, extraversion, agreeableness and open-mindedness. The results, based on the 2002–2010 waves of the German Socio-Economic Panel dataset (SOEP), show that deprivation is negative and significantly related with mental health. However, neurotic individuals are more deprivation-sensitive than are others. Compared to the mean effect, a one standard deviation rise in neuroticism is associated with a deprivation effect that is 36.6% and 51.9% larger among men and women, respectively. Although to a lesser extent, extraverted men and conscientious women are also found to be more deprivation-sensitive than are others, the corresponding figures being 31.1% and 45.9%, respectively. These findings suggest that personality differences should be taken into account in the design of policies, practices and initiatives aimed at alleviating the well-being costs of income deprivation.     

Patterns of Frailty in Older Adults: Comparing Results from Higher and Lower Income Countries Using the Survey of Health,Ageing and Retirement in Europe (SHARE) and the Study on Global AGEing and Adult Health (SAGE)

We use the method of deficit accumulation to describe prevalent and incident levels of frailty in community-dwelling older persons and compare prevalence rates in higher income countries in Europe, to prevalence rates in six lower income countries. Two multi-country data collection efforts, SHARE and SAGE, provide nationally representative samples of adults aged 50 years and older. Forty items were used to construct the frailty index in each data set. Our study shows that the level of frailty was distributed along the socioeconomic gradient in both higher and lower income countries such that those individuals with less education and income were more likely to be frail. Frailty increased with age and women were more likely to be frail in most countries. Across samples we find that the level of frailty was higher in the higher income countries than in the lower income countries.     

BMI and Waist Circumference as Predictors of Well‐being in Older Adults: Findings From the English Longitudinal Study of Ageing

The aim of this study is to examine the association of BMI and waist circumference (WC), with a quality of life (QoL) indicator designed for older ages (CASP19), and with depressive symptoms (Centre for Epidemiologic Studies Depression Scale). We included 8,688 individuals aged ≥52 years who participants of Wave 2 (2004–2005) and Wave 3 (2006–2007) of the English Longitudinal Study of Ageing (ELSA). To explore cross‐sectional relationships (2004–2005), we fitted regression models for BMI and WC (included simultaneously) as our predictors of QoL and depressive symptoms adjusted for covariates. To explore longitudinal relationships, BMI and waist at baseline (2004–2005) were related to the each outcome variable measured at follow‐up (2006–2007), and adjusted for baseline characteristics (2004–2005). For a given BMI, larger WC was associated with lower QoL and higher risk of depressive symptoms for women in cross‐sectional and longitudinal analyses. By contrast for a given WC increased BMI for women was positively associated with QoL and lower odds of depressive symptoms. In men, for a given BMI, increased WC was related to QoL only cross‐sectionally; neither WC nor BMI at baseline were associated with depressive symptoms (cross‐sectionally or longitudinally). In conclusion among older people, for a given BMI, increased WC was related with higher risk of poor QoL and, for women, of depressive symptoms; whereas for a given WC, increased BMI had a protective effect on QoL for women.     

La Dolce Vita in times of harshness: Prevalence of health-related behaviors during the great recession in Italy

The current work investigates the heterogeneous effect of the 2008 recession on health outcomes in the Italian population across the main geographic areas. Health outcomes were proxied by individual-level information on healthy/risky behaviors, such as individual fruit and vegetable consumption, frequency of bodyweight monitoring, smoking, and alcohol intake. These health outcomes were employed as dependent variables in the empirical model that included some socioeconomic individual aspects (e.g., age, gender, education, and income source), as well as consumer price index data for tobacco products, alcoholic beverages, and fruit and vegetables. In this work, we used twelve years of data (2005–2016) from the Italian Multipurpose Household Survey (MHS), which collects individual self-reported characteristics, augmented with information on unemployment rates at the regional level, as well as with consumer price indexes for the goods analyzed. The results indicated that the 2008 economic crisis lowered the probability that individuals engage in healthy behaviors, such as self-monitoring their bodyweight, mostly among individuals in northern and central areas. Likewise, the economic downturn increased the probability of smoking regardless of the geographic area, with a larger magnitude in individuals in northern and central areas, whose health outcomes were more impacted by the economic downturn than individuals living in the southern and island areas.