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1.
N Engl J Med ; 381(25): 2440-2450, 2019 12 19.
Artículo en Inglés | MEDLINE | ID: mdl-31851800

RESUMEN

BACKGROUND: Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity. METHODS: We developed methods to correct for self-reporting bias and to estimate state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI). BMI data reported by 6,264,226 adults (18 years of age or older) who participated in the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias with the use of measured data from 57,131 adults who participated in the National Health and Nutrition Examination Survey. We fitted multinomial regressions for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI [the weight in kilograms divided by the square of the height in meters], <25), overweight (25 to <30), moderate obesity (30 to <35), and severe obesity (≥35). We evaluated the accuracy of our approach using data from 1990 through 2010 to predict 2016 outcomes. RESULTS: The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low-income adults (31.7%; 95% CI, 30.2 to 33.2). CONCLUSIONS: Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with large disparities across states and demographic subgroups. (Funded by the JPB Foundation.).


Asunto(s)
Obesidad Mórbida/epidemiología , Obesidad/epidemiología , Adulto , Índice de Masa Corporal , Femenino , Predicción , Humanos , Renta , Masculino , Obesidad/etnología , Obesidad Mórbida/etnología , Prevalencia , Autoinforme , Distribución por Sexo , Estados Unidos/epidemiología
2.
BMC Public Health ; 19(1): 1458, 2019 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-31694587

RESUMEN

BACKGROUND: The overweight/obesity epidemic is a public health issue in the United States (US), that disproportionately affect certain racial/ethnic minority groups. Perceived discrimination has been implicated as a health risk factor. However, research on race/ethnicity, perceived discrimination, and obesity has been mixed. Researchers suggest that perceptions of discrimination may be dependent upon nativity status. This study evaluated the role that nativity status and race/ethnicity play in the relationship between perceived discrimination and overweight/obesity. METHODS: We used Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005) [N = 33,319]). Multinomial logistic regression assessed a three-way interaction (perceived discrimination × race/ethnicity × nativity) on overweight and obesity, adjusting for sociodemographic factors and health-related behaviors. RESULTS: The three-way interaction was significant for overweight [F (17, 49) = 3.35; p < 0.001] and obesity [F (17, 49) = 5.05; p < 0.001]. Among US-born individuals, US-born non-Hispanic Blacks had a decreased risk of being obese compared to US-born non-Hispanic Whites at mean levels of perceived discrimination [aRRR = 0.71; 95% CI (0.51-0.98); p = 0.04). Among foreign-born individuals, foreign-born South Americans had an increased risk of being overweight at mean levels of perceived discrimination compared to foreign-born non-Hispanic Whites [aRRR = 8.07; 95% CI (1.68-38.77); p = 0.01], whereas foreign-born Dominicans had a decreased risk of being obese compared to foreign-born non-Hispanic Whites [aRRR = 0.05; 95% CI (0.01-0.20); p < 0.001]. CONCLUSION: Perceived racial discrimination is a risk factor for overweight/obesity for certain groups. Race/ethnicity and nativity may play important roles in the relationship between perceived discrimination and overweight/obesity. Future research is needed to identify the behavioral and psychological pathways that link perceived discrimination and overweight/obesity.


Asunto(s)
Grupos Étnicos/psicología , Grupos Minoritarios/psicología , Obesidad/psicología , Sobrepeso/psicología , Discriminación Social/psicología , Adulto , Femenino , Encuestas Epidemiológicas , Hispanoamericanos/psicología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Obesidad/etnología , Sobrepeso/epidemiología , Sobrepeso/etnología , Percepción , Factores de Riesgo , Discriminación Social/etnología , Estados Unidos/epidemiología , Adulto Joven
4.
Artículo en Inglés | MEDLINE | ID: mdl-31581468

RESUMEN

Background: Although obesity may have a role as a risk factor for cerebrovascular mortality, less is known about how demographic and social groups differ in this regard. Aims: This study had two aims: first to investigate the predictive role of baseline obesity on long-term risk of mortality due to cerebrovascular disease, and second, to test racial variation in this effect. Methods: the Americans' Changing Lives Study (ACL) 1986-2011 is a state of the art 25-year longitudinal cohort study. ACL followed a nationally representative sample of Blacks (n = 1156) and Whites (n = 2205) for up to 25 years. Baseline obesity was the main predictor of interest, time to cerebrovascular death was the main outcome of interest. Demographic characteristics, socioeconomic status (educational attainment and household income), health behaviors (exercise and smoking), and health (hypertension and depressive symptoms) at baseline were covariates. Cox proportional hazards models were used to test additive and multiplicative effects of obesity and race on the outcome. Results: From the total 3,361 individuals, 177 people died due to cerebrovascular causes (Whites and Blacks). In the pooled sample, baseline obesity did not predict cerebrovascular mortality (hazard ratio (HR) = 0.86, 0.49-1.51), independent of demographic, socioeconomic, health behaviors, and health factors at baseline. Race also interacted with baseline obesity on outcome (HR = 3.17, 1.09-9.21), suggesting a stronger predictive role of baseline obesity on cerebrovascular deaths for Black people compared to White individuals. According to the models that were run specific to each race, obesity predicted risk of cerebrovascular mortality for Blacks (HR = 2.51, 1.43-4.39) but not Whites (HR = 0.69, 0.31-1.53). Conclusions: Baseline obesity better predicts long-term risk of cerebrovascular death in Black individuals compared to White people. More research should explore factors that explain why racial differences exist in the effects of obesity on cerebrovascular outcome. Findings also have implications for personalized medicine.


Asunto(s)
Afroamericanos/estadística & datos numéricos , Trastornos Cerebrovasculares/etnología , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Obesidad/etnología , Adulto , Anciano , Anciano de 80 o más Años , Animales , Trastornos Cerebrovasculares/mortalidad , Depresión/etnología , Ejercicio , Femenino , Conductas Relacionadas con la Salud/etnología , Humanos , Hipertensión/etnología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Factores de Riesgo , Fumar/etnología , Factores Socioeconómicos , Estados Unidos
5.
Lipids Health Dis ; 18(1): 167, 2019 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-31472689

RESUMEN

BACKGROUND: Metabolic-related markers and inflammatory factors have been proved to be associated with increased risk of dyslipidemia. Elucidating the mechanisms underlying these associations might provide an important perspective for the prevention of dyslipidemia. In the present study, we aimed to explore the effect of metabolic-related markers on dyslipidemia, and to assess what extent inflammation mediating these associations. METHODS: A total of 25,130 participants without dyslipidemia at baseline were included in the present study during 2010-2015. A partial least squares path model was used to explore possible pathways from metabolic-related markers to dyslipidemia, and the mediation role of inflammation. RESULTS: Lipid metabolism factor, blood pressure factor, obesity condition factor, glucose metabolism factor, renal function factor and lifestyle factor had diverse impact on development of dyslipidemia, directly and (or) indirectly. Partial least squares path analysis revealed that the determination coefficient of the model (R2) was 0.52. Lipid metabolism factor, obesity condition factor, and glucose metabolism factor had both direct and indirect effect on dyslipidemia through inflammatory factor. Lipid metabolism factor was the most important risk factor (ß = 0.68) in the prediction of dyslipidemia, followed by obesity condition factor (ß = 0.06) and glucose metabolism factor (ß = 0.03). CONCLUSIONS: Metabolic-related markers are strong risk factors for dyslipidemia. Inflammatory factors have significant mediating effect on these relationships. These findings suggested that comprehensive intervention strategies on metabolic biomarkers and inflammatory factors should be taken into consideration in prevention and treatment of dyslipidemia.


Asunto(s)
Dislipidemias/diagnóstico , Síndrome Metabólico/diagnóstico , Obesidad/diagnóstico , Adulto , Grupo de Ascendencia Continental Asiática , Biomarcadores/sangre , Glucemia/metabolismo , Presión Sanguínea/fisiología , Nitrógeno de la Urea Sanguínea , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Dislipidemias/sangre , Dislipidemias/etnología , Femenino , Humanos , Inflamación , Análisis de los Mínimos Cuadrados , Estilo de Vida , Metabolismo de los Lípidos , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/etnología , Persona de Mediana Edad , Neutrófilos/metabolismo , Neutrófilos/patología , Obesidad/sangre , Obesidad/etnología , Estudios Prospectivos , Riesgo , Triglicéridos/sangre , Población Urbana , gamma-Glutamiltransferasa/sangre
6.
Orv Hetil ; 160(32): 1279-1283, 2019 Aug.
Artículo en Húngaro | MEDLINE | ID: mdl-31387375

RESUMEN

Introduction: Short sleep duration and poor sleep quality may be associated with weight gain; this association has not yet been studied in Roma (Gipsy) population. Aim: Our aim was to study sleep patterns in two adult Roma subgroups (the wealthy Gabor and the poor Lovari Roma), compared to the majority of Hungarian population, in relation to obesity, knowing that Roma population has specific socio-cultural characteristics, with a rapidly changing lifestyle. Method: A population-based cross-sectional survey was conducted in a rural region in Transylvania, where the above groups are cohabiting. The groups were age- and gender-matched. Results: Sleep duration was 7.18 ± 1.6 hours in the Gabor Roma, 7.67 ± 1.5 hours in the Lovari Roma and 7.37 ± 1.5 hours in the non-Roma group. In average, 70% of them had enough sleep (≥7 hours). 38.6% of Gabor Roma, 27.1% of Lovari Roma and 23.5% of non-Roma had poor-quality sleep (p = 0.05). Gabor Roma had significantly higher body mass index (31.1 ± 4.6 versus 27.4 ± 5.2 and 28.66 ± 5.7 kg/m2, p = 0.004), and this correlated inversely with sleep duration (F = 14.85, p<0.000). Conclusion: Gabor Roma had significantly higher percentage of poor-quality sleep. Sleep duration and sleep quality were linked with obesity, mainly in the Roma population. Orv Hetil. 2019; 160(32): 1279-1283.


Asunto(s)
Obesidad/etiología , Trastornos del Sueño-Vigilia/complicaciones , Sueño/fisiología , Adulto , Estudios Transversales , Humanos , Hungría/epidemiología , Obesidad/epidemiología , Obesidad/etnología , Roma , Población Rural
7.
Res Q Exerc Sport ; 90(4): 567-577, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31403896

RESUMEN

Purpose: Despite the well-known health benefits of physical activity (PA), disadvantaged populations usually have lower PA levels than the rest of the population. Some intra- and interpersonal factors such as different types of barriers to PA may influence PA levels, particularly among disadvantaged adult women. The first aim of this qualitative study was to identify the barriers to PA perceived by disadvantaged adult women. The second aim was to analyse the differences in perceived barriers to PA between adult Roma and non-Roma women. Methods: Eleven disadvantaged adult women participated in the current study (M = 37.72; SD = 8.34), seven of whom belonged to the Roma population. Data were obtained from discussion groups as well as from one-to-one interviews, and these were analysed by NVivo Pro 11. Results: Three categories of perceived barriers to PA were identified: personal (i.e., economy, labour, physical limitations, illness, and psychological characteristics) social (i.e., culture, lack of social support, and family), and environmental. Family was identified as the main common and most frequent barrier to PA in disadvantaged adult women. Differences in perceived barriers to PA between adult Roma and non-Roma women were found. While Roma women perceived culture, physical limitations, and lack of social support barriers to PA, non-Roma women mainly perceived labour-related barriers to PA. Conclusions: Multilevel interventions addressing specific barriers to PA for disadvantaged adult women are required to overcome barriers to PA and, consequently, increase PA levels. Particular attention should be paid to specific barriers to PA among adult Roma and non-Roma women, respectively.


Asunto(s)
Ejercicio/psicología , Roma/psicología , Poblaciones Vulnerables/psicología , Adulto , Carencia Cultural , Escolaridad , Ambiente , Familia , Femenino , Humanos , Persona de Mediana Edad , Obesidad/etnología , Sobrepeso/etnología , Pobreza , Investigación Cualitativa , Apoyo Social , España/epidemiología , Desempleo
8.
Creat Nurs ; 25(3): 241-248, 2019 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-31427420

RESUMEN

Food insecurity (FI), the limited or unreliable availability of safe and nutritious food, is a pressing public health concern affecting millions of U.S. citizens. Unfortunately, FI tends to impact those who are most vulnerable (e.g., low-income minorities) and potentially increases obesity risks, diet-sensitive disease risks (e.g., hypertension and type 2 diabetes), and hospital utilization. Low-income Latino patients may be particularly sensitive to adverse outcomes based on unaddressed socioeconomic needs. Nurses are in a prime position to assess and address FI in these patients. Our article will discuss how nurses can be advocates in combating FI in Latino patients with overweight/obesity.


Asunto(s)
Abastecimiento de Alimentos , Hispanoamericanos , Rol de la Enfermera , Obesidad/etnología , Obesidad/enfermería , Sobrepeso/dietoterapia , Sobrepeso/etnología , Sobrepeso/enfermería , Competencia Cultural , Femenino , Hospitalización , Humanos , Masculino , Evaluación en Enfermería , Obesidad/dietoterapia , Educación del Paciente como Asunto , Pobreza , Estados Unidos
9.
Nutrients ; 11(9)2019 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-31466276

RESUMEN

African Americans (AAs) have a higher obesity risk than Whites; however, it is unclear if appetite-related hormones and food intake are implicated. We examined differences in appetite-related hormones, appetite, and food intake between AAs (n = 53) and Whites (n = 111) with overweight or obesity. Participants were randomized into a control group or into supervised, controlled exercise groups at 8 kcal/kg of body weight/week (KKW) or 20 KKW. Participants consumed lunch and dinner at baseline and follow-up, with appetite and hormones measured before and after meals (except leptin). At baseline, AAs had lower peptide YY (PYY; p < 0.01) and a blunted elevation in PYY after lunch (p = 0.01), as well as lower ghrelin (p = 0.02) and higher leptin (p < 0.01) compared to Whites. Despite desire to eat being lower and satisfaction being higher in AAs relative to Whites (p ≤ 0.03), no racial differences in food intake were observed. Compared to Whites, leptin increased in the 8 KKW group in AAs (p = 0.01), yet no other race-by-group interactions were evident. Differences in appetite-related hormones between AAs and Whites exist; however, their influence on racial disparities in appetite, food intake, and obesity within this trial was limited.


Asunto(s)
Afroamericanos , Regulación del Apetito/etnología , Ingestión de Energía/etnología , Grupo de Ascendencia Continental Europea , Disparidades en el Estado de Salud , Obesidad/etnología , Hormonas Peptídicas/sangre , Adulto , Biomarcadores/sangre , Femenino , Ghrelina/sangre , Humanos , Leptina/sangre , Louisiana/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/sangre , Obesidad/fisiopatología , Péptido YY/sangre , Periodo Posprandial , Factores de Tiempo
10.
Medicine (Baltimore) ; 98(33): e16815, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31415397

RESUMEN

BACKGROUND: Acupuncture is effective for reducing body weight; however, evidence in Asian populations is lacking. We performed a systematic review and meta-analysis to evaluate the efficacy of acupuncture for body weight reduction in Asians. METHODS: The Medline, Embase, Cochrane library, and Chinese databases were searched for relevant studies through October 20, 2018. Publications describing randomized controlled trials (RCTs) comparing acupuncture with other treatments for the reduction of body weight were compiled. Reviewers assessed bias and collected data on trial characteristics and outcomes. The study was conducted based on the reporting items of the guidelines for systematic evaluation and meta-analysis (PRISMA). Review Manager 5.2 software was used to calculate weight mean difference (WMD) and 95% confidence intervals (CIs). RESULTS: Twelve RCTs involving 1151 subjects were included. Compared with the control groups, the acupuncture groups exhibited significantly greater reductions of body mass index (BMI)(WMD -1.20kg/m2; 95% CI -1.91, -0.48)and waist circumference (WMD -1.85 cm; 95% CI -3.20, -0.49) In the subgroup analyses, significant differences in the reduction of BMI was observed between the acupuncture and sham acupuncture groups, the acupuncture plus diet and exercise, and the diet and exercise groups, and the acupuncture and no intervention groups, but not between the acupuncture plus exercise and exercise groups [corrected]. CONCLUSIONS: Our study demonstrates that acupuncture is effective in the intervention of overweight/obesity in Asians; however, compared with exercise alone, acupuncture combined with exercise had no effect on the BMI or waist circumstance in the short term. Long-term studies are needed to evaluate the efficacy of acupuncture in weight reduction in Asians.


Asunto(s)
Terapia por Acupuntura/estadística & datos numéricos , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Terapia por Ejercicio/estadística & datos numéricos , Obesidad/terapia , Sobrepeso/terapia , Terapia por Acupuntura/métodos , Adulto , Índice de Masa Corporal , Terapia por Ejercicio/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/etnología , Sobrepeso/etnología , Resultado del Tratamiento , Pérdida de Peso
11.
Aust N Z J Public Health ; 43(4): 328-333, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31268219

RESUMEN

OBJECTIVE: To explore participation, consistency of demographic and health profiles, and short-term impacts across six Aboriginal Knockout Health Challenge (KHC) team-based weight loss competitions, 2012 to 2015. METHODS: Data comprised one competition each from 2012 and 2013 and two per year in 2014 and 2015. We compared baseline and change (pre- to post-competition) in weight, fruit and vegetable consumption, physical activity and waist circumference (baseline only) across competitions using mixed models. RESULTS: Numbers of teams and participants increased from 2012 to 2015 from 13 and 324 to 33 and 830, respectively. A total of 3,625 participants registered, representing 2,645 unique people (25.4% repeat participation). Participants were mainly female and >90% were classified obese at baseline. Baseline weight and weight lost (between 1.9% and 2.5%) were significantly lower in subsequent competitions compared with the first. Improvements in fruit and vegetable consumption and physical activity were comparable across competitions. CONCLUSION: The KHC has increasing and sustained appeal among Aboriginal communities, attracting those at risk from lifestyle-associated chronic disease and effectively reducing weight and promoting healthy lifestyles in the short term. Implications for public health: Community-led programs generated by, and responsive to, Aboriginal Australians' needs can demonstrate consistent community reach and sustained program-level lifestyle improvements.


Asunto(s)
Ejercicio , Promoción de la Salud/organización & administración , Estilo de Vida Saludable , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Sobrepeso/etnología , Pérdida de Peso , Adulto , Investigación Participativa Basada en la Comunidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/etnología , Obesidad/prevención & control , Grupo de Ascendencia Oceánica/psicología , Sobrepeso/prevención & control , Programas de Reducción de Peso , Adulto Joven
12.
Public Health ; 174: 85-96, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31326761

RESUMEN

OBJECTIVES: We systematically reviewed the literature on risk factors for obesity in American Indians (AIs) and Alaska Natives (ANs) of all ages. STUDY DESIGN: We searched titles and abstracts in PubMed with combinations of the following terms: obesity, body mass index (BMI), American Indian, Alaska Native, and Native American. METHODS: We limited our review to articles that provided an empirically testable claim about a variable associated with obesity, measured obesity as a dependent variable, and provided data specific to AI/ANs. RESULTS: Our final sample included 31 articles; 20 examined AI/AN youth (<18 years), and 11 examined AI/AN adults (≥18 years). Risk factors for obesity varied by age. In infants, low birth weight, early termination of breastfeeding, and high maternal BMI, and maternal diabetes increased the risk of childhood obesity. In children and adolescents, parental obesity, sedentary behaviors, and limited access to fruits and vegetables were associated with obesity. In adulthood, sedentary behaviors, diets high in fats and carbohydrates, stress, verbal abuse in childhood, and the belief that health cannot be controlled were associated with obesity. CONCLUSIONS: Extant studies have three limitations: they do not apply a life course perspective, they lack nationally representative data and have limited knowledge of the resilience, resistance and resourcefulness of AI/ANs. Future studies that avoid these shortcomings are needed to inform interventions to reduce the prevalence of obesity in AI/ANs across the life course.


Asunto(s)
Nativos de Alaska/estadística & datos numéricos , Indios Norteamericanos/estadística & datos numéricos , Obesidad/etnología , Humanos , Factores de Riesgo , Estados Unidos/epidemiología
13.
Aust N Z J Public Health ; 43(5): 429-435, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31339603

RESUMEN

OBJECTIVE: To examine country of birth differences in the odds of reporting chronic diseases among those of Lebanese ethnicity in comparison to those of Australian ethnicity. METHODS: Participants were 41,940 Australians aged 45 years and older, sampled from the 45 and Up Study baseline dataset. Participants included those of Lebanese ethnicity born in Lebanon (n=401), Australia (n=331) and other countries (n=73); and those of Australian ethnicity (n=41,135). Logistic regression models were conducted to examine differences in the odds of reporting chronic disease between those of Lebanese ethnicity and those of Australian ethnicity. RESULTS: Those of Lebanese ethnicity had higher odds of reporting diabetes (OR 1.62; 95%CI 1.32-2.00) and lower odds of reporting hypertension (OR 0.82; 95%CI 0.70-0.96) when compared with those of Australian ethnicity. After country of birth stratification, only those born in Lebanon had higher odds of reporting diabetes (OR 2.21; 95%CI 1.71-2.85) and also had lower odds of reporting cancer (OR 0.66; 95%CI 0.46-0.97), when compared with those of Australian ethnicity. CONCLUSIONS: Country of birth differences in health exist among those of Lebanese ethnicity. Implications for public health: Country of birth is an important factor that could assist in explaining differences in health among ethnic groups of the same origin.


Asunto(s)
Enfermedad Crónica/etnología , Emigrantes e Inmigrantes/psicología , Conducta Alimentaria/etnología , Conductas Relacionadas con la Salud/etnología , Estilo de Vida/etnología , Obesidad/etnología , Conducta Sedentaria/etnología , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Enfermedad Crónica/epidemiología , Grupos de Población Continentales , Comparación Transcultural , Estudios Transversales , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , Líbano/etnología , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Vigilancia de la Población , Calidad de Vida/psicología , Características de la Residencia , Factores de Riesgo , Autoinforme , Factores Socioeconómicos , Encuestas y Cuestionarios
14.
Orv Hetil ; 160(28): 1097-1104, 2019 Jul.
Artículo en Húngaro | MEDLINE | ID: mdl-31280599

RESUMEN

Introduction: The Roma population rapidly gains in importance in the social structure of Hungary. An adverse consequence of the multiple disadvantageous position of this minority is the unhealthy nutrition, which leads to obesity and high prevalence of its co-diseases. Aim: Based on primer anthropometric data collection, we will determine the nutritional status of the Hungarian Roma population, then on the basis of official statistical data, an estimation and prognoses will be prepared on the disease burden of obesity according to genders and age. Method: A long-range forecast of the population size of the Roma minority's prognosis has been prepared on the basis of official statistics and time-series by Spectrum 5.0 demographic software. On this basis, applying the Dynamic Modeling for Health Impact Assessment software, we have prepared a forecast for the incidence and prevalence of the most important diseases attributable to obesity. Results: In the next decades, the number of the Roma population will be doubled, but there is a high level of uncertainty of different forecasts. The nutritional status of the Hungarian roma population is less favorable, than the indicators, characterizing the Hungarian population as a whole. In the next half a century, the prevalence of co-morbidities of obesity will be increasing from 6 thousand up to 26 thousand in the case of women, while in the case of men from nearly 6 thousand up to 17 thousand. Conclusions: The rapidly increasing number of the Roma population is an increasing challenge for the Hungarian healthcare system, which highlights the importance of evidence-based prevention and intervention programs. Orv Hetil. 2019; 160(28): 1097-1104.


Asunto(s)
Obesidad , Roma , Femenino , Humanos , Hungría/epidemiología , Masculino , Estado Nutricional , Obesidad/epidemiología , Obesidad/etnología , Prevalencia
15.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(6): 621-626, 2019 Jun 10.
Artículo en Chino | MEDLINE | ID: mdl-31238608

RESUMEN

Objective: To understand the control attempts of body weight and its related factors among overweight and obese adults in China. Methods: Data was from the 2013 Chinese Chronic Diseases and Risk Factors Surveillance Program, which covered 302 surveillance sites. 179 570 adults, selected through multistage stratified cluster sampling method, were interviewed. Demographic characteristics and weight-control attempts were collected via face-to-face interview. BMI, waist circumstance and blood pressure were individually measured under physical examination. Venous blood samples were obtained and tested for FPG, OGTT-2h, TC, TG, LDL-C and HDL-C. A total of 87 545 overweight and obese patients were included in this study, with the exclusion of 152 patients having the missed critical information. Rates on weight control and attempts were analyzed, using the complex weighting on samples to represent the overall overweight and obese adults in China. Results: The rate of weight-control attempts was 16.3% (95%CI: 14.9%-17.7%). Among all the 12 133 patients who had undergone weight-control measures, the proportions of different attempts were as follows: diet (40.9%, 95%CI: 38.4%-43.3%), combination of diet and physical activity (31.5%, 95%CI: 28.9%-34.0%), physical activity (22.8%, 95%CI: 21.0%-24.6%) and drug control (1.3%, 95%CI: 1.0%-1.7%). Factors as: being female (OR=1.26, 95%CI: 1.15-1.38), at younger age (18-44 years old, OR=1.51, 95%CI: 1.31-1.74), with high education levels (college degree or above, OR=4.52, 95%CI: 3.76-5.43), having high annual income (≥24 000 Yuan, OR=1.94, 95%CI: 1.63-2.30) etc., appeared as favorable factors for taking the measures vs. rural residency (OR=0.63, 95%CI: 0.55- 0.72) as the unfavorable one. Conclusion: The rate of weight-control attempts appeared low among the overweight and obese adults who were affected by factors as age, education and income level. Personalized intervention measures should be carried out for people with different characteristics.


Asunto(s)
Obesidad/prevención & control , Sobrepeso/prevención & control , Vigilancia de la Población , Triglicéridos/sangre , Adolescente , Adulto , Índice de Masa Corporal , China , Dieta , Ejercicio , Femenino , Humanos , Lípidos/sangre , Obesidad/sangre , Obesidad/etnología , Sobrepeso/sangre , Sobrepeso/etnología , Características de la Residencia , Factores de Riesgo , Adulto Joven
16.
Clin Lab ; 65(6)2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31232044

RESUMEN

BACKGROUND: The aim of the study is to evaluate the cross-sectional association between serum ferritin level and nonalcoholic fatty liver disease (NAFLD) in a non-obese Chinese population. METHODS: A cross-sectional study was performed among 1,020 non-obese subjects (body mass index < 25 kg/m2) who took their annual health examination at the First Affiliated Hospital, College of Medicine, Zhejiang University. Serum ferritin level and other clinical and laboratory parameters were measured in the population. Liver ultrasound examinations were performed to diagnose NAFLD. RESULTS: Of the 1,020 enrolled participants, 148 (14.51%) fulfilled the diagnostic criteria for NAFLD. Subjects with NAFLD had a higher level of serum ferritin than individuals without NAFLD in non-obese subjects. Serum ferritin level was significantly and positively correlated with parameters of MS (BMI, SBP, TG and FPG) in NAFLD group. Stepwise logistic regression analysis showed that serum ferritin level was significantly associated with the risk factor for NAFLD. After adjusting for confounders, serum ferritin level was an independent factor predicting advanced fibrosis (FIB-4 ≥ 1.3) in NAFLD participants. CONCLUSIONS: Increased serum ferritin level is significantly associated with NAFLD, and elevated serum ferritin level is an independent factor predicting advanced fibrosis for NAFLD in a non-obese Chinese population.


Asunto(s)
Biomarcadores/sangre , Ferritinas/sangre , Enfermedad del Hígado Graso no Alcohólico/sangre , Obesidad/sangre , Adulto , Grupo de Ascendencia Continental Asiática , Índice de Masa Corporal , China , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/etnología , Obesidad/etnología , Factores de Riesgo
17.
Nutrients ; 11(6)2019 Jun 19.
Artículo en Inglés | MEDLINE | ID: mdl-31248113

RESUMEN

This study investigated associations between cardiovascular health (CVH), adiposity, and food insecurity by race, sex, and health literacy in a sample of 800 underserved patients with obesity (body mass index [BMI] ≥ 30 kg/m2). CVH was assessed using American Heart Association Life's Simple 7 (LS7) and adiposity was estimated using BMI and waist circumference (WC). Mixed models including interaction terms between food insecurity and sex, race, and health literacy were analyzed for LS7, BMI, and WC. Stratified models were analyzed as indicated by significant interactions. Mean BMI and WC were 37.3 kg/m2 (4.6 SD) and 113.5 cm (12.4 SD), respectively. Among patients, 31% were food insecure and 31% had low health literacy. There were significant positive associations between food insecurity and BMI (p = 0.03) and WC (p = 0.03) in the overall sample. In sex-stratified models, women who were food insecure had higher BMI (p = 0.02) and WC (p = 0.007) than their food secure counterparts. Further, food insecure patients with better health literacy had greater BMI (p = 0.004) and WC (p = 0.007) than their food secure counterparts. Results suggest that adiposity is a greater burden in food insecure patients, which may be an important consideration for obesity treatment in underserved populations.


Asunto(s)
Adiposidad/etnología , Enfermedades Cardiovasculares/etnología , Enfermedades Cardiovasculares/fisiopatología , Abastecimiento de Alimentos , Área sin Atención Médica , Obesidad/etnología , Obesidad/fisiopatología , Determinantes Sociales de la Salud/etnología , Poblaciones Vulnerables , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/prevención & control , Estudios Transversales , Alfabetización en Salud , Humanos , Louisiana/epidemiología , Persona de Mediana Edad , Estado Nutricional/etnología , Obesidad/diagnóstico , Obesidad/terapia , Ensayos Clínicos Pragmáticos como Asunto , Factores de Riesgo , Factores Sexuales , Circunferencia de la Cintura
18.
J Allied Health ; 48(2): 100-107, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31167011

RESUMEN

BACKGROUND: American Indian (AI) populations suffer disproportionately from cardiovascular disease and depression as compared to other racial/ethnic groups. Behaviors that contribute to obesity are considered obesogenic and include poor diet, low physical activity, and high screen time. This study examined the relationship between depressive symptoms and obesogenic behaviors on cardiometabolic risk factors in AI youth. METHODS: Participants (n=121) were evaluated for depressive symptoms, obesogenic behaviors, weight, blood pressure, lipids, and glucose levels. RESULTS: All participants failed to meet guidelines for intake of sugar-sweetened beverages and fruits/vegetables, 74% did not meet physical activity guidelines, and 85% did not meet screen time guidelines. Lower physical activity was associated with higher body fat percentage (b=-4.20 ± 1.82, p=0.022). Elevated depressive symptoms and presence of at-risk cardiometabolic risk factors were found. Higher depressive symptoms were associated with higher blood glucose (random, fasting, and hemoglobin A1c). CONCLUSIONS: Low physical activity, high screen time, and the presence of depressive symptomology heighten cardiometabolic risk factors in AI children. Associations between depressive symptoms and blood glucose underscore the impact of emotional health on cardiometabolic disease and emphasize need for proper depression assessment in chronic disease prevention efforts.


Asunto(s)
Enfermedades Cardiovasculares/etnología , Depresión/etnología , Enfermedades Metabólicas/etnología , Obesidad/etnología , Adolescente , Glucemia , Presión Sanguínea , Índice de Masa Corporal , Pesos y Medidas Corporales , Niño , Estudios Transversales , Dieta , Ejercicio , Femenino , Hemoglobina A Glucada , Humanos , Indios Norteamericanos , Lípidos/sangre , Masculino , Factores de Riesgo , Tiempo de Pantalla
19.
Obes Facts ; 12(3): 328-343, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31167208

RESUMEN

BACKGROUND: Obesity is more prevalent in men than in women in China, especially within the middle-aged population. OBJECTIVES: The present study aims to determine the contribution of sexual dimorphisms to obesity and related traits in terms of the mechanisms involving the obesity-related genetic variants among patients of Chinese Han ancestry with type 2 diabetes. METHOD: In the Chinese National Diabetes and Metabolic Disorders Study, 2,555 out of 4,036 patients with type 2 diabetes were treatment naive, including 1,142 men and 1,413 women. Single-nucleotide polymorphisms (SNP) from 18 genomic loci previously found to be associated with obesity-related traits were successfully genotyped, and a genetic risk score (GRS) was constructed by summing the risk alleles for obesity. RESULTS: Single SNP analysis showed that genetic variants in SLC30A10, TMEM18, GNPDA2, PRL, TFAP2B, BDNF, MTCH2, FTO, and MC4R were nominally associated with waist circumference (WC), BMI, and risk for abdominal or general obesity in the untreated patients with type 2 diabetes, as well as in the total group of patients with type 2 diabetes (untreated and treated) (p < 0.05). Interactions between sex and SNP in PRL, MTCH2,and FTO were detected (p < 0.05). In the untreated patients with diabetes, the GRS was nominally associated with WC (ß = 0.0032, SE = 0.0011; p = 0.003), BMI (ß = 0.0030, SE = 0.0013; p = 0.027), and increased risk for abdominal (OR = 1.08; 95% CI 1.02-1.13; p = 0.004) or general obesity (OR = 1.07; 95% CI 1.02-1.13; p = 0.011) in men but not in women. GRS-sex interactions were detected in the determinant of WC (p = 0.019) and abdominal obesity (p = 0.016). Among patients aged 30-60 years, GRS was found to be significantly associated with WC (ß = 0.0050, SE = 0.0016; p = 0.002) and abdominal obesity (OR = 1.10; 95% CI 1.04-1.17; p = 0.001) and nominally associated with BMI (ß = 0.0057, SE = 0.0020; p = 0.005) and general obesity (OR = 1.07; 95% CI 1.01-1.14; p = 0.027) in men, whereas in women none of the associations were detected. GRS-sex interactions were present in the determinant of WC (p = 0.015), BMI (p = 0.032), and abdominal obesity (p = 0.012). Among patients aged 60 years or older, neither an association of GRS with obesity-related traits nor GRS-sex interactions were detected. CONCLUSIONS: Genetic factors contribute to obesity-related traits in a sex-dependent pattern among middle-aged Chinese, and men tend to be more susceptible to the genetic risk of obesity.


Asunto(s)
Grupo de Ascendencia Continental Asiática/genética , Diabetes Mellitus Tipo 2/genética , Obesidad/genética , Caracteres Sexuales , Adulto , Anciano , Alelos , China/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/etnología , Femenino , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/etnología , Fenotipo , Polimorfismo de Nucleótido Simple , Proyectos de Investigación , Factores de Riesgo , Circunferencia de la Cintura/genética
20.
Public Health ; 172: 125-134, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31227270

RESUMEN

BACKGROUND: Epidemic obesity poses a major threat to global health. This phenomenon reflects the inability of the average person to cope, biologically and behaviorally, with environmental contexts that promote caloric overconsumption and inadequate caloric expenditure. There is still much to be learned about how to improve these contexts nationally and within-countries for sociodemographic groups with above-average obesity risks. METHODS: Higher obesity risks relative to respective white majority populations were identified among diverse indigenous, other native-born, or migrant 'racial' or ethnic minority (hereafter, ethnic minority) populations in the United States, Canada, Australia, New Zealand, and the Netherlands, using publicly available national survey data or other sources. Cross-national comparisons were of interest for identifying common risk pathways associated with social and economic inequities. Potential explanations were explored through a narrative review of peer-reviewed literature, informed by the World Health Organization's Conceptual Framework for Action on The Social Determinants of Health. MAIN FINDINGS: Identifying viable solutions to the high risk of obesity in ethnic minority populations in these high-income countries requires examination of national-level social, economic, and health system contexts, food systems, and built environments for physical activity, as well as patterns of social stratification and cultural biases related to ethnicity, migration, and other determinants of social disadvantage. These factors can be linked to mediators of exposure or vulnerability to obesity-related risks, such as poverty, being an 'outsider', stress and trauma resulting from historical and current oppression, exposure to bias and discrimination, related biological or behavioral consequences, and inadequate health and social care. CONCLUSIONS: Focusing on ethnic minority populations in high-income countries is critical for public health efforts to address epidemic obesity. Mitigating intersecting risk pathways arising from stratification and bias based on ethnicity and migrant status should be prominent in these efforts.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Países Desarrollados/estadística & datos numéricos , Epidemias/prevención & control , Grupos Étnicos/estadística & datos numéricos , Grupos Minoritarios/estadística & datos numéricos , Obesidad/etnología , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Anciano , Australia/epidemiología , Canadá/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Nueva Zelanda/epidemiología , Obesidad/prevención & control , Factores de Riesgo , Estados Unidos/epidemiología , Adulto Joven
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