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1.
Rev Bras Epidemiol ; 23: e200003, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32130392

RESUMEN

INTRODUCTION: The intake of sugar-sweetened beverages (SSB) varies according to the characteristics of the population. OBJECTIVE: To investigate the SSB intake and demographic, socioeconomic and lifestyle factors associated with its consumption in adolescents, adults, and older adults in São Paulo. METHODS: Data were drawn from the Health Survey of São Paulo, a cross-sectional population-based study including 1,662 individuals aged 12 years or more. SSB were classified into six groups: sugar-sweetened sodas, sweetened coffee and tea, sweetened milk and dairy products, sweetened fruit juice, sweetened fruit drink, and total SSB. The association of each group with demographic, socioeconomic and lifestyle variables was assessed using linear regression models. RESULTS: The mean SSB intake was 668.4 mL in adolescents, 502.6 mL in adults, and 358.2 mL in elderly adults. Sodas and sweetened coffee and tea represented had the greatest contribution to energy intake. SSB consumption was lower among female sex and higher among overweight adolescents, among sufficiently active adults, and among lower household per capita income older adults. Consumption of SSB was high, particularly among adolescents. Public policies are required in order to decrease the consumption of these beverages. CONCLUSION: Age group, sex, household per capita income, and body mass index status were associated with SSB intake.


Asunto(s)
Conducta de Ingestión de Líquido , Estilo de Vida , /estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Estudios Transversales , Ingestión de Energía , Humanos , Persona de Mediana Edad , Encuestas Nutricionales , Sobrepeso/epidemiología , Distribución por Sexo , Factores Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
2.
Medicine (Baltimore) ; 99(3): e18703, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011445

RESUMEN

BACKGROUND: Obesity has become a serious public health issue. The role of Helicobacter pylori (H. pylori) infection in overweight or obesity is inconsistent and controversial. It is very necessary to conduct a systematic review and meta-analysis for determining whether H. pylori infection was associated with risk of overweight/obesity. METHODS: Four databases (PubMed, Web of Science, The Cochrane Library, and EMBASE) will be searched from the inception to January 15, 2019. All observational studies (including cross-sectional, case-control or longitudinal studies) reporting the association between H. pylori infection and overweight/obesity will be included. The primary outcome was the presence and incidence of overweight/obesity in conjunction with H. pylori infection. Study selection, data extraction, and assessment of quality will be conducted independently by 2 reviewers. RevMan 5.3 and STATA 14.0 software will be used for data synthesis. RESULTS: The results of this study will provide a better understanding of the role of H. pylori infection in overweight/obesity among overall population. CONCLUSION: This systematic review and meta-analysis will generate evidence of the association between H. pylori infection and overweight/obesity, and the findings of this study will be published in a peer-reviewed journal.PROSPERO registration number: CRD42019121939.


Asunto(s)
Infecciones por Helicobacter/epidemiología , Sobrepeso/epidemiología , Helicobacter pylori , Humanos , Obesidad/epidemiología , Proyectos de Investigación
3.
Int J Radiat Oncol Biol Phys ; 106(2): 369-376, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-31678226

RESUMEN

PURPOSE: Obesity is increasing in incidence in New Zealand. Maintaining locoregional control after breast cancer surgery is important, as this can improve overall survival. Although obesity has been associated with poorer survival in breast cancer, the correlation with locoregional control is less well evaluated and was the subject of this evaluation. METHODS AND MATERIALS: We used the New Zealand breast cancer registry to identify patients treated with breast conservation with body mass index (BMI) recorded. We retrieved patient demographic, tumor characteristic, and treatment-related information. We assessed local and locoregional control outcomes in addition to breast cancer and overall survival outcomes. RESULTS: Patients (2513) were identified. The median follow-up was 5.25 years. Of these patients, 38% were obese with a BMI of ≥30 kg/m2, 32% were overweight with a BMI of 25.0 to 29.9 kg/m2, and 29% were either normal or underweight with a BMI of ≤24.9 kg/m2. Most patients were postmenopausal (65%). The median tumor size was 16.0 mm (0.2-80 mm) and the majority were grade 2 or 3 tumors (45% and 33%). The majority (66%) were pathologically node negative and lymphovascular invasion was seen in 24%. There were 81% with estrogen receptor positivity and 358 (14.2%) were Her-2 positive. Local relapse free survival at 5 years was 91.5% (95% confidence interval [CI], 90.3-92.7) and at 10 years was 78.5% (95% CI, 75.9-81.1). Local relapse free rate at 5 years was 96.8% (95% CI, 96.0-97.6) and 10 years was 93.9% (95% CI, 92.5-95.3). We did not find BMI to be associated with local or locoregional relapse, disease free, breast cancer specific, or overall survival. CONCLUSIONS: Obesity was not associated with inferior locoregional control or survival outcomes. This supports the practice of continuing to offer breast conserving treatment to women regardless of BMI.


Asunto(s)
Índice de Masa Corporal , Neoplasias de la Mama/cirugía , Mastectomía Segmentaria , Recurrencia Local de Neoplasia , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/uso terapéutico , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Supervivencia sin Enfermedad , Femenino , Humanos , Irradiación Linfática , Metástasis Linfática , Persona de Mediana Edad , Clasificación del Tumor , Recurrencia Local de Neoplasia/mortalidad , Nueva Zelanda/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , Estudios Prospectivos , Resultado del Tratamiento , Carga Tumoral , Adulto Joven
4.
Einstein (Sao Paulo) ; 18: eAO4851, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31721895

RESUMEN

OBJECTIVE: To analyze the pregestational body mass index and weight gain during pregnancy, and to associate data to perinatal outcomes of pregnant women from a Prenatal Care Program. METHODS: A retrospective study was carried out with 151 patients seen at the Healthy Gestation Program of Hospital Israelita Albert Einstein . Data were collected from a medical chart review of the patients seen between March 2015 and March 2016. RESULTS: The chance of developing gestational diabetes for obese patients in early gestation was estimated at 7.5-fold as compared to patients with low or normal body mass index. CONCLUSION: There was a significant association between obesity in early pregnancy and the occurrence of gestational diabetes mellitus in this population.


Asunto(s)
Sobrepeso/epidemiología , Complicaciones del Embarazo/etiología , Aumento de Peso , Adulto , Índice de Masa Corporal , Diabetes Gestacional/epidemiología , Diabetes Gestacional/etiología , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/epidemiología , Atención Prenatal , Estudios Retrospectivos , Factores de Riesgo
5.
Int J Cancer ; 146(3): 664-670, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-30895617

RESUMEN

Breast cancer is the most common cancer and the second-leading cause of cancer-related death among women. Inconsistent findings for the relationship between melatonin levels, sleep duration and breast cancer have been reported. We investigated the association of sleep duration at cohort entry and its interaction with body mass index (BMI) with risk of developing breast cancer in the large population-based Multiethnic Cohort study. Among the 74,481 at-risk participants, 5,790 breast cancer cases were identified during the study period. Although we detected no significant association between sleep duration and breast cancer incidence, higher risk estimates for short (HR = 1.03; 95% CI: 0.97-1.09) and long sleep (HR = 1.05; 95% CI: 0.95-1.15) compared to normal sleep (7-8 hr) were found. The patterns for models stratified by age, BMI, ethnicity and hormone receptor status were similar but did not indicate significant interaction effects. When examining the combined sleep duration and BMI interaction effect, in comparison to the normal BMI-normal sleep group, risk estimates for underweight, overweight and obesity were similar across categories of sleep duration (≤6, 7-8, and ≥9 hr). The underweight-normal sleep group had lower breast cancer incidence (HR = 0.66, 95% CI: 0.50-0.86), whereas the overweight-short sleep, overweight-normal sleep group and all obese women experienced elevated breast cancer incidence. The respective HRs for short, normal and long sleep among obese women were 1.35 (95% CI: 1.20-1.53), 1.27 (95% CI: 1.15-1.42) and 1.46 (95% CI: 1.21-1.76). Future perspectives need to examine the possibility that sleep quality, variations in circadian rhythm and melatonin are involved in breast cancer etiology.


Asunto(s)
Neoplasias de la Mama/epidemiología , Sobrepeso/epidemiología , Sueño/fisiología , Delgadez/epidemiología , Anciano , Índice de Masa Corporal , Neoplasias de la Mama/etiología , California/epidemiología , Ritmo Circadiano/fisiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Persona de Mediana Edad , Sobrepeso/complicaciones , Medición de Riesgo , Factores de Riesgo , Delgadez/complicaciones , Factores de Tiempo
6.
Lancet ; 395(10217): 65-74, 2020 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-31852602

RESUMEN

The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.


Asunto(s)
Desnutrición/epidemiología , Obesidad/epidemiología , Sobrepeso/epidemiología , África del Sur del Sahara/epidemiología , Calidad de los Alimentos , Humanos , Indonesia/epidemiología , Desnutrición/etiología , Estado Nutricional , Valor Nutritivo , Obesidad/etiología , Sobrepeso/etiología , Pobreza , Prevalencia , Factores Socioeconómicos
7.
Lancet ; 395(10217): 75-88, 2020 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-31852605

RESUMEN

Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life can be attributed to interconnected biological pathways, involving imbalance of the gut microbiome, inflammation, metabolic dysregulation, and impaired insulin signalling. Life-course exposure to early undernutrition followed by later overweight increases the risk of non-communicable disease, by imposing a high metabolic load on a depleted capacity for homoeostasis, and in women increases the risk of childbirth complications. These life-course trajectories are shaped both by societal driving factors-ie, rapidly changing diets, norms of eating, and physical activity patterns-and by broader ecological factors such as pathogen burden and extrinsic mortality risk. Mitigation of the DBM will require major societal shifts regarding nutrition and public health, to implement comprehensive change that is sustained over decades, and scaled up into the entire global food system.


Asunto(s)
Desnutrición/metabolismo , Obesidad/metabolismo , Sobrepeso/metabolismo , África del Sur del Sahara/epidemiología , Edad de Inicio , Ejercicio , Femenino , Microbioma Gastrointestinal , Humanos , Indonesia/epidemiología , Masculino , Desnutrición/epidemiología , Desnutrición/microbiología , Redes y Vías Metabólicas , Estado Nutricional , Obesidad/epidemiología , Obesidad/microbiología , Sobrepeso/epidemiología , Sobrepeso/microbiología , Prevalencia
8.
Int J Cancer ; 146(3): 874-883, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-31107541

RESUMEN

Substantial changes in the prevalence of the principal kidney and bladder cancer risk factors, smoking (both cancers) and body fatness (kidney cancer), have occurred but the contemporary cancer burden attributable to these factors has not been evaluated. We quantified the kidney and bladder cancer burden attributable to individual and joint exposures and assessed whether these burdens differ between population subgroups. We linked pooled data from seven Australian cohorts (N = 367,058) to national cancer and death registries and estimated the strength of the associations between exposures and cancer using adjusted proportional hazards models. We estimated exposure prevalence from representative contemporaneous health surveys. We combined these estimates to calculate population attributable fractions (PAFs) with 95% confidence intervals (CIs), accounting for competing risk of death, and compared PAFs for population subgroups. During the first 10-year follow-up, 550 kidney and 530 bladder cancers were diagnosed and over 21,000 people died from any cause. Current levels of overweight and obesity explain 28.8% (CI = 17.3-38.7%), current or past smoking 15.5% (CI = 6.0-24.1%) and these exposures jointly 39.6% (CI = 27.5-49.7%) of the kidney cancer burden. Current or past smoking explains 44.4% (CI = 35.4-52.1%) of the bladder cancer burden, with 24.4% attributable to current smoking. Ever smoking explains more than half (53.4%) of the bladder cancer burden in men, and the burden potentially preventable by quitting smoking is highest in men (30.4%), those aged <65 years (28.0%) and those consuming >2 standard alcoholic drinks/day (41.2%). In conclusion, large fractions of kidney and bladder cancers in Australia are preventable by behavior change.


Asunto(s)
Terapia Conductista , Costo de Enfermedad , Neoplasias Renales/epidemiología , Neoplasias de la Vejiga Urinaria/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Australia/epidemiología , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Predicción , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Neoplasias Renales/prevención & control , Estilo de Vida , Masculino , Persona de Mediana Edad , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Prevalencia , Sistema de Registros/estadística & datos numéricos , Factores de Riesgo , Fumar/efectos adversos , Fumar/epidemiología , Fumar/terapia , Cese del Hábito de Fumar , Neoplasias de la Vejiga Urinaria/prevención & control , Adulto Joven
9.
Ann Vasc Surg ; 62: 76-82, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31201969

RESUMEN

BACKGROUND: Surgical site infections (SSIs) after lower extremity revascularization are a common cause of increased morbidity in patients with peripheral artery disease (PAD). Understanding the multifaceted risk factors for SSIs may suggest closer monitoring for certain patients. The objective of this study is to evaluate the risk factors associated with incidence of SSIs, including patient demographics, operative factors, and socioeconomic status. METHODS: A retrospective review of a prospectively maintained database was queried for all patients who underwent any femoral exposure for the purposes of treating PAD from 2014 to 2017 at a single, academic, public hospital. Patient demographics, procedural data, and a variety of socioeconomic parameters were collected from chart review. Zip code geocoding was also used to obtain surrogates for local socioeconomic factors. The primary outcome measure was SSI within 90 days of operation. RESULTS: A total of 136 patients were identified, of which 19 (14%) developed an SSI. The only demographic variable associated with an increased risk of infection was body mass index (24.8 vs 30.1, P < 0.05). Major preoperative comorbid conditions, smoking status, and insurance status were not associated with an increased risk of complications. In addition, the type of procedure performed [infrainguinal bypass (n = 68), femoral endarterectomy (n = 36), aortofemoral bypass (n = 17), femoral-femoral bypass (n = 8), axillofemoral bypass (n = 7)] was not associated with any trend toward SSI. Estimated blood loss (292 vs 463 mL, P < 0.05), postoperative glucose (169 vs 212, P < 0.05), and postoperative white blood cell count (13.6 vs 18.3, P < 0.05) were the only periprocedural variables associated with SSIs. Lower mean household income, mean family income, and per capita income were all associated with an increased risk of postoperative infection (all P < 0.05). CONCLUSIONS: Socioeconomic factors, including poorer household income, are strongly associated with an increased risk of postoperative SSIs after lower extremity revascularization. Modifiable variables, such as preoperative optimization and procedural conduct, also display an effect on the development of an SSI. As a result, health care providers should maintain a high index of suspicion for the development of SSI in patients with lower socioeconomic status.


Asunto(s)
Renta , Enfermedad Arterial Periférica/cirugía , Clase Social , Determinantes Sociales de la Salud , Infección de la Herida Quirúrgica/epidemiología , Procedimientos Quirúrgicos Vasculares/efectos adversos , Anciano , Índice de Masa Corporal , Bases de Datos Factuales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Sobrepeso/epidemiología , Enfermedad Arterial Periférica/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos/epidemiología
10.
Maturitas ; 131: 21-27, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31787143

RESUMEN

OBJECTIVE: To examine the factors associated with healthy aging in a cohort of Mexican adults after a follow-up of 14 years. STUDY DESIGN: Participants were part of a prospective cohort of the Mexican Healthy Aging Study (MHAS), from which we included 5142 individuals aged 63 years or more. MAIN OUTCOME: Healthy aging, defined as reaching age 77 or 90 without major chronic conditions or physical limitations. MEASURES: Information on age, education, marital status, smoking, alcohol consumption, physical activity, self-perceived depression, health conditions and history of age-related diseases was collected at baseline and follow-up. RESULTS: Among the overall cohort, 57.8% experienced healthy survival to age 77 and 42.2% had died before age 77 or were undergoing normal aging. Participants with long-lived parents and who exercised had a lower risk of being non-healthy agers. Being overweight, obese or a smoker increased the risk of being a non-healthy ager. Physically active participants had increased odds of healthy aging at age 77 (OR: 1.17; 95% CI: 1.01-1.46) and at age 90 (OR: 1.5; 95% CI: 1.01-2.24). Depression had a negative relationship with healthy aging at age 90 (OR: 0.66; 95% CI: 0.45- 0.97). Maternal longevity was associated with healthy aging only at age 77 (OR = 1.34; 95% CI: 1.04-1.72). CONCLUSIONS: Our findings support the view that a combination of genetic and behavioral factors is associated with healthy aging. In accordance with findings in Caucasian populations, our data suggest for the first time that there might also be a genetic determinant for healthy ageing in Latin Americans.


Asunto(s)
Ejercicio , Estado de Salud , Envejecimiento Saludable , Esperanza de Vida , Longevidad , Anciano , Anciano de 80 o más Años , Envejecimiento , Consumo de Bebidas Alcohólicas/epidemiología , Enfermedad Crónica , Depresión/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Estilo de Vida , Masculino , México/epidemiología , Persona de Mediana Edad , Obesidad/epidemiología , Sobrepeso/epidemiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Fumar , Delgadez/epidemiología
11.
PLoS Med ; 16(12): e1002996, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31809506

RESUMEN

BACKGROUND: Previous studies have suggested that cesarean section (CS) is associated with offspring overweight and obesity. However, few studies have been able to differentiate between elective and nonelective CS, which may differ in their maternal risk profile and biological pathway. Therefore, we aimed to examine the association between differentiated forms of delivery with CS and risk of obesity in young adulthood. METHODS AND FINDINGS: Using Swedish population registers, a cohort of 97,291 males born between 1982 and 1987 were followed from birth until conscription (median 18 years of age) if they conscripted before 2006. At conscription, weight and height were measured and transformed to World Health Organization categories of body mass index (BMI). Maternal and infant data were obtained from the Medical Birth Register. Associations were evaluated using multinomial and linear regressions. Furthermore, a series of sensitivity analyses were conducted, including fixed-effects regressions to account for confounders shared between full brothers. The mothers of the conscripts were on average 28.5 (standard deviation 4.9) years old at delivery and had a prepregnancy BMI of 21.9 (standard deviation 3.0), and 41.5% of the conscripts had at least one parent with university-level education. Out of the 97,291 conscripts we observed, 4.9% were obese (BMI ≥ 30) at conscription. The prevalence of obesity varied slightly between vaginal delivery, elective CS, and nonelective CS (4.9%, 5.5%, and 5.6%, respectively), whereas BMI seemed to be consistent across modes of delivery. We found no evidence of an association between nonelective or elective CS and young adulthood obesity (relative risk ratio 0.96, confidence interval 95% 0.83-1.10, p = 0.532 and relative risk ratio 1.02, confidence interval 95% 0.88-1.18, p = 0.826, respectively) as compared with vaginal delivery after accounting for prepregnancy maternal BMI, maternal diabetes at delivery, maternal hypertension at delivery, maternal smoking, parity, parental education, maternal age at delivery, gestational age, birth weight standardized according to gestational age, and preeclampsia. We found no evidence of an association between any form of CS and overweight (BMI ≥ 25) as compared with vaginal delivery. Sibling analysis and several sensitivity analyses did not alter our findings. The main limitations of our study were that not all conscripts had available measures of anthropometry and/or important confounders (42% retained) and that our cohort only included a male population. CONCLUSIONS: We found no evidence of an association between elective or nonelective CS and young adulthood obesity in young male conscripts when accounting for maternal and prenatal factors. This suggests that there is no clinically relevant association between CS and the development of obesity. Further large-scale studies are warranted to examine the association between differentiated forms of CS and obesity in young adult offspring. TRIAL REGISTRATION: Registered as observational study at ClinicalTrials.gov Identifier: NCT03918044.


Asunto(s)
Índice de Masa Corporal , Cesárea/efectos adversos , Diabetes Gestacional/epidemiología , Sobrepeso/epidemiología , Obesidad Pediátrica/epidemiología , Adolescente , Adulto , Peso al Nacer/fisiología , Cesárea/estadística & datos numéricos , Estudios de Cohortes , Femenino , Humanos , Masculino , Edad Materna , Embarazo , Factores de Riesgo , Suecia/epidemiología , Adulto Joven
12.
Niger J Clin Pract ; 22(12): 1685-1692, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31793475

RESUMEN

Objectives: Obesity was previously seen as a problem in high-income countries. It is also a problem in low and middle-income countries today. The sedentary lifestyle has made this situation more pronounced. Childhood obesity continues in adulthood. Adequate and balanced nutrition and mobile lifestyle have a great role in the prevention and treatment of obesity. The aim of this study was to determine the prevalence of obesity among primary and secondary school students and related factors. Methods: The sample size was calculated as 1278 (213 × 6) for the gender distribution to be appropriate and for the primary and secondary school students to be included in the district center and villages. Considering 15% of the students' non-response rate, the number of students planned to be reached is 1500. Selection was made after the students were ranked by class, gender and place of residence. Of the 1500 students who were sampled, 1298 (86.53%) were evaluated. Results: There was no difference in body mass index between gender and place of residence. The prevalence of being overweight or obesity among secondary school students (25.2%) was significantly higher than primary school students (20.5%). Conclusion: In the childhood age group; sedentary lifestyle, having breakfast and obesity in parents had a significant effect on obesity. It is considered important for children and family members to have proper nutrition and mobile life behaviors.


Asunto(s)
Estilo de Vida , Obesidad/epidemiología , Sobrepeso/epidemiología , Estudiantes/estadística & datos numéricos , Adolescente , Adulto , Índice de Masa Corporal , Niño , Femenino , Humanos , Masculino , Prevalencia , Instituciones Académicas
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1386-1391, 2019 Nov 10.
Artículo en Chino | MEDLINE | ID: mdl-31838809

RESUMEN

Objective: To investigate the status of self-measurement of body weight in overweight and obese adults in China and identify the related factors. Methods: A total of 87 670 adults were enrolled in this study, who were selected through multi stage cluster random sampling from 177 099 residents aged ≥18 years in 302 surveillance areas in China where the fourth chronic non-communicable disease and related factor surveillance project was conducted in 2013. The information about their demographic characteristics and body weight measurement were collected by using questionnaire. Their body height, body weight, waist circumstance and blood pressure were measured respectively through physical examination. Fasting venous blood samples were obtained and assayed for FPG, TC, TG, LDL-C and HDL-C levels. Venous blood samples after 75 g glucose intake were obtained and assayed for OGTT-2h level. The proportion of self-body weight measurement were analyzed after complex sample weighting. Results: The proportion of overweight and obese adults who had self-body weight measurement within 1 week, 1 month and 1 year were 18.9%, 23.0% and 30.2%, respectively. The proportion of those having self-body weight measurement within 1 week was higher in men than in women, and lowest in ≥60 years old group (P<0.05). The proportion of overweight and obese adults who had never measured their body weight was 20.5%, the proportion was higher in women than in men, and highest in ≥60 years old group (P<0.05). Older age (OR=0.73, 95%CI: 0.64-0.82) was risk factor for self-body weight measurement; female (OR=1.11, 95%CI: 1.03-1.19), higher education level (junior college and above OR=3.79, 95%CI: 2.89-4.97), high- income (OR=1.61, 95%CI: 1.31-1.98), dyslipidemia (OR=1.13, 95%CI: 1.04-1.23), diabetes (OR=1.15, 95%CI: 1.03-1.30) were the protective factors for self-body weight measurement. Conclusion: It is necessary to promote self-body weight measurement in overweight and obese adults in China. Targeted health education should be carried out for different groups to encourage regular self-body weight measurement to maintain healthy body weight.


Asunto(s)
Obesidad , Sobrepeso , Adolescente , Adulto , Anciano , Índice de Masa Corporal , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Sobrepeso/epidemiología , Vigilancia de la Población/métodos , Prevalencia , Factores de Riesgo
14.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 833-839, 2019 Dec 25.
Artículo en Chino | MEDLINE | ID: mdl-31874473

RESUMEN

Objective: To examine the association of pre-pregnancy obesity, excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with the risk of large for gestational age (LGA), and assess the dynamic changes in population attributable risk percent (PAR%) for having these exposures. Methods: A retrospective cohort study was conducted to collect data on pregnant women who received regular health care and delivered in Beijing Obstetrics and Gynecology Hospital from January to December in 2011, 2014 and 2017, respectively. Information including baseline characteristics, metabolic indicators during pregnancy, pregnancy complications, and pregnancy outcomes were collected. Multivariate logistic regression model was constructed to assess their association with LGA delivery. Adjusted relative risk and prevalence of these factors were used to calculate PAR%and evaluate the comprehensive risk. Results: (1)The number of participants were 11 132, 13 167 and 4 973 in 2011, 2014 and 2017, respectively. Corresponding prevalence of LGA were 15.19% (1 691/11 132), 14.98% (1 973/13 167) and 16.21% (806/4 973). No significant change in the prevalence of LGA was observed across all years investigated (all P>0.05). (2)According to results from multivariate logistic regression model, advanced maternal age, multiparity, pre-pregnancy overweight or obesity, GWG,GDM and serum triglyceride level≥1.7 mmol/L in the first trimester were associated with high risk of LGA (all P<0.05). Among these factors, pre-pregnancy overweight or obesity, excessive GWG and multiparity were common risk factors of LGA. GDM was not associated with risk of LGA in 2017 database. (3) Dynamic change of PAR% in these years were notable. PAR% of GWG for LGA decreased (32.6%, 27.2% and 22.2% in 2011, 2014 and 2017, respectively), while PAR% of pre-pregnancy overweight or obesity showed an upward trend (4.2%, 3.3% and 8.4%). In addition, PAR% of multiparity increased as well (3.5%, 6.3% and 15.9%). (4) Further analysis showed that excessive GWG in the first and second trimesters contributed the most (20.2% and 19.0% in 2014 and 2017). Conclusions: Excessive GWG, pre-pregnancy overweight or obesity and multiparity are the important risk factors what contribute to LGA. PAR% of excessive GWG for LGA decrease in recent years. However, GWG in the first and second trimesters is a critical factor of LGA. Appropriate weight management in pre-pregnancy, the first or second trimester is the key point to reduce the risk of LGA.


Asunto(s)
Diabetes Gestacional/epidemiología , Macrosomía Fetal/epidemiología , Obesidad/complicaciones , Peso al Nacer , Índice de Masa Corporal , China/epidemiología , Femenino , Macrosomía Fetal/etiología , Edad Gestacional , Humanos , Obesidad/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Estudios Retrospectivos , Aumento de Peso
15.
PLoS Med ; 16(12): e1003007, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31887145

RESUMEN

BACKGROUND: The French dietary guidelines were updated in 2017, and an adherence score to the new guidelines (Programme National Nutrition Santé Guidelines Score 2 [PNNS-GS2]) has been developed and validated recently. Since overweight and obesity are key public health issues and have been related to major chronic conditions, this prospective study aimed to measure the association between PNNS-GS2 and risk of overweight and obesity, and to compare these results with those for the modified Programme National Nutrition Santé Guidelines Score (mPNNS-GS1), reflecting adherence to 2001 guidelines. METHODS AND FINDINGS: Participants (N = 54,089) were recruited among French adults (≥18 years old, mean baseline age = 47.1 [SD 14.1] years, 78.3% women) in the NutriNet-Santé web-based cohort. Mean (SD) score was 1.7 (3.3) for PNNS-GS2 and 8.2 (1.6) for mPNNS-GS1. Selected participants were those included between 2009 and 2014 and followed up to September 2018 (median follow-up = 6 years). Collected data included at least three 24-hour dietary records over a 2-year period following inclusion, baseline sociodemographics, and anthropometric data over time. In Cox regression models, PNNS-GS2 was strongly and linearly associated with a lower risk of overweight and obesity (HR for quintile 5 versus quintile 1 [95% CI] = 0.48 [0.43-0.54], p < 0.001, and 0.47 [0.40-0.55], p < 0.001, for overweight and obesity, respectively). These results were much weaker for mPNNS-GS1 (HR for quintile 5 versus quintile 1 = 0.90 [0.80-0.99], p = 0.03, and 0.98 [0.84-1.15], p = 0.8, for overweight and obesity, respectively). In multilevel models, PNNS-GS2 was negatively associated with baseline BMI and BMI increase over time (ß for a 1-SD increase in score [95% CI] = -0.040 [-0.041; -0.038], p < 0.001, and -0.00080 [-0.00094; -0.00066], p < 0.001, respectively). In "direct comparison" models, PNNS-GS2 was associated with a lower risk of overweight and obesity, lower baseline BMI, and lower BMI increase over time than mPNNS-GS1. Study limitations include possible selection bias, reliance on participant self-report, use of arbitrary cutoffs in data analyses, and residual confounding, but robustness was tested in sensitivity analyses. CONCLUSIONS: Our findings suggest that adherence to the 2017 French dietary guidelines is associated with a lower risk of overweight and obesity. The magnitude of the association and the results of the direct comparison reinforced the validity of the updated recommendations. TRIAL REGISTRATION: The NutriNet-Santé Study ClinicalTrials.gov (NCT03335644).


Asunto(s)
Índice de Masa Corporal , Dieta , Política Nutricional/legislación & jurisprudencia , Aumento de Peso/fisiología , Adolescente , Adulto , Estudios de Cohortes , Dieta/efectos adversos , Conducta Alimentaria/fisiología , Femenino , Francia , Conductas Relacionadas con la Salud/fisiología , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , Obesidad/epidemiología , Sobrepeso/epidemiología , Estudios Prospectivos , Adulto Joven
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1147-1151, 2019 Nov 06.
Artículo en Chino | MEDLINE | ID: mdl-31683403

RESUMEN

Objective: To examine the association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia. Methods: From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre-pregnancy body mass and gestational weight gain indicators with macrosomia. Results: 20 321 mother-infant were included in the final analysis. 20 321 pregnant women were (30.09±4.10) years old and delivered at (39.20±1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26±431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre-pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69-2.35) and 4.05 (95%CI: 3.05-5.39), respectively. After adjusting for the age, the pre-pregnancy BMI, delivery weeks, delivery mode and infant's gender, compared to the weight-gain appropriate group, higher weight gain rate in the mid-pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.66-2.39) and 1.80 (95%CI: 1.55-2.08), respectively. Conclusion: The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.


Asunto(s)
Índice de Masa Corporal , Macrosomía Fetal/epidemiología , Sobrepeso/epidemiología , Aumento de Peso , Adulto , Peso al Nacer , China/epidemiología , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Obesidad/epidemiología , Embarazo , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Segundo Trimestre del Embarazo , Factores de Riesgo
17.
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
18.
BMC Public Health ; 19(1): 1512, 2019 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-31718605

RESUMEN

BACKGROUND: Due to the high prevalence and adverse consequences, overweight and obesity in children continues to be a major public health concern worldwide. Socioeconomic background and health-related behaviours (such as diet, physical activity and sedentary behaviors) are important factors associated with weight status in children. Using a series of height and weight assessments from the Australian Capital Territory Physical Activity and Nutrition Survey (ACTPANS), trends in prevalence of overweight and obesity by socioeconomic status were examined in ACT Year 6 school children between 2006 and 2018. METHODS: The ACTPANS has been conducted every 3 years since 2006. A total of 6729 children were surveyed. Complete data on height and weight were available for 6384 (94.9%) participants. Trends in the prevalence of overweight and obesity and associations between weight status and risk factors (such as socioeconomic status, physical activity, screen time and consumption of sugar-sweetened soft drinks (SSD)) were examined using logistic regression. RESULTS: The prevalence of overweight and obesity remained stable in girls (from 22.5% in 2006 to 21.6% in 2018) but declined in boys (from 27.8 to 17.9%). During the same period, levels of physical activity increased slightly, while screen time and the consumption of fast food and SSD decreased. Socioeconomic gradient, based on the school-level Index of Community Socio-Educational Advantage (ICSEA), was highly associated with prevalence of overweight and obesity. Since 2006, the estimated prevalence of overweight and obesity has remained high in the lowest SES groups, but a concurrent downward trend was observed in the highest SES group, leading to increasing disparity between SES groups. Children in the lowest ICSEA quintile were more likely to be overweight or obese compared to those in the moderate and highest ICSEA quintiles. Children in lower ICSEA quintiles also reported lower levels of physical activity, higher levels of screen time, and higher levels of fast food and SSD consumption compared to those in higher ICSEA quintiles. CONCLUSIONS: While recent trends in overweight and obesity in ACT children are encouraging, the prevalence remains unacceptably high, especially in those from low socioeconomic backgrounds. Additional prevention efforts are required to address the socioeconomic disparity.


Asunto(s)
Conducta del Adolescente , Conducta Infantil , Conductas Relacionadas con la Salud , Obesidad Pediátrica/epidemiología , Clase Social , Adolescente , Territorio de la Capital Australiana/epidemiología , Peso Corporal , Niño , Dieta , Ejercicio , Femenino , Disparidades en el Estado de Salud , Humanos , Modelos Logísticos , Masculino , Sobrepeso/epidemiología , Sobrepeso/etiología , Obesidad Pediátrica/etiología , Prevalencia , Factores de Riesgo , Instituciones Académicas , Tiempo de Pantalla , Conducta Sedentaria , Encuestas y Cuestionarios
19.
Int J Behav Nutr Phys Act ; 16(1): 104, 2019 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-31718657

RESUMEN

BACKGROUND: Accurate assessment of fruit and vegetable intake (FVI) is essential for public health nutrition research and surveillance. Blood carotenoid concentrations are robust biomarkers of FVI, but collecting blood samples typically is not feasible in population-based studies. Understanding how well non-invasive measures compare to blood estimates is important for advancing surveillance and evaluation. The objective of this study was to examine the associations between serum carotenoids and four non-invasive measures of FVI in overweight and obese women. METHODS: This study utilized baseline data from 157 overweight or obese women (95.5% white, mean age 58.56 years ± 9.49 years) enrolled in the Strong Hearts, Healthy Communities randomized trial, including two direct measures of carotenoids and three self-reported measures of FVI. Participants completed a fasting blood draw, dermal carotenoid scans using resonance Raman spectroscopy (RRS), a two-item FVI screener modeled after the American Heart Association's Life's Simple 7 "My Life Check" tool (modified AHA tool), the National Cancer Institute's All-Day Fruit and Vegetable Screener (FVS), multiple 24-h dietary recalls, physical measurements, and demographic and health behavior questions. We analyzed blood for total carotenoids and derived total FVI estimates from self-report tools. We used multivariate linear regression models to examine associations between each non-invasive tool and serum carotenoids under four scenarios analogous to different research contexts in which varying breadths of participant data are available. We also calculated adjusted Pearson's correlations between serum carotenoids, dermal carotenoids, and the self-reported measures. RESULTS: Dermal carotenoids were strongly correlated with serum carotenoids (0.71, P < 0.00067) and associated with serum carotenoids in all regression models (0.42-0.43, P < 0.002). None of the self-reported FVI measures were significantly associated with serum or dermal carotenoids in adjusted regression models or correlation analyses. CONCLUSIONS: Compared to self-reported FVI, we found dermal carotenoids measured by RRS to be a superior method to approximate serum carotenoids among overweight and obese women. More research is needed to investigate these assessment methods in diverse populations. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02499731, registered July 16, 2015.


Asunto(s)
Carotenoides/análisis , Dieta/estadística & datos numéricos , Frutas , Sobrepeso , Verduras , Anciano , Carotenoides/sangre , Femenino , Humanos , Persona de Mediana Edad , Obesidad/sangre , Obesidad/epidemiología , Obesidad/metabolismo , Sobrepeso/sangre , Sobrepeso/epidemiología , Sobrepeso/metabolismo , Ensayos Clínicos Controlados Aleatorios como Asunto , Piel/química , Espectrometría Raman
20.
PLoS Med ; 16(11): e1002968, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31774821

RESUMEN

BACKGROUND: In high-income countries, obesity prevalence (body mass index greater than or equal to 30 kg/m2) is highest among the poor, while overweight (body mass index greater than or equal to 25 kg/m2) is prevalent across all wealth groups. In contrast, in low-income countries, the prevalence of overweight and obesity is higher among wealthier individuals than among poorer individuals. We characterize the transition of overweight and obesity from wealthier to poorer populations as countries develop, and project the burden of overweight and obesity among the poor for 103 countries. METHODS AND FINDINGS: Our sample used 182 Demographic and Health Surveys and World Health Surveys (n = 2.24 million respondents) from 1995 to 2016. We created a standard wealth index using household assets common among all surveys and linked national wealth by country and year identifiers. We then estimated the changing probability of overweight and obesity across every wealth decile as countries' per capita gross domestic product (GDP) rises using logistic and linear fixed-effect regression models. We found that obesity rates among the wealthiest decile were relatively stable with increasing national wealth, and the changing gradient was largely due to increasing obesity prevalence among poorer populations (3.5% [95% uncertainty interval: 0.0%-8.3%] to 14.3% [9.7%-19.0%]). Overweight prevalence among the richest (45.0% [35.6%-54.4%]) and the poorest (45.5% [35.9%-55.0%]) were roughly equal in high-income settings. At $8,000 GDP per capita, the adjusted probability of being obese was no longer highest in the richest decile, and the same was true of overweight at $10,000. Above $25,000, individuals in the richest decile were less likely than those in the poorest decile to be obese, and the same was true of overweight at $50,000. We then projected overweight and obesity rates by wealth decile to 2040 for all countries to quantify the expected rise in prevalence in the relatively poor. Our projections indicated that, if past trends continued, the number of people who are poor and overweight will increase in our study countries by a median 84.4% (range 3.54%-383.4%), most prominently in low-income countries. The main limitations of this study included the inclusion of cross-sectional, self-reported data, possible reverse causality of overweight and obesity on wealth, and the lack of physical activity and food price data. CONCLUSIONS: Our findings indicate that as countries develop economically, overweight prevalence increased substantially among the poorest and stayed mostly unchanged among the wealthiest. The relative poor in upper- and lower-middle income countries may have the greatest burden, indicating important planning and targeting needs for national health programs.


Asunto(s)
Obesidad/epidemiología , Sobrepeso/epidemiología , Adolescente , Adulto , Índice de Masa Corporal , Estudios Transversales , Países en Desarrollo/estadística & datos numéricos , Composición Familiar , Femenino , Salud Global , Encuestas Epidemiológicas , Humanos , Renta , Masculino , Persona de Mediana Edad , Pobreza , Prevalencia , Factores Socioeconómicos
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