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AIM: To determine the association between known risk factors (e.g., obesity, metabolic syndrome and its components) and the development of pre-diabetes or diabetes over time in a cohort of Mexican health workers. METHODS: Participants in the Mexican Health Worker Cohort Study with complete information at two waves of data collection, 2004-2006 (W1) and 2011-2013 (W2), were included in the analysis (n = 1,174). Multivariable binary and multinomial logistic regression were used to examine the cross-sectional associations between specific risk factors and diabetes status (diabetes, pre-diabetes, or neither) at W1 and the longitudinal associations between changes in risk factors and progression of diabetes status from W1 to W2, respectively. RESULTS: Mean time between waves was 7.0 years (SD 1.1). Prevalence of pre-diabetes and diabetes was 16% and 10% at W1 and increased to 30% and 16% at W2, respectively. The cross-sectional prevalence of pre-diabetes and diabetes was significantly higher among men, participants over the age of 45 years, and individuals who were overweight or obese or had metabolic syndrome (MS), three or more components of the MS, elevated alanine aminotransferase (ALT) levels, or elevated uric acid. In longitudinal analyses, remaining obese or gaining weight between waves was associated with an increased risk of developing pre-diabetes. A greater risk of developing pre-diabetes or diabetes was also observed among individuals who either maintained or acquired MS, elevated ALT, or elevated uric acid (only for diabetes) from W1 to W2. CONCLUSIONS: Weight gain and acquiring or maintaining MS, elevated ALT levels, or elevated uric acid were associated with a significant risk of developing pre-diabetes or diabetes. Our findings, especially in the context of the obesity epidemic in Mexico, point towards an urgent need for initiatives to help reduce excess weight in order to avert future cases of pre-diabetes and diabetes.
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Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Mão de Obra em Saúde/estatística & dados numéricos , Síndrome Metabólica/complicações , Obesidade/complicações , Sobrepeso/complicações , Estado Pré-Diabético/epidemiologia , Adulto , Estudos Transversais , Diabetes Mellitus/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Síndrome Metabólica/fisiopatologia , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Estado Pré-Diabético/etiologia , Prevalência , Fatores de RiscoRESUMO
UNLABELLED: OBJECTIVE AND MAIN OUTCOME MEASURES: This article provides 2005-2008 population-based prevalence data on obesity and overweight among youth residing in Puerto Rico. DESIGN AND SETTING: Data for this report are from the Asthma, Depression, and Anxiety in Puerto Rican Youth (ADA) study. Measures included height and weight level data on youth in Puerto Rico aged 10 to 19 years with and without asthma as well as body mass index data on their caregivers. PARTICIPANTS: A total of 436 youth-caregiver dyads were selected and weighted to represent the general population of youth in Puerto Rico using 2008 US Census data. RESULTS: Household surveys demonstrated that 40% of youth aged 10 to 19 were overweight or obese. Twenty-five percent met moderate-to-vigorous-intensity physical activity guidelines, however, physical activity was not associated with overweight or obesity in this sample. In multivariate analyses, females were 50% less likely than males to be overweight or obese. Older youth were 73% less likely to be overweight or obese than younger youth. Youth whose parents were obese were more than two times more likely to be overweight or obese than those whose parents were at a desirable weight. CONCLUSIONS: Youth in Puerto Rico have higher rates of overweight and obesity and lower compliance to moderate-to-vigorous-intensity physical activity guidelines than rates reported for youth on the mainland. More population-based research is needed to understand the epidemiology of obesity and overweight among island Puerto Rican youth and the contribution of physical activity to the phenomenon.
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Hispânico ou Latino/estatística & dados numéricos , Obesidade/etnologia , Adolescente , Fatores Etários , Índice de Massa Corporal , Criança , Exercício Físico , Feminino , Humanos , Masculino , Prevalência , Porto Rico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
OBJECTIVE: To investigate whether aerobic fitness and obesity in school children are associated with standardized test performance. STUDY DESIGN: Ethnically diverse (n = 1989) 5th, 7th, and 9th graders attending California schools comprised the sample. Aerobic fitness was determined by a 1-mile run/walk test; body mass index (BMI) was obtained from state-mandated measurements. California standardized test scores were obtained from the school district. RESULTS: Students whose mile run/walk times exceeded California Fitnessgram standards or whose BMI exceeded Centers for Disease Control sex- and age-specific body weight standards scored lower on California standardized math, reading, and language tests than students with desirable BMI status or fitness level, even after controlling for parent education among other covariates. Ethnic differences in standardized test scores were consistent with ethnic differences in obesity status and aerobic fitness. BMI-for-age was no longer a significant multivariate predictor when covariates included fitness level. CONCLUSIONS: Low aerobic fitness is common among youth and varies among ethnic groups, and aerobic fitness level predicts performance on standardized tests across ethnic groups. More research is needed to uncover the physiological mechanisms by which aerobic fitness may contribute to performance on standardized academic tests.
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Escolaridade , Obesidade/psicologia , Aptidão Física , Índice de Massa Corporal , Peso Corporal , California , Criança , Etnicidade , Exercício Físico , Feminino , Humanos , Masculino , Obesidade/etnologia , Fatores SocioeconômicosRESUMO
INTRODUCTION: Proactive worksite strategies that change the physical or sociocultural environment(s) to incorporate obligatory physical activity may be necessary to engage sedentary people. This study describes implementation and evaluation of an intervention, Pausa para tu Salud (Pause for Your Health), that integrated a brief period of group exercise into the workday. METHODS: An uncontrolled pretest-post-test study design tested the effects of integrating daily 10-minute exercise breaks during paid work time during January 2003 through January 2004. A total of 335 Mexican Ministry of Health office workers provided baseline data as a part of routine annual clinical screening examinations. RESULTS: Baseline mean body mass index and waist circumferences were 27.8 kg/m(2) and 87.6 cm for women and 26.6 kg/m(2) and 89.7 cm for men. Complete data were available for 271 (80.9%) employees at 1-year follow-up. Two-tailed, paired t-test comparisons were used. Body mass index decreased by 0.32 kg/m(2) (P = .05), and waist circumference by 1.6 cm (P = .0009) overall. The body mass index decrease, however, was significant only for men (-0.43 kg/m(2), P = .03). Multivariate analyses revealed a significant decrease in diastolic blood pressure among women (z = -2.04, P = .042). CONCLUSION: The intervention was associated with significant improvements in both measures of body composition. Substantive health and organizational benefits may result from integrating brief periods of physical activity into the workday if these findings are replicated in randomized controlled trials in other worksites.