Recent trends in weight loss attempts: repeated cross-sectional analyses from the health survey for England.

BACKGROUND: Public policies and clinical guidelines encourage people to achieve and maintain a healthy weight and societal culture, especially among women who tend to idealise thinness. OBJECTIVES: To examine trends over time in the prevalence of weight loss attempts in England (1997-2013) and to investigate if the characteristics associated with attempts to lose weight have changed. METHODS: Observational study using nationally representative data on adults ⩾18 years who participated in the Health Survey for England (HSE) in 1997 (n=8066), 1998 (n=14 733), 2002 (n=8803), 2012 (n=7132) and 2013 (n=7591), with self-reported attempts to lose weight, cardiovascular disease (CVD) events or medications and measured height, weight and blood pressure. Multivariable logistic regression was used to assess the association between weight loss attempts and survey year, socio-demographic variables and health status. RESULTS: The age-standardised prevalence of weight loss attempts in the English population increased from 39% in 1997 to 47% in 2013. In 2013, 10% of those with BMI <22; 30% with BMI ⩾22 to <25; 53% with BMI ⩾25 to <30; and 76% with BMI ⩾30 were trying to lose weight. The odds of trying to lose weight increased linearly with each year: odds ratio (OR) 1.021 (95% confidence interval (CI) 1.018-1.024) and 1.024 (95% CI 1.008-1.039) after adjustment for changes in BMI and population characteristics. The biggest predictors of weight loss attempts were being in the overweight/obese categories: 5.42 (95% CI 5.05-5.81) and 12.68 (95% CI 11.52-13.96), respectively; and among women: 3.01 (95% CI 2.85-3.18). Having a BMI >25 and a CVD-related condition was associated with only a small increase in the odds of trying to lose weight. There was no evidence that these predictors changed over time. CONCLUSIONS: More people are making weight loss attempts each year across all BMI categories. Having a health condition that would improve with weight loss was only very modestly associated with an increase in reported weight loss attempts, which reinforces data that suggests people's prime motivation to lose weight is unrelated to health.

The double burden of under- and overnutrition and nutrient adequacy among Chinese preschool and school-aged children in 2009-2011.

BACKGROUND/OBJECTIVES: Coincident with economic development, China has experienced a marked transition from undernutrition to overweight/obesity over the last few decades. We aimed to explore the burden of under- and overnutrition and nutrient adequacy among 2-12-year-old Chinese children. SUBJECTS/METHODS: We included anthropometry, dietary intake and biomarkers from 2-12-year-olds who participated in the 2009-2011 China Health and Nutrition Survey (n=1191 in 2009; n=1648 in 2011). Dietary intakes were compared with the 2013 Chinese Dietary Recommended Intakes. RESULTS: In 2011, ~19% of 2-6-year-old children were underweight, 4% were stunted, 10% were overweight and 12% were obese. Among 7-12-year-old children, stunting was almost 0%, whereas ~21% were underweight, 13% were overweight and 6% were obese in 2011. Overweight and obesity were more prevalent among children from urban areas and higher income households. In particular, 2-6-year-old children from urban areas and higher income households experienced the highest increase in obesity from 2009 to 2011 (P<0.05). Children from urban areas and higher income households had overall higher intakes of total daily energy and most macro- and micronutrients (P<0.05). However, a significant proportion of children did not meet the recommendations for important micronutrients. CONCLUSIONS: Underweight and stunting currently coexist with overweight and obesity among Chinese children <12-year-old. We found critical disparities in the prevalence of under- and overweight/obesity, as well as in nutrient intakes and dietary adequacies between children from different incomes, revealing that the burden of childhood under- and overnutrition may constitute a public health concern in modern China.

Trends in purchases and intake of foods and beverages containing caloric and low-calorie sweeteners over the last decade in the United States.

BACKGROUND: Current food databases might not capture rapidly occurring changes in the food supply, such as the increased use of caloric (CS) and low-calorie sweeteners (LCS) in products. OBJECTIVE: We explored trends in purchases and intake of foods and beverages containing LCS, CS or both sweeteners over the last decade in the United States, as well as household and socioeconomic status (SES) predictors of these trends. METHODS: We analyzed household purchases from Homescan 2000-2010 (n = 140 352 households; 408 458 individuals) and dietary intake from National Health And Nutrition Examination Survey (NHANES) 2003-2010 (n = 34 391 individuals). We estimated per capita purchases and intake (g or mL d(-1)) and percent of consumers of foods and beverages containing LCS, CS or both LCS + CS. We estimated change in purchases associated with SES and household composition using random-effects longitudinal models. RESULTS: From 2000 to 2010, percent of households purchasing CS products decreased, whereas that for LCS and LCS + CS products increased among all types of households and particularly among those with children. African-American, Hispanic and households with children had a higher % CS beverage purchases (+9, +4 and +3%, respectively, P < 0.001) and lower % LCS beverage purchases (-12, -5 and -2%, respectively, P < 0.001). CONCLUSIONS: During a period of declining purchases and consumption of CS products, we have documented an increasing trend in products that contain LCS and a previously unexplored trend in products with both LCS and CS, especially important among households with children.

New computed tomography-derived indices to predict cardiovascular and insulin-resistance risks in overweight/obese patients.

OBJECTIVE: To determine whether a series of new computed tomography (CT)-derived indices are better diagnostic criteria than the classical CT-derived measurements. A second objective is to propose specific or sensitive threshold values of the most accurate criteria for the occurrence of metabolic disturbances. SUBJECTS/METHODS: Anthropometric measurements and CT scans were performed in 74 obese subjects. Fat thicknesses, diameters, diagonals and areas were determined. Plasma lipids, insulin, glucose and fat cell size were analyzed. A multivariate regression analysis was performed to determine the most accurate predictor index for metabolic alterations explaining the highest percentage of variance. RESULTS: All the new indices were highly correlated with body mass index, percentage of fat and fat cell size. Subcutaneous thicknesses were greater in women, while internal-coronal and sagittal diameters, visceral adipose tissue (VAT) and internal circumference area were greater in men (P<0.001). Those observations were reinforced by the adipocyte size in both fat depots. Subcutaneous parameters showed the strongest correlation with metabolic alterations, being positively associated with metabolic risk in women and negatively in men. Multivariate regression analysis showed that the best predictor index was the superficial subcutaneous adipose tissue (SSAT) and its relation to visceral area (SSAT/VAT), explaining 42% of total variance for high-density lipoprotein-cholesterol in men and 26% for homeostasis model assessment in women. After receiver operating characteristic-curves analysis, three threshold values for both sexes were proposed to select the most appropriate depending on the clinical situation. CONCLUSION: For the first time, we have described SSAT and the SSAT/VAT ratio as important indices in obesity-related disturbances.