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1.
Eur J Endocrinol ; 182(1): G1-G32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31855556

RESUMO

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.


Assuntos
Índice de Massa Corporal , Hipotireoidismo/diagnóstico , Obesidade/diagnóstico , Comorbidade , Endocrinologia , Humanos , Hipotireoidismo/epidemiologia , Obesidade/epidemiologia , Prevalência , Testes de Função Tireóidea
2.
Sci Total Environ ; 699: 134397, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31677469

RESUMO

Children are vulnerable to air pollution-induced lung function deficits, and the prevalence of obesity has been increasing in children. To evaluate the joint effects of long-term PM1 (particulate matter with an aerodynamic diameter ≤ 1.0 µm) exposure and obesity on children's lung function, a cross-sectional sample of 6740 children (aged 7-14 years) was enrolled across seven northeastern Chinese cities from 2012 to 2013. Weight and lung function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF), were measured according to standardized protocols. Average PM1, PM2.5, PM10 and nitrogen dioxide (NO2) exposure levels were estimated using a spatiotemporal model, and sulphur dioxide (SO2) and ozone (O3) exposure were estimated using data from municipal air monitoring stations. Two-level logistic regression and general linear models were used to analyze the joint effects of body mass index (BMI) and air pollutants. The results showed that long-term air pollution exposure was associated with lung function impairment and there were significant interactions with BMI. Associations were stronger among obese and overweight than normal weight participants (the adjusted odds ratios (95% confidence intervals) for PM1 and lung function impairments in three increasing BMI categories were 1.50 (1.07-2.11) to 2.55 (1.59-4.07) for FVC < 85% predicted, 1.44 (1.03-2.01) to 2.51 (1.53-4.11) for FEV1 < 85% predicted, 1.34 (0.97-1.84) to 2.04 (1.24-3.35) for PEF < 75% predicted, and 1.34 (1.01-1.78) to 1.93 (1.26-2.95) for MMEF < 75% predicted). Consistent results were detected in linear regression models for PM1, PM2.5 and SO2 on FVC and FEV1 impairments (PInteraction < 0.05). These modification effects were stronger among females and older participants. These results can provide policy makers with more comprehensive information for to develop strategies for preventing air pollution induced children's lung function deficits among children.


Assuntos
Poluição do Ar/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Obesidade/epidemiologia , Adolescente , Poluentes Atmosféricos/análise , Criança , China/epidemiologia , Cidades , Feminino , Volume Expiratório Forçado , Humanos , Pulmão/efeitos dos fármacos , Masculino , Dióxido de Nitrogênio/análise , Sobrepeso , Ozônio/análise , Material Particulado/análise , Testes de Função Respiratória , Dióxido de Enxofre , Capacidade Vital
3.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852078

RESUMO

We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.


Assuntos
Índice de Massa Corporal , Obesidade/complicações , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/cirurgia
4.
N Engl J Med ; 381(25): 2440-2450, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31851800

RESUMO

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.).


Assuntos
Obesidade Mórbida/epidemiologia , Obesidade/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Previsões , Humanos , Renda , Masculino , Obesidade/etnologia , Obesidade Mórbida/etnologia , Prevalência , Autorrelato , Distribuição por Sexo , Estados Unidos/epidemiologia
5.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 833-839, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31874473

RESUMO

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.


Assuntos
Diabetes Gestacional/epidemiologia , Macrossomia Fetal/epidemiologia , Obesidade/complicações , Peso ao Nascer , Índice de Massa Corporal , China/epidemiologia , Feminino , Macrossomia Fetal/etiologia , Idade Gestacional , Humanos , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Retrospectivos , Ganho de Peso
6.
Medicine (Baltimore) ; 98(51): e18354, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860991

RESUMO

Many cancer patients develop diabetes, which may result in reduction of chemotherapy effectiveness and increased infection risk and cardiovascular mortality. Diabetes may also increase the risks of chemotherapy-related toxicity and post-operative mortality, or represent an obstacle to optimal cancer treatment. However, the clinical predictors of diabetes in cancer patients remain largely unknown. Therefore, the aim of our study was to evaluate the risk factors for developing diabetes and construct a nomogram to predict diabetes in cancer patients.We investigated patients from a national sample cohort obtained from the Korea National Health Insurance Service (KNHIS), which included 2% of the Korean population. Patients who had undergone routine medical evaluation by the KNHIS between 2004 and 2008 and been hospitalized due to cancer (ICD-10 codes C00-97) during the past 3 years were included. After excluding patients with type 2 diabetes and missing data, 10,899 patients were enrolled and followed-up until 2013. A total of 7630 (70%) patients were assigned as the training cohort and used to construct the nomogram which was based on a multivariable logistic regression model. The remaining patients (n = 3269) were used as the validation cohort.The incidence rate of diabetes was 12.1 per 1000 person-years over a mean follow-up of 6.6 ±â€Š1.8 years. Significant risk factors for developing diabetes were age, sex, obesity, fasting plasma glucose, hypertension, and hypercholesterolmia. A nomogram was constructed using these variables and internally validated. The area under the curve was 0.70 (95% confidence interval, .666-.730, P < .0001) and the calibration plot showed agreement between the actual and nomogram-predicted diabetes probabilities.The nomogram developed in this study is easy to use and convenient for identifying cancer patients at high-risk for type 2 diabetes, enabling early type 2 diabetes screening and management.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Neoplasias/epidemiologia , Medição de Risco , Fatores Etários , Idoso , Glicemia/análise , Estudos de Coortes , Feminino , Seguimentos , Humanos , Hipercolesterolemia/epidemiologia , Hipertensão/epidemiologia , Incidência , Masculino , Nomogramas , Obesidade/epidemiologia , República da Coreia/epidemiologia , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais
7.
BMJ ; 367: l5837, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666218

RESUMO

OBJECTIVE: To evaluate whether calorie labeling of menus in large restaurant chains was associated with a change in mean calories purchased per transaction. DESIGN: Quasi-experimental longitudinal study. SETTING: Large franchise of a national fast food company with three different restaurant chains located in the southern United States (Louisiana, Texas, and Mississippi) from April 2015 until April 2018. PARTICIPANTS: 104 restaurants with calorie information added to in-store and drive-thru menus in April 2017 and with weekly aggregated sales data during the pre-labeling (April 2015 to April 2017) and post-labeling (April 2017 to April 2018) implementation period. MAIN OUTCOME MEASURES: Primary outcome was the overall level and trend changes in mean purchased calories per transaction after implementation of calorie labeling compared with the counterfactual (ie, assumption that the pre-intervention trend would have persisted had the intervention not occurred) using interrupted time series analyses with linear mixed models. Secondary outcomes were by item category (entrees, sides, and sugar sweetened beverages). Subgroup analyses estimated the effect of calorie labeling in stratums defined by the sociodemographic characteristics of restaurant census tracts (defined region for taking census). RESULTS: The analytic sample comprised 14 352 restaurant weeks. Over three years and among 104 restaurants, 49 062 440 transactions took place and 242 726 953 items were purchased. After labeling implementation, a level decrease was observed of 60 calories/transaction (95% confidence interval 48 to 72; about 4%), followed by an increasing trend of 0.71 calories/transaction/week (95% confidence interval 0.51 to 0.92) independent of the baseline trend over the year after implementation. These results were generally robust to different analytic assumptions in sensitivity analyses. The level decrease and post-implementation trend change were stronger for sides than for entrees or sugar sweetened beverages. The level decrease was similar between census tracts with higher and lower median income, but the post-implementation trend in calories per transaction was higher in low income (change in calories/transaction/week 0.94, 95% confidence interval 0.67 to 1.21) than in high income census tracts (0.50, 0.19 to 0.81). CONCLUSIONS: A small decrease in mean calories purchased per transaction was observed after implementation of calorie labeling in a large franchise of fast food restaurants. This reduction diminished over one year of follow-up.


Assuntos
Ingestão de Energia/fisiologia , Fast Foods/efeitos adversos , Rotulagem de Alimentos , Obesidade/prevenção & controle , Restaurantes/estatística & dados numéricos , Comportamento do Consumidor/estatística & dados numéricos , Fast Foods/estatística & dados numéricos , Humanos , Renda/estatística & dados numéricos , Estudos Longitudinais , Ensaios Clínicos Controlados não Aleatórios como Assunto , Obesidade/epidemiologia , Obesidade/etiologia , Prevalência , Sudeste dos Estados Unidos/epidemiologia
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1147-1151, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683403

RESUMO

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.


Assuntos
Índice de Massa Corporal , Macrossomia Fetal/epidemiologia , Sobrepeso/epidemiologia , Ganho de Peso , Adulto , Peso ao Nascer , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Obesidade/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Segundo Trimestre da Gravidez , Fatores de Risco
9.
Epidemiol Health ; 41: e2019042, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31623423

RESUMO

OBJECTIVES: The purpose of this study was to estimate the effects of health-risk behaviors, alone and in combination, on health outcomes. METHODS: This study used sample cohort data provided by the National Health Insurance Service focusing on the use of hospital services, direct medical expenses, length of stay, and re-entry rate according to health-risk behaviors. A frequency analysis and the chi-square test were used to investigate associations between the demographic characteristics of study subjects and their health-risk behaviors. The strength of the association of each factor was calculated as the odds ratio in a crossover analysis. RESULTS: Obesity had the largest effect, especially in combination with smoking and drinking. In particular, significant associations were shown with the duration of hospitalization and direct medical expenses. After adjustment for sex, age, economic status, and pre-existing medical conditions, the duration of hospitalization was 7.37 times longer and that of medical expenses was 5.18 times higher in the obese group relative to the non-obese group. Drinking showed a statistically significant association with the number of days of hospitalization. After adjusting for the control variables, the number of hospital days was 1.24 longer in the drinking group than in the non-drinking group. CONCLUSIONS: An analysis of combinations of health risk factors showed obesity had the largest effect.


Assuntos
Comportamentos de Risco à Saúde , Nível de Saúde , Doença Crônica/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Obesidade/epidemiologia , República da Coreia/epidemiologia
10.
Epidemiol Health ; 41: e2019039, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31623425

RESUMO

OBJECTIVES: Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi. METHODS: A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2 , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds. RESULTS: In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43). CONCLUSIONS: Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.


Assuntos
Obesidade/epidemiologia , Sobrepeso/epidemiologia , Determinantes Sociais da Saúde , Adolescente , Adulto , Estudos Transversais , Demografia , Feminino , Humanos , Malaui/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
11.
Zhonghua Nei Ke Za Zhi ; 58(10): 751-757, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31594173

RESUMO

Objective: To investigate the characteristics of body composition (BC) in gout patients and its clinical significance. Methods: Consecutive gout patients were recruited between August 2017 and December 2018. Demographic information, clinical characteristics and comorbidities were collected. BC was assessed by bioelectric impedance analysis including body fat percentage (BF%), trunk and limb BF%, appendicular skeletal muscle index. Overfat was defined by BF% ≥25% for male and ≥35% for female. The association between BC and serum uric acid (sUA) was evaluated by multiple linear regression. Results: A total of 362 gout patients were recruited with median age 38 (30, 52) years, 96.1% (348/362) were male. Mean sUA was (551±133) µmol/L. The mean BF% was (25.8±6.4)% with 53.6%(194/362) patients overfat. Male gout patients with overfat showed more affected joints [4(2, 6) vs. 2(2, 5)], higher sUA [(576±126)µmol/L vs. (523±134) µmol/L], higher prevalence of dyslipidemia [70.1%(131/187) vs. 54.0%(87/161)], metabolic syndrome [60.8%(118/187) vs. 28.0%(47/161)], fatty liver [58.2%(113/187) vs. 35.1%(59/161)] and hypertension [44.4%(83/187) vs. 25.5%(41/161)] than male patients with normal fat (all P<0.05). Their BF%, trunk BF% and limb BF% were positively correlated with the numbers of affected joints, sUA, metabolic syndrome, fatty liver, and hypertension, respectively (r=0.154-0.435, all P<0.05). Multivariable linear regression suggested that BF% (ß=4.29, P=0.020) and trunk BF% (ß=9.11, P=0.007), but not limb BF%, were positively correlated with sUA. Conclusion: Overfat is very common in gout patients. The proportion of trunk fat in male patients is positively correlated with sUA. When assessing obesity in gout patients clinically, body composition analysis should be performed simultaneously.


Assuntos
Composição Corporal/fisiologia , Gota/diagnóstico , Obesidade/epidemiologia , Ácido Úrico/sangue , Adulto , Dislipidemias/epidemiologia , Feminino , Gota/sangue , Gota/epidemiologia , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/sangue , Prevalência
12.
Rev Lat Am Enfermagem ; 27: e3177, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596412

RESUMO

OBJECTIVE: analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students. METHOD: this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed. RESULTS: female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity. CONCLUSION: overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.


Assuntos
Sobrepeso/psicologia , Estresse Psicológico/epidemiologia , Estudantes de Enfermagem/psicologia , Adulto , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Obesidade/psicologia , Sobrepeso/prevenção & controle , Circunferência da Cintura
13.
Rev Saude Publica ; 53: 79, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576940

RESUMO

OBJECTIVE: To determine the prevalence of work ability (WA) and describe characteristics of the subgroup with poor WA among military police officers. METHODS: A descriptive and cross-sectional study with 329 male military police officers engaged in street patrolling in Salvador, Bahia, Brazil, selected by proportionate stratified sampling. The Work Ability Index and a structured form were used to collect information about age, education, marital status, housing, salary, car ownership, work hours, rank (official or enlisted), drinking, smoking, frequency of vigorous physical activity, and obesity. Data were analyzed by uni and bivariate statistical techniques. RESULTS: The work ability of the 329 military police officers was classified as poor (10.3%), moderate (28.9%), good (34.7%), and excellent (26.1%), with mean score of 37.8 and standard deviation of 7.3 points. Policemen with poor work ability, compared with those with moderate, good or excellent WA, presented higher proportions of individuals who did not own their residences (p < 0.001), with work hours above eight hours/day (p < 0.026), and obesity (p < 0.001). In the subgroup of the 26 policemen who concomitantly did not own their residences, worked more than eight 8 hours/day and were obese, the prevalence of poor work ability was 31.0%. The prevalence of poor WA was 31.0% among the 29 policemen who were simultaneously obese and did not own their residences and of 27.9% among the 43 policemen who were obese and work hours above eight hours/day. CONCLUSIONS: A high percentage of military police officers from Salvador presented poor or moderate work ability, which may hamper or compromise their policing activities. The prevalence of poor work ability was higher among the policemen who did not own their residences, worked more than 8 hours/day and were obese.


Assuntos
Polícia/estatística & dados numéricos , Avaliação da Capacidade de Trabalho , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Exercício , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Valores de Referência , Fumar/epidemiologia , Fatores Socioeconômicos , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
14.
S D Med ; 72(9): 419-423, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31581377

RESUMO

BACKGROUND: A disparity in overweight/obesity prevalence exists between rural and urban youth; however, definitions of 'rural' vary widely and the degree to which rurality impacts overweight/obesity prevalence is unclear. Therefore, the purpose of this study was to examine the school height and weight data in a rural Midwest state to determine differences in overweight and obesity prevalence among youth by using Rural-Urban Continuum (RUC) codes to define county-level degree of urbanization. METHODS: De-identified statewide data were obtained in electronic format from the state Department of Health. Height, weight, sex and age were used to calculate body mass index (BMI) z-scores, which were used to determine BMI percentile and categories. The county variable was used to assign a RUC code to each individual. Logistic regression was used to examine binary weight classifications by rural status while controlling for age, sex and race/ethnicity. RESULTS: Odds of obesity and of overweight/obesity were higher among rural youth compared to non-rural. Odds of overweight/obesity increased with increasing rurality. Compared to youth who lived in counties with a RUC code of 3, youth who lived in counties with RUC codes of 5, 7, 8 and 9 had greater odds of overweight/obesity. The number of youth classified as 'rural' ranged from 11-48 percent, depending on how 'rural' was defined. Likewise, overweight/obesity prevalence differed by 4.6 percent depending on how 'rural' was defined. CONCLUSIONS: Consistently defining 'rural' and determining degree of rurality is important in understanding how geographic location plays a role in overweight/obesity among youth. Future research should work to assess the physical and social environments of these different types of rural areas to better understand the role that rurality plays in contributing to overweight/obesity among youth. Assessing social determinants of health and its impact on health in rural youth is essential for designing effective public health interventions that can be implemented to address the issue.


Assuntos
Obesidade , Sobrepeso , População Rural , População Urbana , Adolescente , Índice de Massa Corporal , Criança , Humanos , Meio-Oeste dos Estados Unidos/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência
15.
Einstein (Sao Paulo) ; 18: eAO4682, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31664330

RESUMO

OBJECTIVE: To investigate the epidemiological data of hypertension in pregnant women, as well as to identify its possible associated events. METHODS: Data collection was performed at the high-risk prenatal outpatient clinic and in the maternity ward at a public hospital in the São Paulo city, during the morning and afternoon periods, from October 2015 to July 2016. A questionnaire with 22 questions prepared by the researchers was used. The margin of error was 5% and the confidence level was 95%. For the calculation, the two-proportion equality, Pearson correlation and ANOVA tests were used. RESULTS: Among the interviewees, 43% had chronic hypertension, 33.3% presented with up to 20 weeks of gestation, 23.7% presented after the 20th week of gestation, 62.3% were between 18 and 35 years of age, 78.1% had a family history of hypertension, and among those aged 36 to 45 years, 11.4% were in the first gestation, and 26.3% in the second gestation. Considering the associated conditions, diabetes prevailed with 50%; obesity with 22.2%, and the most selected foods for consumption among pregnant women, 47.5% had high energy content (processed/ultraprocessed). CONCLUSION: After an epidemiological analysis of the prevalence of hypertension, pregnant women with chronic hypertension, preexisting hypertension diagnosed during pregnancy, and hypertensive disease of pregnancy were identified. Regarding the possible factors associated with arterial hypertension, higher age, family history of hypertension, preexistence of hypertension, late pregnancies, diabetes, obesity and frequent consumption of processed/ultraprocessed foods were found.


Assuntos
Hipertensão Induzida pela Gravidez/epidemiologia , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Preferências Alimentares , Humanos , Idade Materna , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Gravidez , Gravidez em Diabéticas/epidemiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
16.
Afr Health Sci ; 19(2): 1897-1909, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656473

RESUMO

Background: One of the public health problems in developing countries is child malnutrition. An important factor for children's well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children's health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data. Methods: This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis. Results: The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother's age, mother's Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children's nutritional status in Ethiopia. Conclusion: This child's age of a child, sex, weight of child at birth, mother's BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.


Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Antropometria , Índice de Massa Corporal , Peso Corporal , Criança , Transtornos da Nutrição Infantil/diagnóstico , Pré-Escolar , Etiópia/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Desnutrição/etiologia , Obesidade/epidemiologia , Prevalência , Características de Residência , Fatores Socioeconômicos , Magreza/epidemiologia
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(10): 1296-1303, 2019 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-31658534

RESUMO

Objective: In this study, a systematic review was made on scientific evidence regarding the impact of food environment on diet-related behavior and obesity in China. Methods: Search on related keywords and references were conducted from four electronic databases including the Cochrane Library, PubMed, Web of Science, and CNKI. Results: Data showed that good availability, accessibility of neighborhood food outlets had increased the diversity of food, including the intakes of total calories, protein, fat, and carbohydrate; however, the consumption of healthy foods such as fruit and vegetables was reducing among the Chinese residents. The effects of neighborhood food environment on obesity remained inconclusive. A large number of fast food restaurants around schools might be responsible for the increase of risk on obesity among students. Regulations set on the school vicinity food stalls might reduce the intake of sugary beverages, snacks and fast food among students. Conclusion: Building a healthy food environment is warranted to nudge the Chinese people towards a healthier diet pattern. However, more evidence is needed to support the evidence in building a healthy food environment.


Assuntos
Dieta , Obesidade/epidemiologia , China/epidemiologia , Fast Foods , Humanos , Características de Residência , Restaurantes , Instituições Acadêmicas
18.
Am Surg ; 85(9): 944-948, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638504

RESUMO

The incidence of esophageal cancer in the United States seems to have significantly increased since the 1970s. In undertaking this study, we sought to describe changes in the incidence, histologic type, and presenting stage of esophageal cancer over the past four decades. With Institutional Review Board approval, the Surveillance, Epidemiology, and End Results database of the National Cancer Institute was queried. Regression analysis was used to analyze data, and significance was accepted with 95 per cent probability. Forty-two thousand seven hundred thirty-nine patients had squamous cell carcinoma or adenocarcinoma located in their upper, middle, and/or lower esophagus from 1973 through 2010, reflecting a 7.5-fold annual increase from 1973 through 2010. Squamous cell carcinoma increased annually 2.5-fold (P < 0.001) and esophageal adenocarcinoma increased annually 57-fold from 1973 through 2010 (P < 0.001), whereas the overall population in the United States increased only 43 per cent (215,092,900 to 308,745,538) in the same period. From 1973 through 2010, there was a significant increase in the incidence of esophageal cancer in the United States. This increase was much greater than the increase in the population in the United States. The incidence of adenocarcinoma increased much more than that of squamous cell carcinoma of the esophagus from 1973 through 2010.


Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Esofágicas/epidemiologia , Adenocarcinoma/patologia , Idoso , Carcinoma de Células Escamosas/patologia , Comorbidade , Neoplasias Esofágicas/patologia , Feminino , Refluxo Gastroesofágico/epidemiologia , Humanos , Incidência , Masculino , Estadiamento de Neoplasias , Obesidade/epidemiologia , Fatores de Risco , Programa de SEER , Estados Unidos/epidemiologia
19.
Nutr. hosp ; 36(5): 1049-1054, sept.-oct. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184625

RESUMO

Introduction: anthropometric indicators (AIs) such as waist circumference (WC), body mass index (BMI), waist/hip index (WHpI), waist/height index (WHtI) and body fat percentage (BFP) are useful tools for the diagnosis of nutritional status (NS) in adolescents. Each of these parameters has advantages and disadvantages. The purpose of the present study was to analyze the association of these AIs (WC, BMI, WHpI, WHtI, and BFP) to evaluate nutritional status and estimate the cardiometabolic risk (CMR) in Mexican adolescents. Material and method: in a cross-sectional descriptive study, the NS was analyzed through various AIs and CMR with the WHtI criteria. Nine hundred and seventeen adolescents between 15 and 17 years old participated in the study, of whom 488 (52.9%) were female and 429 (47.1%) male, all students of middle school in Tuxtla Gutiérrez, Chiapas, Mexico. Results and conclusion: women presented a higher prevalence of obesity according to most indicators. The WHtI was the parameter that detected the highest prevalence of obesity (31%), correlating with the BMI and the BFP. Moreover, there was evidence of a significant relation between NS (assessed by all the anthropometric indicators) and CMR. The WHtI could be considered as an adequate tool for the diagnosis of obesity associated with CMR in adolescents


Introducción: los indicadores antropométricos (IA) como la circunferencia de cintura (CC), el índice de masa corporal (IMC), el índice cintura/ cadera (ICC), el índice cintura/talla (ICT) y el porcentaje de grasa corporal (PGC) son herramientas útiles para el diagnóstico del estado nutricional (EN) en los adolescentes. Sin embargo, cada uno de estos IA presentan ventajas y desventajas. El propósito del presente estudio fue analizar la asociación de los IA (IMC, CC, ICC, ICT y PGC) para evaluar el EN y estimar el riesgo cardiometabólico (RCM) en adolescentes mexicanos. Material y método: el diseño del estudio fue descriptivo transversal. Se analizó el EN a través de diversos IA y el RCM bajo los criterios de ICT. Este estudio fue conducido en 917 adolescentes de entre 15 y 17 años, de los cuales 488 (52,9%) eran mujeres y 429 (47,1%) varones, todos estudiantes de nivel medio superior de Tuxtla Gutiérrez, Chiapas, México. Resultados y conclusión: las mujeres presentaron mayor prevalencia de obesidad con la mayoría de los IA utilizados. El ICT fue el IA que detectó mayor prevalencia de obesidad (31%), correlacionándose con el IMC y el PGC. Además, se evidenció una asociación significativa entre el EN valorado por todos los IA y el RCM. El ICT podría ser considerado como una herramienta adecuada para el diagnóstico de obesidad asociada a RCM en adolescentes


Assuntos
Humanos , Masculino , Feminino , Adolescente , Antropometria/métodos , Avaliação Nutricional , Estado Nutricional , Doenças Cardiovasculares/diagnóstico , Obesidade/epidemiologia , Fatores de Risco , Doenças Cardiovasculares/prevenção & controle , Relação Cintura-Quadril/métodos , Peso-Estatura , Estudos Transversais , México/epidemiologia
20.
Nutr. hosp ; 36(5): 1087-1094, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184631

RESUMO

Objetivos: analizar la prevalencia de salud metabólica en pacientes obesos de Mallorca. Métodos: los participantes se clasificaron en obesos sanos metabólicamente (OSM) y obesos no sanos metabólicamente (ONSM) en función de si presentaban o no síndrome metabólico (SMet), definido según los criterios del NCEP ATP III. Se evaluaron hábitos alimentarios, tóxicos y estilo de vida, tiempo de evolución de la obesidad, antecedentes de lactancia materna, obesidad en la infancia y familiares de obesidad y diabetes mellitus, así como glucosa, colesterol total, colesterol-HDL y triglicéridos plasmáticos en 457 pacientes obesos residentes en Mallorca. Resultados: la prevalencia de OSM fue del 49,2% y la de ONSM fue del 50,8%. El fenotipo de OSM disminuyó con la edad. Todos los pacientes presentaron hábitos inadecuados. Ambos grupos presentaron similar consumo de frutas, ensaladas y verduras, hábito tabáquico y práctica de actividad física. El 37,4% de los sujetos consumía bebidas azucaradas y el 52,9% consumía alcohol, más en ONSM (4,3%) que en OSM (0,4%). Los sujetos ONSM presentaron mayores valores de índice de masa corporal (IMC), circunferencia abdominal, porcentaje de grasa e índice de grasa visceral (IGV) y variables metabólicas estudiadas que los OSM. Conclusiones: más de la mitad de la población obesa analizada presentó complicaciones metabólicas, aunque toda la población obesa mostró similares hábitos alimentarios y de estilo de vida inadecuados. El incremento de edad, el bajo nivel educativo, los años de evolución de la obesidad y la localización visceral de la grasa se asocian a un estado metabólico no saludable. Deberían aunarse criterios para definir y tipificar el estado metabólico de los sujetos obesos


Aims: to assess the prevalence of metabolic health in Mallorca obese patients. Methods: participants were classified in metabolically healthy obese (MHO) and metabolically non-healthy obese (MNHO). Food, toxic and lifestyle habits, time of obesity evolution, breastfeeding, obesity in childhood and family history of obesity and diabetes mellitus, as well as glycemia, total cholesterol, HDL-cholesterol and triglyceridemia were evaluated in 457 obese patients. Results: prevalence of MHO was 49.2% and that of MNHO was 50.8%. MHO phenotype decreased with age. All patients showed inadequate habits. Consumption of fruits, salads and vegetables, tobacco and physical activity were similar between both groups; 37.4% of patients consumed sugary sweet drinks, and 52.9% consumed alcohol, higher in MNHO (4.3%) than in MHO (0.4%). MNHO showed higher values of BMI, abdominal circumference, fat percentage and visceral fatty index, as well as all metabolically studied outcomes. Conclusions: more than half of assessed obese population showed metabolic complications, but all obese population showed similar inadequate food and lifestyle habits. Increase of age, low educational level, years of obesity evolution, and visceral localization of fat are associated with a metabolically non-healthy status. Criteria to define and typify the metabolic state of obese subjects should be unified


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/complicações , Espanha/epidemiologia , Obesidade/classificação , Comportamento Alimentar , Atividade Motora , Índice de Massa Corporal , Estilo de Vida , Inquéritos Nutricionais , Antropometria , Estudos Transversais
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