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1.
Cell Metab ; 33(2): 234-241, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33465335

RESUMO

Long-standing systemic inequalities-fueling unequal access to critical resources such as healthcare, housing, education, and employment opportunities-are largely responsible for the significant race disparities in obesity and COVID-19. Because of this legacy, public health emergencies like the COVID-19 pandemic disproportionately impact communities of color, exacerbated by high rates of pre-existing chronic diseases like obesity. Learning from this history is instructive for understanding our present situation and for crafting effective solutions that promote health equity. Critical action is needed now to meaningfully address the disproportionate impact of these major public health problems on Black and Brown populations.


Assuntos
/patologia , Política de Saúde , Obesidade/patologia , Afro-Americanos , /etnologia , Equidade em Saúde , Disparidades nos Níveis de Saúde , Humanos , Obesidade/complicações , Obesidade/etnologia , Política , /isolamento & purificação
2.
JAMA ; 324(14): 1429-1438, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33048153

RESUMO

Importance: The prevalence of leading risk factors for morbidity and mortality in the US significantly varies across regions, states, and neighborhoods, but the extent these differences are associated with a person's place of residence vs the characteristics of the people who live in different places remains unclear. Objective: To estimate the degree to which geographic differences in leading risk factors are associated with a person's place of residence by comparing trends in health outcomes among individuals who moved to different areas or did not move. Design, Setting, and Participants: This retrospective cohort study estimated the association between the differences in the prevalence of uncontrolled chronic conditions across movers' destination and origin zip codes and changes in individuals' likelihood of uncontrolled chronic conditions after moving, adjusting for person-specific fixed effects, the duration of time since the move, and secular trends among movers and those who did not move. Electronic health records from the Veterans Health Administration were analyzed. The primary analysis included 5 342 207 individuals with at least 1 Veterans Health Administration outpatient encounter between 2008 and 2018 who moved zip codes exactly once or never moved. Exposures: The difference in the prevalence of uncontrolled chronic conditions between a person's origin zip code and destination zip code (excluding the individual mover's outcomes). Main Outcomes and Measures: Prevalence of uncontrolled blood pressure (systolic blood pressure level >140 mm Hg or diastolic blood pressure level >90 mm Hg), uncontrolled diabetes (hemoglobin A1c level >8%), obesity (body mass index >30), and depressive symptoms (2-item Patient Health Questionnaire score ≥2) per quarter-year during the 3 years before and the 3 years after individuals moved. Results: The study population included 5 342 207 individuals (mean age, 57.6 [SD, 17.4] years, 93.9% men, 72.5% White individuals, and 12.7% Black individuals), of whom 1 095 608 moved exactly once and 4 246 599 never moved during the study period. Among the movers, the change after moving in the prevalence of uncontrolled blood pressure was 27.5% (95% CI, 23.8%-31.3%) of the between-area difference in the prevalence of uncontrolled blood pressure. Similarly, the change after moving in the prevalence of uncontrolled diabetes was 5.0% (95% CI, 2.7%-7.2%) of the between-area difference in the prevalence of uncontrolled diabetes; the change after moving in the prevalence of obesity was 3.1% (95% CI, 2.0%-4.2%) of the between-area difference in the prevalence of obesity; and the change after moving in the prevalence of depressive symptoms was 15.2% (95% CI, 13.1%-17.2%) of the between-area difference in the prevalence of depressive symptoms. Conclusions and Relevance: In this retrospective cohort study of individuals receiving care at Veterans Health Administration facilities, geographic differences in prevalence were associated with a substantial percentage of the change in individuals' likelihood of poor blood pressure control or depressive symptoms, and a smaller percentage of the change in individuals' likelihood of poor diabetes control and obesity. Further research is needed to understand the source of these associations with a person's place of residence.


Assuntos
Transtorno Depressivo/epidemiologia , Diabetes Mellitus/epidemiologia , Migração Humana/estatística & dados numéricos , Hipertensão/epidemiologia , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Doença Crônica/epidemiologia , Doença Crônica/etnologia , Transtorno Depressivo/etnologia , Diabetes Mellitus/etnologia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Geografia Médica , Migração Humana/tendências , Humanos , Hipertensão/etnologia , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Incerteza , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Serviços de Saúde para Veteranos Militares/estatística & dados numéricos
3.
N Engl J Med ; 383(10): 909-918, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32877581

RESUMO

BACKGROUND: Evidence of the effectiveness of treatment for obesity delivered in primary care settings in underserved populations is lacking. METHODS: We conducted a cluster-randomized trial to test the effectiveness of a high-intensity, lifestyle-based program for obesity treatment delivered in primary care clinics in which a high percentage of the patients were from low-income populations. We randomly assigned 18 clinics to provide patients with either an intensive lifestyle intervention, which focused on reduced caloric intake and increased physical activity, or usual care. Patients in the intensive-lifestyle group participated in a high-intensity program delivered by health coaches embedded in the clinics. The program consisted of weekly sessions for the first 6 months, followed by monthly sessions for the remaining 18 months. Patients in the usual-care group received standard care from their primary care team. The primary outcome was the percent change from baseline in body weight at 24 months. RESULTS: All 18 clinics (9 assigned to the intensive program and 9 assigned to usual care) completed 24 months of participation; a median of 40.5 patients were enrolled at each clinic. A total of 803 adults with obesity were enrolled: 452 were assigned to the intensive-lifestyle group, and 351 were assigned to the usual-care group; 67.2% of the patients were Black, and 65.5% had an annual household income of less than $40,000. Of the enrolled patients, 83.4% completed the 24-month trial. The percent weight loss at 24 months was significantly greater in the intensive-lifestyle group (change in body weight, -4.99%; 95% confidence interval [CI], -6.02 to -3.96) than in the usual-care group (-0.48%; 95% CI, -1.57 to 0.61), with a mean between-group difference of -4.51 percentage points (95% CI, -5.93 to -3.10) (P<0.001). There were no significant between-group differences in serious adverse events. CONCLUSIONS: A high-intensity, lifestyle-based treatment program for obesity delivered in an underserved primary care population resulted in clinically significant weight loss at 24 months. (Funded by the Patient-Centered Outcomes Research Institute and others; PROPEL ClinicalTrials.gov number, NCT02561221.).


Assuntos
Disparidades em Assistência à Saúde , Estilo de Vida Saudável , Obesidade/terapia , Populações Vulneráveis , Perda de Peso , Adulto , Idoso , Dieta Redutora , Exercício Físico , Feminino , Letramento em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/etnologia , Obesidade/fisiopatologia , Educação de Pacientes como Assunto , Atenção Primária à Saúde , Fatores Socioeconômicos , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-32858944

RESUMO

The primary purpose of this study was to describe obesity, body composition, convenience food consumption, physical activity, and muscle strength among Asian American youth compared to other racial/ethnic groups. The secondary purpose was to examine whether obesity, body composition, convenience food consumption, physical activity, and muscle strength differed by acculturation levels among Asian American youth. A secondary analysis was conducted using data from 12,763 children aged 2 to 17 years that participated in the 2011-2018 US National Health and Nutrition Examination Survey (NHANES). In the NHANES interview, acculturation, dietary behavior, and physical activity questionnaires were administered. The acculturation level was indicated by the language spoken at home. In the NHANES examination, anthropometry, dual-energy X-ray absorptiometry (DXA), and muscle strength assessments were conducted. Compared to non-Hispanic White American boys, Asian American boys had similar levels of obesity, central obesity, and fat mass. Among the five racial/ethnic groups examined, lean body mass, muscle mass, convenience food consumption, and daily physical activity were the lowest in the Asian group. More acculturated Asian American boys, but not girls, were more likely to be obese (OR = 3.28 (1.63, 6.60)). More acculturated Asian American youth more frequently consumed convenience food (1.4 more meals/month (1.2, 1.6)). This study highlights the obesity problem among Asian American boys, which worsens with acculturation to America. The study results also suggest that although Asian American youth consume less convenience food overall than non-Hispanic White American youth, increasing acculturation may negatively influence food choices.


Assuntos
Aculturação , Americanos Asiáticos/estatística & dados numéricos , Composição Corporal/fisiologia , Exercício Físico , Fast Foods/estatística & dados numéricos , Comportamento Alimentar/etnologia , Obesidade/prevenção & controle , Adolescente , Americanos Asiáticos/psicologia , Criança , Pré-Escolar , Fast Foods/efeitos adversos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Inquéritos Nutricionais , Obesidade/etnologia , Fatores Socioeconômicos , Estados Unidos/epidemiologia
6.
BMC Public Health ; 20(1): 1229, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787811

RESUMO

BACKGROUND: Associations between high BMI and sleep duration and chronic illness are recognised. Short sleep is an accepted predictor of high BMI for children, including Indigenous Australian children. Short sleep has also been associated with high BMI in Australian adults, although not specifically in Indigenous Australian adults. This study aims to determine whether the relationship between sleep duration and BMI observed in non-Indigenous adults holds for Indigenous adults. METHODS: Data collected from 5204 non-Indigenous and 646 Indigenous participants aged over 18 years in a nationally representative Australian Health Survey 2011-2013 were analysed. Sleep duration was self-reported as the time between going to bed and time waking up; BMI was derived from measurement and categorised into normal weight (BMI = 18.5-24.9) and overweight/obese (BMI ≥ 25). Logistic regression was performed for the non-Indigenous and Indigenous groups separately to examine the association between sleep duration and BMI in each group. RESULTS: Proportionally more Indigenous people were classified as overweight/obese than non-Indigenous (χ2 = 21.81, p < 0.001). Short sleep was reported by similar proportions in both groups (Indigenous 15% vs non-Indigenous 17%) whereas long sleep of > 9 h was reported by proportionally more Indigenous than non-Indigenous people (41% vs 26%). Without accounting for possible confounders, the association between sleep duration and BMI for the Indigenous group was not significant but a possible dose-response relationship was evident, with the odds of overweight/obesity being greatest for those who typically slept < 7 h (OR = 1.77, 95% CI 0.38-3.94) and < 6 h (OR = 1.55, 95%CI = 0.58-4.14). The same model for the non-Indigenous group was significant, with the odds of overweight/obesity being greatest for those who typically slept < 6 h (OR = 1.67, 95%CI 1.25-2.25). The risk of overweight/obesity diminished for both groups with sleep > 7 h. Accounting for a range of socioeconomic and personal confounders attenuated the strength of these relationships marginally. CONCLUSION: Adding to reports relating sleep duration and BMI for Australian adults, this study provides evidence for an inverse relationship in non-Indigenous adults and suggests a similar trend for Indigenous adults. This trend was non-significant but is consistent with previous results for Indigenous children.


Assuntos
Povos Indígenas/estatística & dados numéricos , Obesidade/etnologia , Sobrepeso/etnologia , Sono , Adulto , Austrália/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores de Tempo
7.
BMC Public Health ; 20(1): 1068, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631296

RESUMO

BACKGROUND: Cardiovascular disease (CVD) prevalence has increased continuously over the last 30 years in China. Dyslipidemia is an important modifiable risk factor in CVD. We aimed to collect current data on the prevalence of dyslipidemia in northern China and explore potential influencing factors. METHODS: In this cross-sectional study, we selected a representative sample of 65,128 participants aged ≥35 years in Inner Mongolia during 2015-2017. All participants completed a questionnaire and were examined for risk factors. Dyslipidemia was defined according to 2016 Chinese guidelines for adults. The associated factors for dyslipidemia were estimated by multivariate logistic regression analysis. RESULTS: The age-standardized prevalence of dyslipidemia was 31.2% overall, with 4.3, 2.4, 14.7, and 17.4% for high total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and low high-density lipoprotein cholesterol (HDL-C), respectively. The dyslipidemia prevalence was significantly higher in men than women (37.9% vs. 27.5%, P < 0.001), but postmenopausal women had a higher prevalence of dyslipidemia components (except low HDL-C). Compared with Han participants, Mongol participants had a lower prevalence of dyslipidemia (29.1% vs. 31.4%, P < 0.001). Male sex, living in urban areas, Han ethnicity, smoking, obesity, central obesity, hypertension, and diabetes were all positively correlated with dyslipidemia; alcohol consumption was linked to lower risk of dyslipidemia. CONCLUSIONS: Our study revealed that dyslipidemia is a health problem in northern China. Greater efforts to prevent and manage dyslipidemia, especially in men under age 55 years, postmenopausal women, and people with unhealthy lifestyles or chronic diseases.


Assuntos
Fatores Etários , Dislipidemias/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Fatores Sexuais , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/etnologia , China/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Dislipidemias/etnologia , Dislipidemias/etiologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/etnologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/etnologia , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fumar/etnologia
8.
Matern Child Health J ; 24(9): 1130-1137, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32632842

RESUMO

OBJECTIVES: Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children. METHODS: Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced. RESULTS: Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced. CONCLUSIONS: Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.


Assuntos
Peso Corporal/etnologia , Grupos Étnicos/estatística & dados numéricos , Obesidade/etnologia , Ganho de Peso/etnologia , Adulto , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Índice de Massa Corporal , Criança , Cuidado da Criança , Pré-Escolar , Estudos Transversais , Feminino , Haiti/etnologia , Humanos , Masculino , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Índias Ocidentais/etnologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-32604719

RESUMO

The prevalence of obesity has been persistent amongst Hispanics over the last 20 years. Socioeconomic inequities have led to delayed diagnosis and treatment of chronic medical conditions related to obesity. Factors contributing include lack of insurance and insufficient health education. It is well-documented that obesity amongst Hispanics is higher in comparison to non-Hispanics, but it is not well-understood how the socioeconomic context along with Hispanic ethnic concentration impact the prevalence of obesity within a community. Specifically studying obesity within Hispanic dominant regions of the United States, along the Texas-Mexico border will aid in understanding this relationship. El Paso, Texas is predominantly Mexican-origin Hispanic, making up 83% of the county's total population. Through the use of electronic medical records, BMI averages along with obesity prevalence were analyzed for 161 census tracts in the El Paso County. Geographic weighted regression and Hot Spot technology were used to analyze the data. This study did identify a positive association between Hispanic ethnic concentration and obesity prevalence within the El Paso County. Median income did have a direct effect on obesity prevalence while evidence demonstrates that higher education is protective for health.


Assuntos
Registros Eletrônicos de Saúde , Hispano-Americanos , Obesidade , Humanos , México/etnologia , Obesidade/etnologia , Texas/epidemiologia , Estados Unidos
10.
Nutr Metab Cardiovasc Dis ; 30(10): 1785-1794, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32605881

RESUMO

BACKGROUND AND AIMS: Metabolic syndrome (MetS) increases the risk of cardiovascular disease and type 2 diabetes. Despite a higher prevalence of MetS in African American (AA) women, little is known about the effectiveness of lifestyle interventions in improving metabolic markers in this high-risk group. This study investigated the effectiveness of a community-based lifestyle intervention delivered by lay health coaches in reducing MetS among AA women. METHODS AND RESULTS: A cluster-randomized diabetes prevention program (DPP) was implemented in 11 churches utilizing a community-based participatory research (CBPR) approach to develop and deliver the interventions. A total of 221 adults, AA women who were overweight or obese, and did not have diabetes were included in this study. The prevalence of MetS was 42.08% before receiving the DPP intervention and 31.22% after the intervention that represented a 10.86% absolute reduction and a 25.81% relative reduction from baseline. The adjusted odds ratio (OR) of being free from MetS at post-intervention in contrast to baseline was 2.14 (p = 0.02). Factors that increased the odds of being free from MetS were younger age, reduction in intake of total calories, total fat, saturated and trans-fat, and dietary sodium. CONCLUSION: A faith adapted lifestyle intervention held in church settings and delivered by minimally trained lay health coaches reduced the prevalence of MetS in AA women who were overweight or obese. Findings from this study can be used to translate evidence into public health programs at the community level for the prevention of type 2 diabetes and cardiovascular disease. CLINICAL TRIAL REGISTRATION NUMBER: NCT04082702 (www.clinicaltrials.gov).


Assuntos
Afro-Americanos , Serviços de Saúde Comunitária , Diabetes Mellitus Tipo 2/prevenção & controle , Organizações Religiosas , Estilo de Vida Saudável , Síndrome Metabólica/prevenção & controle , Obesidade/terapia , Comportamento de Redução do Risco , Adulto , Cristianismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/etnologia , Feminino , Humanos , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/etnologia , Prevalência , Fatores de Risco , Fatores Sexuais , Texas/epidemiologia , Resultado do Tratamento
11.
Artigo em Inglês | MEDLINE | ID: mdl-32708480

RESUMO

As postpartum obesity is becoming a global public health challenge, there is a need to apply postpartum obesity modeling to determine the indicators of postpartum obesity using an appropriate statistical technique. This research comprised two phases, namely: (i) development of a previously created postpartum obesity modeling; (ii) construction of a statistical comparison model and introduction of a better estimator for the research framework. The research model displayed the associations and interactions between the variables that were analyzed using the Structural Equation Modeling (SEM) method to determine the body mass index (BMI) levels related to postpartum obesity. The most significant correlations obtained were between BMI and other substantial variables in the SEM analysis. The research framework included two categories of data related to postpartum women: living in urban and rural areas in Iran. The SEM output with the Bayesian estimator was 81.1%, with variations in the postpartum women's BMI, which is related to their demographics, lifestyle, food intake, and mental health. Meanwhile, the variation based on SEM with partial least squares estimator was equal to 70.2%, and SEM with a maximum likelihood estimator was equal to 76.8%. On the other hand, the output of the root mean square error (RMSE), mean absolute error (MSE) and mean absolute percentage error (MPE) for the Bayesian estimator is lower than the maximum likelihood and partial least square estimators. Thus, the predicted values of the SEM with Bayesian estimator are closer to the observed value compared to maximum likelihood and partial least square. In conclusion, the higher values of R-square and lower values of MPE, RMSE, and MSE will produce better goodness of fit for SEM with Bayesian estimators.


Assuntos
Ingestão de Alimentos , Estilo de Vida , Saúde Mental , Obesidade/etnologia , Adulto , Teorema de Bayes , Índice de Massa Corporal , Demografia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Período Pós-Parto , Reprodutibilidade dos Testes , Adulto Jovem
13.
Medicine (Baltimore) ; 99(27): e21016, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629722

RESUMO

We evaluated the statewide burden of obesity and its complications among government and state funded programs (Medicare and Medicaid) and commercial insurance.We calculated the prevalence of obesity and the prevalence of relevant comorbidities among different demographic groups and based on health insurance, among adults (18-65 years old) who visited a statewide health network in the state of Rhode Island, in 2017.The overall prevalence of obesity among 74,089 individuals was 38.88% [Asians 16.77%, Whites 37.49%, Hispanics 44.23%, and Blacks 48.44%]. Medicare or Medicaid beneficiaries were 26% and 27%, respectively, more likely to have obesity than those who had commercial insurance (Odds Ratio:1.26, 95% confidence interval [CI]:1.20-1.32; Odds Ratio:1.27, 95%CI:1.22-1.32). Moreover, Medicaid and Medicare beneficiaries with obesity had a higher prevalence of diabetes compared with privately insured with obesity (10.58% and 10.44% vs 4.45%). Medicare beneficiaries with obesity had a statistically higher prevalence of ischemic heart disease (4.34%, 95%CI: 3.77-4.91) than privately insured (3.21%, 95%CI: 2.94-3.47).Based on statewide data among 18 to 65 years old adults, Medicare and Medicaid provide health coverage to 40% of individuals with obesity and 46% of those with the obesity-related comorbidities and complications. State and federal health care programs need to support and expand obesity-related services and coverage.


Assuntos
Demografia/tendências , Cobertura do Seguro/economia , Obesidade/economia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Comorbidade , Efeitos Psicossociais da Doença , Estudos Transversais , Demografia/estatística & dados numéricos , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Medicaid/economia , Medicare/economia , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/etnologia , Prevalência , Rhode Island/epidemiologia , Estados Unidos , Adulto Jovem
14.
Surg Obes Relat Dis ; 16(8): 1096-1099, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32522406

RESUMO

BACKGROUND: On March 13, 2020, the World Health Organization declared COVID-19 a pandemic. Shortly after that, it was reported that mortality rates in New York City (NYC), the epicenter of the pandemic in the United States, were found to be significantly higher in black and Hispanic populations. OBJECTIVES: The aim of this article is to evaluate the mortality rates in NYC among the different ethnic groups and the different boroughs as they relate to the obesity rates to see whether this issue merits further evaluation. SETTING: NYC. METHODS: COVID-19 data were obtained from the official New York authorities in relation to total number of cases in the different boroughs of NYC. Age-adjusted COVID-19-related mortality rates of the different ethnic groups were also obtained. These data were cross-compared with historic community health data on obesity rates previously published and also obesity rates among the different ethnic groups in NYC. RESULTS: The 2 NYC boroughs that have the highest mortality rates are the Bronx (6%) and Brooklyn (5.4%). Both the Bronx and Brooklyn were also found to have the highest obesity rates at 32% and 27%, respectively. The 2 ethnic groups with the highest obesity rates (Hispanic and black) were also found to have the highest age-adjusted mortality rates per 100,000 compared with the other ethnic groups (22.8% and 19.8%, respectively). CONCLUSIONS: The Hispanic and black populations in NYC seem to be disproportionately affected by the COVID-19 pandemic because of the higher incidence of mortality rates. Obesity may have played a role in the high incidence of mortality in those ethnic groups.


Assuntos
Afro-Americanos/estatística & dados numéricos , Betacoronavirus , Infecções por Coronavirus/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Obesidade/etnologia , Pneumonia Viral/etnologia , Adulto , Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Obesidade/complicações , Obesidade/mortalidade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Taxa de Sobrevida
15.
BMC Public Health ; 20(1): 864, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503538

RESUMO

BACKGROUND: The prevalence of overweight and obesity among women of childbearing age is considered a public health concern. Few studies have been conducted in the Gaza Strip to determine the magnitude of overweight and obesity. This study aimed to determine the prevalence of overweight and obesity along with their associated factors among women in the Gaza Strip. METHODS: A cross-sectional study was conducted to recruit a total of 357 mothers aged 18-50 years. Interviews were carried out among mothers to collect sociodemographic information, nutritional information, and physical activity. Anthropometric measurements [height, weight and waist circumference (WC)] were conducted with the mothers. Body Mass Index (BMI) was computed to determine the prevalence of overweight and obesity. Multinomial logistic regression was used to examine the associated factors of overweight and obesity. RESULTS: The combined prevalence of overweight and obesity among mothers was (64.1%). The results of multinomial logistic regression showed the risk of overweight and obesity increased with age, the highest risk being in mothers aged > 33.0 years (OR = 2.7, 95% CI: (1.06,6.86)), and (OR = 5.72, 95% CI: (2.07,15.78)), respectively, compared to mothers aged < 33.0 years. Moreover, mothers with medium and high educational levels had a slightly higher risk of obesity (OR = 0.31, 95% CI: (0.15,0.64)), and (OR = 0.32, 95% CI: (0.12,0.82)) respectively than mothers with low educational level. Household income was positively associated with overweight and obesity. Mothers exposed to higher monthly income were more likely to be overweight or obese (OR = 2.64, 95% CI: (1.20, 5.83)), and (OR = 3.06, 95% CI: (1.28,7.29)), respectively. Nutrition knowledge was significantly associated with a high prevalence of obesity (OR = 1.20, 95% CI: (1.03,1.38)). CONCLUSIONS: This study showed a higher prevalence of overweight and obesity among Palestinian women than previous studies. Age, educational level, monthly income, and nutrition knowledge were associated with the prevalence of overweight and obesity, compared to other variables that were not associated with overweight and obesity such as location, work status, physical activity, and sitting hours. Urgent action is needed to tackle overweight and obesity among women. Effective intervention is required to increase nutrition knowledge among women to improve their eating behaviors.


Assuntos
Árabes/estatística & dados numéricos , Mães/estatística & dados numéricos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Exercício Físico , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Obesidade/etnologia , Obesidade/etiologia , Sobrepeso/etnologia , Sobrepeso/etiologia , Prevalência , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
16.
N Z Med J ; 133(1516): 22-32, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32525859

RESUMO

AIM: We aimed to investigate the correlation between epicardial adipose tissue (EAT) and body mass index (BMI) in different ethnic groups in New Zealand. METHODS: The study included 205 individuals undergoing open heart surgery. Maori and Pacific groups were combined to increase statistical power. EAT was measured using 2D echocardiography. RESULTS: There were 164 New Zealand Europeans (NZE) and 41 Maori/Pacific participants. The mean (SD) age of the study group was 67.9 (10.1) years, 69.1 (9.5) for NZE and 63.5 (11.4) for Maori/Pacific. BMI was 29.6 (5.5) kg/m2 for NZE and 31.8 (6.2) for Maori/Pacific. EAT thickness was 6.2 (2.2) mm and 6.0 (1.8) mm for NZE and Maori/Pacific, respectively. Using univariate linear regression, BMI showed moderate correlation with EAT in NZE (R2=0.26, p<0.001); however, there was no significant correlation between BMI and EAT in Maori/Pacific patients (R2=0.05, p=0.17). Using multivariate analysis, BMI remained a significant predictor of EAT thickness in NZE (R2 =0.27, p<0.001). CONCLUSIONS: BMI was associated with EAT thickness in NZE patients, but not in Maori/Pacific patients. The same level of BMI can carry different connotations of risk in different ethnic groups, with BMI likely being an inconsistent measure of obesity in in Maori/Pacific patients.


Assuntos
Tecido Adiposo , Índice de Massa Corporal , Obesidade/etnologia , Pericárdio , Tecido Adiposo/diagnóstico por imagem , Idoso , Ecocardiografia , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Grupo com Ancestrais Oceânicos , Pericárdio/diagnóstico por imagem
17.
South Med J ; 113(6): 311-319, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32483642

RESUMO

OBJECTIVES: Prevalence and trends in all cardiovascular disease (CVD) risk factors among young adults (18-39 years) have not been evaluated on a large scale stratified by sex and race. The aim of this study was to establish the prevalence and temporal trend of CVD risk factors in US inpatients younger than 40 years of age from 2007 through 2014 with racial and sex-based distinctions. In addition, the impact of these risk factors on inpatient outcomes and healthcare resource utilization was explored. METHODS: A cross-sectional nationwide analysis of all hospitalizations, comorbidities, and complications among young adults from 2007 to 2014 was performed. The primary outcomes were frequency, trends, and race- and sex-based differences in coexisting CVD risk factors. Coprimary outcomes were trends in all-cause mortality, acute myocardial infarction, arrhythmia, stroke, and venous thromboembolism in young adults with CVD risk factors. Secondary outcomes were demographics and resource utilization in young adults with versus without CVD risk factors. RESULTS: Of 63 million hospitalizations (mean 30.5 [standard deviation 5.9] years), 27% had at least one coexisting CVD risk factor. From 2007 to 2014, admission frequency with CVD risk factors increased from 42.8% to 55.1% in males and from 16.2% to 24.6% in females. Admissions with CVD risk were higher in male (41.4% vs 15.9%) and white (58.4% vs 53.8%) or African American (22.6% vs 15.9%) patients compared with those without CVD risk. Young adults in the Midwest (23.9% vs 21.1%) and South (40.8% vs 37.9%) documented comparatively higher hospitalizations rates with CVD risk. Young adults with CVD risk had higher all-cause in-hospital mortality (0.4% vs. 0.3%) with a higher average length of stay (4.3 vs 3.2 days) and charges per admission ($30,074 vs $20,124). CONCLUSIONS: Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists.


Assuntos
Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , Doenças Vasculares Periféricas/epidemiologia , Fumar/epidemiologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/etnologia , Americanos Asiáticos/estatística & dados numéricos , Bases de Dados Factuais , Diabetes Mellitus/etnologia , Dislipidemias/etnologia , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Mortalidade Hospitalar , Hospitalização , Humanos , Hipertensão/etnologia , Índios Norte-Americanos/estatística & dados numéricos , Masculino , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etnologia , Obesidade/etnologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Doenças Vasculares Periféricas/etnologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar/etnologia , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etnologia , Estados Unidos/epidemiologia , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etnologia , Adulto Jovem
18.
Vasc Med ; 25(4): 309-318, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32484395

RESUMO

Arterial stiffness (AS) and obesity are recognized as important risk factors of cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between AS and obesity. AS was defined as high augmentation index (AIx) and low elasticity (C1, large artery elasticity; C2, small artery elasticity) in participants enrolled in the Multi-Ethnic Study of Atherosclerosis at baseline. We compared AIx, C1, and C2 by body mass index (BMI) (< 25, 25-29.9, 30-39.9, ⩾ 40 kg/m2) and waist-hip ratio (WHR) (< 0.85, 0.85-0.99, ⩾ 1). The obesity-AS association was tested across 10-year age intervals. Among 6177 participants (62 ± 10 years old, 52% female), a significant inverse relationship was observed between obesity and AS. After adjustments for CVD risk factors, participants with a BMI > 40 kg/m2 had 5.4% lower AIx (mean difference [Δ] = -0.82%; 95% CI: -1.10, -0.53), 15.4% higher C1 (Δ = 1.66 mL/mmHg ×10; 95% CI: 1.00, 2.33), and 40.2% higher C2 (Δ = 1.49 mL/mmHg ×100; 95% CI: 1.15, 1.83) compared to those with a BMI < 25 kg/m2 (all p for trend < 0.001). Participants with a WHR ⩾ 1 had 5.6% higher C1 (∆ = 0.92 mL/mmHg ×10; 95% CI: 0.47, 1.37) compared to those with a WHR < 0.85. The WHR had a significant interaction with age on AIx and C2, but not with BMI; the inverse relationships of the WHR with AIx and C2 were observed only in participants < 55 years between the normal (WHR < 0.85) and the overweight (0.85 ⩽ WHR < 0.99) groups. Different associations of WHR and BMI with arterial stiffness among older adults should be further investigated.


Assuntos
Adiposidade , Doenças Cardiovasculares/fisiopatologia , Obesidade/fisiopatologia , Rigidez Vascular , Adiposidade/etnologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/etnologia , Prognóstico , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia , Relação Cintura-Quadril
19.
Artigo em Inglês | MEDLINE | ID: mdl-32560329

RESUMO

Weight stigma and binge eating have been found to be associated in Western populations; however, this relationship is understudied among Asian Americans. The aims of the study were to (1) investigate the prevalence of binge eating and its relationship with experienced weight stigma in higher-weight Asian Americans, and (2) examine whether the level of acculturation moderates this relationship. Data were collected from a cross-sectional study with 166 higher-weight Asian American adults living in North Carolina, United States. Demographic data, the frequency of experiencing weight stigma, the severity of binge eating, the levels of acculturation, the perceived racism against Asians, and perceived stress were assessed via self-reported questionnaires. The results indicated that experienced weight stigma was a significant independent predictor over and above the effects of other stressors, such as racism and general stress. The level of acculturation did not influence the relationship between the experienced weight stigma and binge eating after adjusting for relevant covariates. Our findings contribute to the limited literature examining weight stigma and binge eating among Asian American populations, highlighting that higher levels of experienced weight stigma are associated with a greater degree of binge eating.


Assuntos
Americanos Asiáticos , Transtorno da Compulsão Alimentar , Obesidade , Sobrepeso , Estereotipagem , Adulto , Americanos Asiáticos/psicologia , Transtorno da Compulsão Alimentar/etnologia , Peso Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Obesidade/etnologia , Sobrepeso/etnologia , Inquéritos e Questionários
20.
Orv Hetil ; 161(27): 1137-1145, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32564005

RESUMO

INTRODUCTION: Population-specific obesity in different age groups and in the Roma population as well as the presence of noncommunicable diseases that are linked to obesity necessitate the development of ethnical-specific prevention and intervention programmes. AIM: Our goal is to model the effects on nutritional status of interventional programmes of different intensities carried out in various age groups of the Roma population. METHOD: We defined the effect of different public health interventions on the state of health of the Roma population by use of the Dynamic Modeling for Health Impact Assessment software. Two models of interventions were studied throughout our research: one that focuses on only one aspect of lifestyle changes; and one that includes radical prevention programmes that aim to change lifestyles as a whole and have an impact on nutritional status. RESULTS: Nearly 20% of Roma men and women are obese, and by 2070, one third of the Roma population will be overweight or obese without any public health intervention. Not even when the most efficient proceedings of the scientific literature are applied do prevention-intervention programmes of moderate-intensity offer a perceptible result about the incidence and prevalence of diseases linked to obesity. In the case of application of these programs, not more than a ten-person order of magnitude decrease can be achieved. This is not enough to prove a statistical detectability on the population level. Whereas, complex intervention programmes, based on a comprehensive transformation of lifestyle and food consumption patterns can present perceptible outcome primarily among the middle-aged and the elderly. CONCLUSION: The survey results direct attention to the fact that reducing the burden of disease in the Roma population caused by obesity is only to be achieved as a complex, all-councils act that requires resources much greater than what is available now. Orv Hetil. 2020; 161(27): 1137-1145.


Assuntos
Avaliação do Impacto na Saúde/métodos , Obesidade/etnologia , Qualidade de Vida , Roma/estatística & dados numéricos , Idoso , Efeitos Psicossociais da Doença , Feminino , Humanos , Hungria/epidemiologia , Estilo de Vida/etnologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Sobrepeso/etnologia
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