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1.
BMJ ; 367: l5584, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619383

RESUMO

OBJECTIVE: To investigate the association between weight changes across adulthood and mortality. DESIGN: Prospective cohort study. SETTING: US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014. PARTICIPANTS: 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline). MAIN OUTCOME MEASURES: All cause and cause specific mortality from baseline until 31 December 2015. RESULTS: During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality. CONCLUSIONS: Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.


Assuntos
Doenças Cardiovasculares , Causas de Morte , Mortalidade Prematura/tendências , Mortalidade/tendências , Neoplasias , Ganho de Peso , Perda de Peso , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Neoplasias/mortalidade , Inquéritos Nutricionais , Obesidade/diagnóstico , Obesidade/mortalidade , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Razão Cintura-Estatura
2.
Rev Saude Publica ; 53: 66, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553376

RESUMO

OBJECTIVE: To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS: A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS: The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS: The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.


Assuntos
Sobrepeso/complicações , Medição de Risco/métodos , Razão Cintura-Estatura , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/fisiopatologia , Distribuição de Poisson , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
3.
BMC Public Health ; 19(1): 1035, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375086

RESUMO

BACKGROUND: To determine the optimal cut-off values and evaluate the associations of body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR) with cardiovascular disease (CVD) risk factors. METHODS: A large-scale cross-sectional survey was conducted among 35,256 adults aged 20-74 years in Shanghai between June 2016 and December 2017. Receiver operating characteristic (ROC) analyses were conducted to assess the optimal cut-off anthropometric indices of CVD risk factors including hypertension, diabetes, dyslipidemia and hyperuricemia. Multivariate Logistic regression models were preformed to evaluate the odds ratio of CVD risk factors. RESULTS: The area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of hypertension and diabetes, and AUCs were higher in women than men. The optimal cut-off values of WHtR were approximately 0.51 in both sexes, while the cut-off values of BMI and WC were higher for men compared with women. The optimal cutoff values of BMI and WC varied greatly across different age groups, but the difference in WHtR was relatively slight. Among women, the optimal threshold of anthropometric indices appeared to increase with age for hypertension and diabetes. The odds ratio between anthropometric indices and CVD risk factors were attenuated with age. WHtR had the greatest odds ratio for CVD risk factors among adults under 60 years old except for women with hypertension, while among 60-74 years, BMI yielded the greatest odds ratio in terms of all CVD outcomes except for women with diabetes. CONCLUSIONS: WHtR had the best performance for discriminating hypertension and diabetes and potentially be served as a standard screening tool in public health. The associations between three anthropometric indices and CVD risk factors differed by sex and decreased with age. These findings indicated a need to develop age- and gender-specific difference and make effective strategies for primary prevention of CVDs.


Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Obesidade/diagnóstico , Circunferência da Cintura , Razão Cintura-Estatura , Adulto , Idoso , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores de Risco , Adulto Jovem
4.
BMC Public Health ; 19(1): 700, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170949

RESUMO

BACKGROUND: Little is known about the long-term shifts in distributions of three abdominal-obesity-related indicators, waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) among Chinese adults. Traditional mean regression models used in the previous analyses were limited in their ability to capture cross-distribution among effects. The current study aims to describe the shift in distribution of WC, WHpR, and WHtR over a period of 18 years (1993-2011) in China, and to reveal quantile-specific associations of the three indicators with key covariates. METHODS: Longitudinal data from seven waves of the China Health and Nutrition Surveys (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009 and 2011 were analyzed. The LMS method was used to illustrate the gender-specific quantile curves of WC, WHtR and WHpR over age. Separate gender-stratified longitudinal quantile regressions were employed to investigate the effect of important factors on the trends of the three indicators. RESULTS: A total of 11,923 participants aged 18-65 years with 49,507 observations were included in the analysis. The density curves of WC, WHtR and WHpR shifted to right and became wider. The three outcomes all increased with age and increased more at upper percentiles. From the multivariate quantile regression, physical activity was negatively associated in both genders; smoking only had a negative effect on male indicators. Education and drinking behavior both had opposite effects on the three indicators between men and women. Marital status and income were positively associated with the shifts in WC, WHtR and WHpR in male and female WC, while urbanicity index had a positive effect on three outcomes in men but inconsistent effect among female outcomes. CONCLUSIONS: The abdominal-obesity related indicators of the Chinese adults experienced rapid growth according to our population-based, age- and gender-specific analyses. Over the 18-year study period, major increases in WC, WHtR and WHpR were observed among Chinese adults. Specifically, these increases were greater at upper percentiles and in men. Age, physical activity, energy intake, drinking, smoking, education, income and urbanicity index were associated with elevated abdominal obesity indicators, and the effects differed among percentiles and between genders.


Assuntos
Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Obesidade/epidemiologia , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril , Adolescente , Adulto , Idoso , Índice de Massa Corporal , China/epidemiologia , Ingestão de Energia , Exercício , Feminino , Humanos , Renda , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade Abdominal/epidemiologia , Análise de Regressão , Adulto Jovem
5.
J Sports Sci ; 37(18): 2159-2167, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31156048

RESUMO

Average acceleration (AvAcc) and intensity gradient (IG) have been proposed as standardised metrics describing physical activity (PA) volume and intensity, respectively. We examined hypothesised between-group PA differences in AvAcc and IG, and their associations with health and well-being indicators in children. ActiGraph GT9X wrist accelerometers were worn for 24-h·d-1 over 7days by 145 children aged 9-10. Raw accelerations were averaged per 5-s epoch to represent AvAcc over 24-h. IG represented the relationship between log values for intensity and time. Moderate-to-vigorous PA (MVPA) was estimated using youth cutpoints. BMI z-scores, waist-to-height ratio (WHtR), peak oxygen uptake (VO2peak), Metabolic Syndrome risk (MetS score), and well-being were assessed cross-sectionally, and 8-weeks later. Hypothesised between-group differences were consistently observed for IG only (p < .001). AvAcc was strongly correlated with MVPA (r = 0.96), while moderate correlations were observed between IG and MVPA (r = 0.50) and AvAcc (r = 0.54). IG was significantly associated with health indicators, independent of AvAcc (p < .001). AvAcc was associated with well-being, independent of IG (p < .05). IG was significantly associated with WHtR (p < .01) and MetS score (p < .05) at 8-weeks follow-up. IG is sensitive as a gauge of PA intensity that is independent of total PA volume, and which relates to important health indicators in children.


Assuntos
Aceleração , Exercício , Acelerometria/instrumentação , Índice de Massa Corporal , Aptidão Cardiorrespiratória , Criança , Estudos Transversais , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Síndrome Metabólica , Consumo de Oxigênio , Obesidade Pediátrica , Projetos Piloto , Qualidade de Vida , Classe Social , Tiazinas , Razão Cintura-Estatura , Punho
6.
Wei Sheng Yan Jiu ; 48(2): 214-219, 2019 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-31133097

RESUMO

OBJECTIVE: To investigate the association between serum leptin concentration with blood pressure and hypertension in different gender. METHODS: A total of 343 non-hypertensive residents aged 30 to 65 were randomly selected from Zhejiang Province in 2014. Parameters including height, weight, waist, blood pressure, serum lipid and serum leptin concentration of participants were measured and determined by physical examination and laboratory detection in 2014 and 2017. The differences in serum leptin levels between the new hypertensive and non-hypertensive people were compared after three years. The relationship between serum leptin levels and hypertension was analyzed by Logistic regression. RESULTS: In 2014 and 2017, concentration of serum leptin in females was significantly higher than that in males, and the blood pressure in males was higher than that in females. At the end of follow-up, 26 new cases of hypertension were found. Serum leptin levels were higher in the female hypertensive group than in the non-hypertensive group(P=0. 0289), whereas there was no statistical difference in males(P>0. 01). Regardless of gender, serum leptin was significantly positively correlated with body mass index(BMI) and waist-to-height ratio(WHtR)(P<0. 0001), and also had correlation with blood pressure. However, after adjusting for BMI or WHtR, the correlation between serum leptin and blood pressure disappeared(P>0. 01). Logistic regression also showed the similar result. CONCLUSION: Serum leptin is not directly related to blood pressure and hypertension, and the positive correlation between them may be explained largely by BMI and WHtR.


Assuntos
Pressão Sanguínea/fisiologia , Hipertensão/sangue , Leptina/sangue , Adulto , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , China/epidemiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Razão Cintura-Estatura
7.
Curr Med Sci ; 39(2): 330-336, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31016530

RESUMO

A host of studies found waist-to-height ratio (WHtR) having higher diagnostic value than other abdominal obesity anthropometric indicators for metabolic disorders. But the cut-off points are still not consistent. This study was aimed to explore the optimal cut-off point of WHtR in Chinese population and identify the association between WHtR and cluster of metabolic risk factors. In total, 13379 Han adults (7553 men and 5726 women) from over 40 institutions who took physical examination in Xuanwu Hospital of Capital Medical University between January 2014 and January 2015 were involved in this cross-sectional study. Subjects with two or more components of metabolic syndrome (MetS) were considered to have multiple risk factors. Optimal cut-off points of WHtR for cluster of metabolic risk factors were analyzed by receiver operating characteristic (ROC) curve analysis. The optimal cut-off points of WHtR were 0.51 for men and 0.49 for women. People with elevated WHtR had higher levels of metabolic risk factors. And the prevalence of individual and clusters of 5 risk factors were all higher among WHtR-defined abdominal obesity people than in normal subjects. The optimal cut-off points of WHtR were 0.51 for men and 0.49 for women. In conclusion, people with elevated WHtR are susceptible to cluster of metabolic risk factors.


Assuntos
Síndrome Metabólica/etiologia , Síndrome Metabólica/fisiopatologia , Obesidade Abdominal/complicações , Obesidade Abdominal/fisiopatologia , Grupo com Ancestrais do Continente Asiático , Pequim , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/fisiopatologia , Curva ROC , Fatores de Risco , Razão Cintura-Estatura
8.
BMC Public Health ; 19(1): 391, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971258

RESUMO

BACKGROUND: Persons of African and Middle-Eastern origin living in European countries have a high prevalence of type 2 diabetes, accompanied by high prevalence of obesity among women but not always among men. The aim of this study was to examine whether there are differences in the association between anthropometric measures and glucose levels measured with glycated haemoglobin and fasting blood glucose among persons of migrant origin in Finland. METHODS: Cross-sectional population-based data of the 30-64 year-old participants in the health examination of the Migrant Health and Wellbeing Study was used, selecting persons without diabetes (Russian origin n = 293, Somali origin n = 184, Kurdish origin n = 275). The reference group were non-diabetic participants in the Health 2011 Survey (n = 653), representative of the general Finnish population. Anthropometric measures included body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR, available for Maamu Study participants only). RESULTS: Depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-18% of variation in HbA1c among persons of Russian origin, 5-10% among persons of Somali origin, 1-3% among persons of Kurdish origin and 11-13% among the general population. Also depending on whether continuous or categorical anthropometric measures were used, age, sex and anthropometrics explained 13-19% of variation in fasting blood glucose among persons of Russian origin, 15-20% among persons of Somali origin, 13-17% among persons of Kurdish origin and 16-17% among the general population. With exception for BMI, strength of the association between continuous anthropometric measures and HbA1c was significantly lower among persons of Kurdish origin compared with the general Finnish population (p = 0.044 for WC and p = 0.040 for WHtR). CONCLUSIONS: A low degree of association between anthropometric measures and HbA1c was observed among persons of Kurdish origin. Findings of this study suggest caution is warranted when using HbA1c as a screening tool for glucose impairment among persons without diabetes in populations of diverse origin.


Assuntos
Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Hemoglobina A Glicada/análise , Migrantes/estatística & dados numéricos , Adulto , Antropometria , Índice de Massa Corporal , Estudos Transversais , Feminino , Finlândia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Federação Russa/etnologia , Somália/etnologia , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril
9.
Rev Bras Epidemiol ; 22: e190017, 2019 Mar 21.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30916142

RESUMO

OBJECTIVE: To determine the predictive power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), and their respective cut-off points for high blood pressure (BP) screening in Brazilian children and adolescents. METHOD: Cross-sectional study conducted with 1,139 students aged 6 to 17years. Body weight, height, WC, and BP were measured. High BP was classified as systolic or diastolic ≥ 95th percentile. Receiver Operating Characteristic (ROC) curves were constructed, and the area under the curve, sensitivity, and specificity were calculated. RESULTS: The prevalence of high BP was 27.0%. Anthropometric indices showed a significant association with high BP (accuracy ranging from 0.62 - 0.81), except for WHtR among male adolescents.Sensitivity was low, regardless of the anthropometric index, gender, and age group. CONCLUSION: BMI, WC, and WHtR were associated with high BP, but the cut-off points tested showed low sensitivity. Determining specific cut-off points for each population can enable the use of anthropometric indices in high BP screening.


Assuntos
Hipertensão/diagnóstico , Adolescente , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Programas de Rastreamento , Obesidade/complicações , Obesidade/epidemiologia , Valor Preditivo dos Testes , Prevalência , Curva ROC , Sensibilidade e Especificidade , Circunferência da Cintura , Razão Cintura-Estatura
10.
Nutrients ; 11(3)2019 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-30832419

RESUMO

The emotional consequences of excessive body mass, associated with body image and acceptance, have become a global public health challenge as they may decrease the general well-being and hinder weight loss in overweight and obese individuals. Therefore, this study aimed to analyze the influence of age, body mass index (BMI), and waist-to-height ratio (WHtR) on body mass acceptance, attitudes, and motivation toward body mass reduction in overweight and obese Caucasian women with excessive abdominal fat. The previously validated BodyMass⁻DRama (Body Mass⁻Dietary Restrictions: Acceptance, Motivation, Attitudes) questionnaire was applied in this study. The declared acceptance, attitudes and motivation towards body mass reduction were compared between subgroups based on age (20⁻40, 40⁻50, and 50⁻60 years), BMI (25.0⁻30.0, 30.0⁻35.0, and ≥35.0 kg/m²), and quartiles of WHtR. The age, BMI and WHtR were stated to be associated with declared acceptance, attitudes, and motivation towards body mass reduction. The different age groups indicated the following as the reasons for excessive body mass: young respondents-low physical activity and consumption of sweets; middle-aged ones-large/irregular meals; aging ones-large/irregular meals and low physical activity (p = 0.0161). While describing motivation toward body mass reduction, young respondents indicated the role of a physician or dietitian (p = 0.0012) or someone who can control them (p = 0.0044), as well as their expectation to be more successful at work after body mass reduction (p = 0.0045), while the aging ones indicated appreciation and plaudits from others (p = 0.0264) as a motivating factor. Respondents with the highest BMI declared having spending free time actively constricted (p = 0.0007); they declared more often than others of feeling exhausted (p = 0.0395) or tired all the time (p = 0.0445), but less often of feeling full of joy (p = 0.0457) or full of energy (p <0.0001). Respondents with moderate WHtR declared less often than others that they expect to enjoy socializing (p = 0.0376), but more often to be able to have a better vacation after body mass reduction (p = 0.0128), while those with the lowest WHtR expected to be more physically active (p = 0.0487). Women with the highest WHtR most commonly indicated external pressure from relatives or co-workers as a motivating factor for body mass reduction (p = 0.0435). Due to these differences between Caucasian women with excessive body mass, the approach of physicians and dietitians, as well as methods applied to motivate patients, need to be customized.


Assuntos
Atitude Frente a Saúde , Imagem Corporal/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Adulto , Fatores Etários , Índice de Massa Corporal , Exercício/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Motivação , Obesidade/etnologia , Obesidade/terapia , Sobrepeso/etnologia , Sobrepeso/terapia , Inquéritos e Questionários , Razão Cintura-Estatura , Programas de Redução de Peso , Adulto Jovem
11.
Nutr Hosp ; 36(1): 96-102, 2019 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-30834755

RESUMO

Introduction: Background: there is limited information about the usefulness of the waist-to-height ratio (WHtR) to identify Colombian adolescents with cardiometabolic risk factors (CRF). Objective: to compare the utility of WHtR, body mass index (BMI), and waist circumference (WC) to identify adolescents with CRF. Methods: a study with 346 youths (aged 14.0 ± 2.3 years) was performed. Anthropometric measurements were collected and BMI, WC and WHtR were calculated. Fasting blood lipids, glucose and insulin were measured; the homeostasis model assessment of insulin resistance (HOMA-IR) was computed. The presence of multiple non-WC metabolic syndrome (MetS) factors (high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol [HDL-C]) was analyzed. The area under the curve (AUC) and the odds ratios (OR) were calculated. Results: the BMI, WC and WHtR were comparable at identifying adolescents with high HOMA-IR (AUC = 0.686, 0.694 and 0.641, respectively), low HDL-C (AUC = 0.623, 0.652 and 0.572, respectively) and multiple non-WC MetS factors (AUC = 0.694, 0.715 and 0.688, respectively). The OR of having multiple non-WC MetS factors was similar in overweight adolescents (1.65, 95% CI: 0.86-3.14) and those with WHtR ≥ 0.50 (3.76, 95% CI: 1.95-7.3). There were no OR differences of having multiple non-WC MetS factors among adolescent with obesity (9.88, 95% CI: 3.1-31.7), WC ≥ P90 (18.3, 95% CI: 4.0-83.5) and WHtR ≥ 0.55 (11.0, 95% CI: 3.0-4.4). Conclusions: WHtR, BMI and WC have similar capacities to identify Colombian adolescents with CRF. WHtR showed to be an alternative tool to BMI and WC measurements when screening adolescents for cardiometabolic risk.


Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/epidemiologia , Razão Cintura-Estatura , Adolescente , Glicemia/análise , Criança , HDL-Colesterol/sangue , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Lipídeos/sangue , Masculino , Obesidade/sangue , Obesidade/diagnóstico , Obesidade/epidemiologia , Sobrepeso/sangue , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura
12.
Medicina (Kaunas) ; 55(2)2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30795629

RESUMO

Background and objectives: Higher physical fitness is associated with a more favorable weight and body composition in the general population, although this association has not been studied in patients with systemic lupus erythematosus (SLE). The aim of the present study was to examine the association of different components of physical fitness with body composition in women with SLE with mild disease activity. Materials and Methods: This cross-sectional study included 77 women with SLE (43.2 ± 13.8 years old) and clinical stability during the previous 6 months. Body composition (including body mass index (BMI), fat mass index (FMI), waist circumference, waist-to-height ratio and waist-to-hip ratio) was assessed using a stadiometer, an anthropometric tape, and a bioimpedance device. Physical fitness included cardiorespiratory fitness (Siconolfi step test and 6 min walk test), muscular strength (handgrip strength test as upper body measure and 30 s chair stand as lower body measure), and flexibility (back-scratch test). Participants with a fitness level equal or above the median of the study sample were categorized as "fit" and those below the median were categorized as "unfit". Linear regression assessed the association of physical fitness with body composition parameters. Results: Cardiorespiratory fitness and upper body muscular strength were negatively associated with BMI, FMI, waist circumference, and waist-to-height ratio (all, p < 0.05). Lower body muscular strength and flexibility were negatively related to FMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio (all, p < 0.05). These relationships were still significant after controlling for age, disease duration, accrual damage, and SLE activity. Overall, fit patients presented significantly lower values in all body composition parameters compared to unfit patients (all, p < 0.05). Conclusions: The main findings of the present study suggest that physical fitness is inversely associated with body composition in women with SLE. Given the cross-sectional nature of this study, future clinical trials should study the causal pathways underlying these relationships.


Assuntos
Composição Corporal , Aptidão Cardiorrespiratória/fisiologia , Força da Mão/fisiologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril , Teste de Caminhada
13.
Nutrients ; 11(2)2019 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-30717465

RESUMO

The sustainability of education focused on improving the dietary and lifestyle behaviours of teenagers has not been extensively studied. The aim of this study was to determine the sustainability of diet-related and lifestyle-related school-based education on sedentary and active lifestyle, diet quality and body composition of Polish pre-teenagers in a medium-term follow-up study. An education-based intervention study was carried out on 464 students aged 11⁻12 years (educated/control group: 319/145). Anthropometric measurements were taken and body mass index (BMI) and waist-to-height ratios (WHtR) were calculated, both at the baseline and after nine months. Dietary data from a short-form food frequency questionnaire (SF-FFQ4PolishChildren) were collected. Two measures of lifestyle (screen time, physical activity) and two diet quality scores (pro-healthy, pHDI, and non-healthy, nHDI) were established. After nine months, in the educated group (vs. control) a significantly higher increase was found in nutrition knowledge score (mean difference of the change: 1.8 points) with a significantly higher decrease in physical activity (mean difference of the change: -0.20 points), nHDI (-2.3% points), the z-WHtR (-0.18 SD), and the z-waist circumference (-0.13 SD). Logistic regression modelling with an adjustment for confounders revealed that after nine months in the educated group (referent: control), the chance of adherence to a nutrition knowledge score of at least the median was over 2 times higher, and that of the nHDI category of at least the median was significantly lower (by 35%). In conclusion, diet-related and lifestyle-related school-based education from an almost one-year perspective can reduce central adiposity in pre-teenagers, despite a decrease in physical activity and the tendency to increase screen time. Central adiposity reduction can be attributed to the improvement of nutrition knowledge in pre-teenagers subjected to the provided education and to stopping the increase in unhealthy dietary habits.


Assuntos
Composição Corporal , Dieta , Exercício , Educação em Saúde , Obesidade Abdominal/dietoterapia , Serviços de Saúde Escolar , Comportamento Sedentário , Índice de Massa Corporal , Criança , Comportamento Alimentar , Feminino , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Dieta Saudável , Humanos , Estilo de Vida , Masculino , Obesidade Pediátrica/dietoterapia , Polônia , Instituições Acadêmicas , Estudantes , Razão Cintura-Estatura
14.
PLoS One ; 14(1): e0209992, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30682054

RESUMO

BACKGROUND: Obesity increases mortality, and is linked to cardiovascular diseases and metabolic syndrome (MetS). Therefore, the purpose of this study was to analyze the ability of different adiposity indices to identify subjects with MetS among people with intermediate cariovascular risk. MATERIALS AND METHODS: The cross-sectional study involved 2478 subjects, recruited by the MARK study. Adiposity measures: general adiposity by body mass index (BMI), central adiposity by waist-to-height ratio (WHtR), fat mass percent by the Clínica Universidad de Navarra-body adiposity estimator (CUN-BAE), percentage of body fat and of visceral adipose tissue by body roundness index (BRI) and visceral obesity and general adiposity with body shape index (ABSI). The diagnosis of MetS was made in accordance with the criteria established in the international consensus of the Joint Scientific Statement National Cholesterol Education Program III. RESULTS: The highest correlation coefficients were obtained by the glycemic components (HbA1c and FPG) of the MetS and ranged from 0.155 to 0.320. The exception was ABSI, which showed lower values in the global analysis and in the males. Values of the area under the ROC curve with the adiposity indices ranged from 0.773 with the BMI in males to 0.567 with ABSI in males. In the logistic regression analysis, all adiposity factors, except ABSI, showed similar OR values of MetS after adjusting for possible confounding factors. In the global analysis, the adiposity index that showed a highest OR of MetS was CUN-BAE (OR 5.50; 95% CI 4.27-7.09). In the analysis by gender, the highest ORs were BMI in males (OR 5.98; 95% CI 4.70-7.60) and both WHtR and BRI in females (OR 4.15; 95% CI 3.09-5.58). CONCLUSION: All adiposity indices, except for ABSI, show an association with MetS and similar ability to detect subjects with MetS among people with intermediate cariovascular risk.


Assuntos
Adiposidade , Doenças Cardiovasculares/etiologia , Síndrome Metabólica/complicações , Obesidade Abdominal/complicações , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Razão Cintura-Estatura
15.
PLoS One ; 14(1): e0210591, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30629671

RESUMO

The present study aimed to estimate the differences in rates of prehypertension and hypertension in children and adolescents among three regions with different socioeconomic status in China, and explore the corresponding risk factors associated with prehypertension and hypertension to guide the prevention. Blood pressure measurements of 13 762 children and adolescents aged 6-17 years were obtained from a prospective national survey (the China Health and Nutrition Survey, 1991-2011). Prehypertension and hypertension were defined by age and gender, according to China's standard criteria. Chi-square tests were used to compare the differences in the prevalence of prehypertension and hypertension among three regions. Trend chi-square tests were used to detect the trends in rates of prehypertension and hypertension over survey years. Logistic regression models were used to detect the potential risk factors of prehypertension and hypertension in children and adolescents. During the survey years, the overall prevalence of prehypertension and hypertension were 6.0% and 10.6%. The corresponding rates in the western region were lowest, but increased rapidly over the two decades (84.0% and 122.6% increases respectively, P<0.001). The overall hypertension rate remained high in the eastern region, despite the slower increase (24.2% increase). In the central region, although the prehypertension rate remained stable, the rate of hypertension had a 94.8% increase these years (P<0.0001). According to the results of logistic regression, age, body mass index (BMI) and waist/height ratio (WHtR) were associated with prehypertension and hypertension. Children and adolescents in the eastern region had the highest level of prehypertension and hypertension, while the rapid increase of blood pressure in the western and central regions were also supposed to concern. Improvement of the healthy lifestyle is urgent for prehypertension and hypertension prevention in children and adolescents.


Assuntos
Hipertensão/epidemiologia , Pré-Hipertensão/epidemiologia , Adolescente , Fatores Etários , Pressão Sanguínea , Índice de Massa Corporal , Criança , China/epidemiologia , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Estilo de Vida , Masculino , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/fisiopatologia , Prevalência , Fatores de Risco , Urbanização , Circunferência da Cintura , Razão Cintura-Estatura
16.
Diabetes Metab Syndr ; 13(1): 696-706, 2019 Jan - Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30641792

RESUMO

OBJECTIVE: We compared the ability of the selected anthropometric indicators to best predict the prevalence of hypertension among the Indian tribes. METHODS: A cross-sectional study was undertaken among 1431 adult participants (705 males and 726 females) between the ages of 20 and 60 years from six major tribes in India. Selected anthropometric indicators such as body mass index (BMI), waist-hip-ratio (WHR), waist-height-ratio (WHtR), percentage body fat (PBF), visceral fat (VF), minimum-waist-circumference (MWC) and sum-of-the-four skinfold thickness (SF4), along with the physiological parameters such as blood pressure were recorded. Discriminant analysis (DA) was performed to examine and compare the ability of the selected anthropometric indicators towards classifying hypertension among males, females and the total population. RESULTS: Significant independent association was observed for hypertension and similar conditions within gender and selected age-group categories. The overall hypertension prevalence among the studied tribes was observed at 12.6%. Standardized function coefficients (SFCs) in discriminant analysis revealed PBF(0.89, 0.36, and 0.76 for overall, males, and females respectively) as the most powerful discriminator of hypertension. In addition, visceral fat (0.74, 1.46, and 0.58 for overall, males and females respectively) was observed to be the other significant indicator of hypertensive blood pressure. These exploratory findings for the first time indicate fat deposition, rather than body density alone, as an emerging physiological and metabolic risk among Indian tribes. CONCLUSION: In the context of the highly prevalent chronic undernutrition, internal fat deposition is a major classifying factor of physiological and metabolic intolerance. It also indicates the increasing trend in lifestyle changes and the associated adversities among the Indian tribes.


Assuntos
Hipertensão/epidemiologia , Adulto , Distribuição da Gordura Corporal , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Hipertensão/diagnóstico , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril
17.
Diabetes Metab Syndr ; 13(1): 48-54, 2019 Jan - Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30641748

RESUMO

AIM: This study compared the ability of anthropometric parameters to predict Metabolic Syndrome (MetS). METHODS: Eleven anthropometric parameters: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), abdominal volume index (AVI), Conicity Index (CI), body adiposity index (BAI), lipid accumulation product (LAP) and waist circumference-triglyceride index (WTI) were measured and calculated in apparently healthy subjects with and without MetS. A receiver operating characteristic (ROC) curve was applied to assess their ability to predict MetS. RESULTS: Of the 535 subjects recruited 23% had MetS. WC had the largest area under the curve (AUC) in both men (0.814 95% CI 0.721-0.907) and women (0.819 95%CI 0.771-0.867). This did not differ from the AUC of BMI, WHtR, BRI, CI, BAI, LAP in men and BMI, WHtR, BAI, LAP, VAI and WTI in women (P > 0.05). The cutoff point for WC was 89.5 cm and 91.8 cm in men and women respectively. The AUC of WC was the largest in the 40-49 and 60 years and above age groups while the AUC of LAP was the largest for age groups 30-39 and 50-59 years. CONCLUSION: Of the 11 anthropometric parameters assessed, the WC was the best at predicting MetS in both men and women. There is need to ascertain the cutoff point and establish landmark for measuring WC especially for the sub Saharan region.


Assuntos
Antropometria , Biomarcadores/análise , Síndrome Metabólica/diagnóstico , Obesidade/complicações , Adiposidade , Adulto , Composição Corporal , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Masculino , Síndrome Metabólica/etiologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Circunferência da Cintura , Razão Cintura-Estatura , Relação Cintura-Quadril
18.
J Sports Sci ; 37(12): 1327-1337, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30588878

RESUMO

This study aimed to analyse the association between socioeconomic status (SES) and fatness and fitness in preschoolers. 2,638 preschoolers (3-5 years old; 47.2% girls) participated. SES was estimated from the parental educational and occupational levels, and the marital status. Fatness was assessed by body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR). Physical fitness components were assessed using the PREFIT battery. Preschoolers whose parents had higher educational levels had lower fatness (P < 0.05). BMI significantly differed across occupational levels of each parent (P < 0.05) and WHtR across paternal levels (P = 0.004). Musculoskeletal fitness was different across any SES factor (P < 0.05), except handgrip across paternal occupational levels (P ≥ 0.05). Preschoolers with high paternal occupation had higher speed/agility (P = 0.005), and those with high or low maternal education had higher VO2max (P = 0.046). Odds of being obese and having low musculoskeletal fitness was lower as SES was higher (P < 0.05). Those with married parents had higher cardiorespiratory fitness than single-parent ones (P = 0.010). School-based interventions should be aware of that children with low SES are at a higher risk of obesity and low fitness already in the first years of life.


Assuntos
Adiposidade , Aptidão Cardiorrespiratória , Classe Social , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Características da Família , Feminino , Força da Mão , Humanos , Masculino , Consumo de Oxigênio , Circunferência da Cintura , Razão Cintura-Estatura
19.
P R Health Sci J ; 37(4): 195-199, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30548054

RESUMO

OBJECTIVE: Better than simple anthropometric parameters, the visceral adiposity index (VAI) has recently been proposed as a predictor of cardiometabolic risk in adults. However, there are conflicting results on the associations of these parameters in children and adolescents. Therefore, we aimed to estimate this potential relationship between VAI, anthropometric parameters (i.e., body mass index [BMI], waist circumference [WC], and waist-to-height ratio [WHtR], respectively), and inflammation as measured by high-sensitivity C-reactive protein (hs-CRP) levels in a cohort of adolescent girls. METHODS: A total of 90 adolescent girls from 16 to 19 years old were included in cross-sectional study. Anthropometric and biochemical parameters (glucose, lipid parameters, and hsCRP) were measured. The VAI, derived from anthropometric and lipid parameters, calculated {[WC/36.58 + (1.89 × BMI)] × (triglycerides/0.81) × (1.52/HDL-cholesterol)} was calculated. RESULTS: A comparison of the receiver operating characteristic (ROC) curves showed that all the curves for the anthropometric parameters (e.g., BMI, WC, WHtR) had excellent discriminatory capability with regard to inflammation level status (low vs. high level) and significantly larger areas under the curve (AUC = 0.885, AUC = 0.863, AUC = 0.860, respectively; P < 0.001) than the ROC curve for VAI did (AUC = 0.686; P = 0.021). CONCLUSION: Visceral adiposity index is not superior over anthropometric parameters in relation to inflammation as measured by high sensitivity C-reactive protein in adolescent girls.


Assuntos
Adiposidade/fisiologia , Antropometria/métodos , Inflamação/metabolismo , Gordura Intra-Abdominal/metabolismo , Adolescente , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Estudos Transversais , Feminino , Humanos , Lipídeos/sangue , Curva ROC , Circunferência da Cintura/fisiologia , Razão Cintura-Estatura , Adulto Jovem
20.
Nutr Hosp ; 35(6): 1270-1274, 2018 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-30525839

RESUMO

BACKGROUND: adequate exposure to Physical Education (PE) classes contributes to a healthier lifestyle among children during their lifespan. OBJECTIVE: the main objective of this research was to evaluate the perception of obese schoolchildren regarding their participation in PE class and to determine their self-esteem compared with overweight and normal weight groups. METHOD: in total, 656 schoolchildren (284 females and 372 males), between eleven and 14 years of age, participated in this study. Assessments were made regarding age, sex, anthropometric variables, children's self-esteem, and perception of participation in the PE class. RESULTS: obese schoolchildren presented significantly lower values of self-esteem (p < 0.001), and exhibited the highest proportion of schoolchildren with low self-esteem (53%). There was a significant relationship between obesity and the following sentence: "I am the last one they choose for games and in games and sports"; 48.53% of schoolchildren with obesity responded positively. With the following sentence: "I look instead of playing", 57.4% of schoolchildren with obesity responded positively. CONCLUSION: the results revealed that schoolchildren with obesity feel excluded from PE classes and show low levels of self-esteem, compared with normal weight schoolchildren.


Assuntos
Antropometria , Obesidade Pediátrica/psicologia , Percepção , Educação Física e Treinamento , Autoimagem , Estudantes/psicologia , Adolescente , Índice de Massa Corporal , Criança , Chile , Feminino , Humanos , Masculino , Obesidade Pediátrica/terapia , Percepção/fisiologia , Instituições Acadêmicas , Circunferência da Cintura , Razão Cintura-Estatura
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