Racial Differences in Obesity Measures and Risk of Colorectal Adenomas in a Large Screening Population

Obesity is an important risk factor for colorectal neoplasia; however, little research exists on racial differences in obesity measures [body mass index (BMI), waist circumference (WC), and waist-hip-ratio (WHR)] associated with adenoma. We used data from the Diet and Health Studies, Phases III–V to examine differences in the contribution of obesity measures to adenoma risk by race. The sample consisted of 2184 patients (1806 white, 378 African American) undergoing outpatient colonoscopy for average risk screening. Covariates included demographics, health history, and validated measures of diet and physical activity. Among whites, BMI [overweight: odds ratio (OR) = 1.31, 95% confidence interval (CI), 1.00–1.71; obese: OR = 1.89, 95% CI, 1.41–2.56), WC (OR = 1.47, 95% CI, 1.09–1.99), and WHR (OR = 1.60, 95% CI, 1.24–2.06) were associated with adenomas. BMI was not associated with adenomas in African Americans. Although the CIs were wide, the point estimates for WHR (OR = 1.07, 95% CI, 0.51–2.22) and WC (OR = 1.04, 95% CI, 0.56–1.92) were slightly elevated above the null. BMI was associated with adenomas only among whites, whereas WHR and WC appeared to be important risk factors among both races. Racial differences in adenoma risk may be due to differences in body shape and weight and/or fat distribution.     

Contraceptive choices of overweight and obese women in a publically funded hospital: possible clinical implications

BackgroundDespite the growing obesity epidemic in the United States, family planning for overweight and obese women has been understudied. The aim of this study was to describe the contraception methods selected by normal weight, overweight and obese women.Study DesignWe retrospectively reviewed 7262 charts of women who underwent first trimester surgical termination of pregnancy at the John H. Stroger, Jr. Hospital of Cook County between January 1, 2008, and January 1, 2010. We analyzed the relationship between body mass index (BMI) and choice of contraceptive method, after adjusting for age, race, smoking and level of education.ResultsWhen compared to patients with BMI <25 kg/m², overweight (BMI 25–29.9 kg/m²) and obese patients (BMI ≥30 kg/m²) were more likely to select the intrauterine device (OR 1.3, 95% CI 1.28–1.32 for overweight; OR 1.6, 95% CI 1.59–1.61 for obese), contraceptive ring (OR 1.4, 95% CI 1.28–1.52 for overweight; OR 1.6, 95% CI 1.57–1.63 for obese) and tubal ligation (OR 1.5 95% CI 1.44–1.62 for overweight; OR 2.9, 95% CI 2.79–3.01 for obese). They were less likely to choose injectable contraception (OR 0.7, 95% CI 0.59–0.81 for overweight; OR 0.52, 95% CI 0.48–0.56 for obese). There was no relationship between BMI and choice of condoms, oral contraceptive pills and implantable methods.ConclusionIn our population, the contraceptive choices of overweight and obese women differed from those of normal weight women. These differences in contraceptive selection are important to recognize in light of the potential effect of BMI on the safety and efficacy of different contraceptive methods. Further research is needed to evaluate the contraceptive preferences, risks and benefits for overweight and obese women.     

Role of disability in the association between obesity and unintentional injuries

BackgroundWe assessed the mediating role of disability in the association between obesity and elevated injury risk among U.S. white and African American adults.MethodsData from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. Respondents were categorized into 6 groups: underweight (<18.5 kg/m²), normal weight (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²), obese class I (30.0-34.9 kg/m²), obese class II (35.0-39.9 kg/m²), and obese class III (≥40 kg/m²). Responses to the 12 items in SF-12v2 were used to transform raw scales to the norm-based Physical Component Summary measure (PCS). Disability was defined as having a PCS score below 30 (mean, −2.00 SD). Self-reported unintentional injuries in the past 12 months were compared between respondents with and without disability within each body mass index (BMI) category. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were examined for men and women separately using 3 logistic regression models that considered age, race, education level, poverty status, chronic medical conditions, major injury risk behaviors, obesity, and disability status.ResultsA total of 31,276 non-Hispanic white and African American respondents reported an injury incidence of 18.6%. Disability correlated with significantly higher injury incidence (p < .01). Controlling for major sociodemographics, chronic medical conditions, and major injury risk behaviors, we observed a statistically significant association between obesity and injuries (OR = 1.27, 95% CI = 1.06-1.54, for BMI ≥ 40; OR = 1.11, 95% CI = 1.01-1.23, for BMI of 30.0 to <40) among women; however, this association became nonsignificant after status of disability was considered in the final regression model. This finding was not seen for men.ConclusionThe elevated injury risk among white and African American women with extreme obesity was mediated substantially by disability. No such finding was found, however, for men.     

Prevalence and Socio-Demographic Determinants of Overweight and Obesity in a Nigerian Population

Objective

This survey explored prevalence of overweight and obesity and their associations with socio-demographic variables in a Nigerian population.

Methods

This cross-sectional survey involved 1521 adults in Nnewi. Age, sex, educational and occupational status, and BMI were recorded.

Results

Prevalence of overweight was higher in males (32.3%; 95% CI, 29.5%–35.2%) than in females (29.8%; 95% CI, 26.8%–33.0%); the reverse was the case for prevalence of obesity (19.6%; 95% CI, 17.3%–22.2% in males and 36.0%; 95% CI, 32.8%–39.4% in females). Higher odds ratios (ORs) for overweight and obesity were observed in participants aged 41–60 years (OR 2.03; 95% CI, 1.57–2.61 for overweight and OR 4.29; 95% CI, 3.25–5.67 for obesity) and those >60 years (OR 1.72; 95% CI, 1.21–2.43 for overweight and OR 4.21; 95% CI, 2.86–6.19 for obesity) compared to those aged 18–40 years. Female sex was associated with higher ORs for overweight (OR 1.20; 95% CI, 0.96–1.51) and obesity (OR 2.21; 95% CI, 1.73–2.83). Participants with secondary education had marginally higher ORs for overweight (OR 1.15; 95% CI, 0.88–1.51) and obesity (OR 1.17; 95% CI, 0.86–1.59) than those with tertiary education, and so were those with primary education for obesity (OR 1.19; 95% CI, 0.74–1.89) but higher OR for overweight (OR 1.44; 95% CI, 0.98–2.13). Unskilled participants had about the same OR for overweight and obesity as professionals, and while skilled participants had about the same OR for overweight as professionals, their OR for obesity (OR 1.27; 95% CI, 0.67–2.43) was fairly higher than that for professionals.

Conclusions

Prevalence of overweight is higher in males than in females, but the reverse is the case for prevalence of obesity. Older age and female sex are associated with increased risk of overweight and obesity, while working at a skilled occupation is associated with obesity, and tertiary educational attainment is associated with overweight.Key words: determinants, obesity, overweight, prevalence, developing country     

Natural histories of metabolite BMI phenotypes and their impacts on cardiovascular disease risk over a decade-long follow-up

PurposeThe prognostic significance of obesity phenotypes is under debate, and few studies have characterized their transition trajectories. This study examined the natural courses of different phenotypes and their associations with cardiovascular disease risks.MethodsA total of 1827 participants were followed for 14 years and re-evaluated every 4–5 years. Four metabolite BMI phenotypes were determined according to overweight or obesity (BMI ≥ 24 kg/m²) and metabolic health status (≤1 Adult Treatment Panel III criteria, excluding waist circumference). Cardiovascular risks were assessed by evaluating baPWV and hypertension, diabetes and chronic kidney disease (CKD) development.ResultsMore than 20% of participants changed their initial phenotypes within 5 years. One-third of healthy overweight/obese (MHO) individuals became unhealthy, and only 10.6% regressed to a healthy normal weight (MHN) at the end of follow-up. Compared with MHN participants, MHO participants had higher odds of increased baPWV (OR: 1.18, 95% CI, 0.42–3.33) and increased risks of incident hypertension (HR: 1.87, 95% CI, 1.18–2.98) and diabetes (HR: 2.61, 95% CI, 1.35–5.03). Metabolic deterioration during follow-up resulted in an increased risk of baPWV and clinical diseases.ConclusionsThe natural trajectory of metabolite BMI phenotypes is time-varying, and interventions for both healthy and unhealthy overweight/obese individuals should be widely recommended.     

Race disparities in cardiovascular disease risk factors within socioeconomic status strata

Purpose

Racial differences in socioeconomic status (SES) explain some, but not all, of racial disparities in cardiovascular disease (CVD) risk. To address this, race disparities among higher SES individuals need to be assessed. The purpose of this study was to assess whether racial disparities in CVD risk factors differ by SES levels.

The Effects of Religious Attendance and Obesity on Health by Race/Ethnicity

ObjectivesThe objectives of this paper are to examine the effects of religion and obesity on health and determine how the relationship varies by racial/ethnic groups with data from the Panel Study of American Race and Ethnicity (PS-ARE).MethodsUsing ordinal logistic regression, the effects of religion and obesity on self-rated health and how the relationship varies by racial/ethnic groups are investigated. Additionally, to determine whether certain ethnic groups are more impacted by the frequency of religious attendance and obesity, whites, blacks, and Hispanics are analyzed separately with ordinal logistic regression.ResultsWhen obesity was added in focal relationship between religious services attendance and self-rated health strengthened this focal relationship which is a suppression effect between religious services attending and self-rated health adding obesity. For BMI is also significantly associated with decreased odds of reporting better health–normal weight (OR = 2.99; 95% CI = 2.43–3.67) and overweight (OR = 2.19; 95% CI = 1.79–2.68) compared to obese. Subjects who attend religious services 1–2 time a year (OR = 1.30; 95% CI = 1.04–1.62) and 1–3 times a month (OR = 1.28; 95% CI = 1.05–1.57) are associated with increased odds of reporting better health. In whites, attending religious services 1–2 times a year are associated with increased odds of reporting better health (OR = 1.48; 95% CI = 1.09–2.00) and 1–3 times a month are also associated with increased odds of reporting health (OR = 1.34; 95% CI = 1.02–1.78) compared to never attending religious attendance. The frequency of religious services attendance of blacks and Hispanics are not associated with self-rated health. For BMI, being white is more positively associated with increased odds of reporting better health than black and Hispanic subjects. Although white subjects are less likely to attend religious services more frequently than black and Hispanic subjects, the influence on self-rated health in white subjects is more evidenced than other racial/ethnic groups.ConclusionsAlthough it was not proven that the association between participation in religious services and self-rated health is mediated by obesity, the research shows the suppression effect of obesity between participation in religious services and self-rated health.     

Peer Reviewed: The Association Between Body Mass Index and Arthritis Among US Adults: CDC’s Surveillance Case Definition

Introduction

The Centers for Disease Control and Prevention modified the surveillance case definition of arthritis to a more stringent form in 2002. To date, the association between arthritis and obesity (an established risk factor for arthritis) has not been examined with the new definition. We describe the association between body mass index (BMI) (kg/m²) and arthritis using the new arthritis case definition to provide a more accurate assessment of the relationship between weight and arthritis among US adults.

Methods

We used data from the 2005 Behavioral Risk Factor Surveillance System (N = 356,112) and univariate and multivariate analyses to assess the relationship between BMI and arthritis among US adults.

Results

Overall, 26% of US adults had self-reported arthritis. Obese respondents (BMI ≥30.0 kg/m²) were 1.9 times more likely to report arthritis compared with normal-weight respondents (BMI <25.0 kg/m²), and distinguishing between obese levels revealed an even greater association between BMI and arthritis (class III obesity [BMI ≥40.0], odds ratio [OR] = 3.3, 95% confidence interval [CI] = 3.1-3.6; class II obesity [BMI 35.0-39.9 kg/m²], OR = 2.5, 95% CI = 2.3-2.7; class I obesity [BMI 30.0-34.9], OR = 1.9, 95% CI = 1.8-2.0).

Conclusion

BMI is an independent risk factor for self-reported arthritis. Maintaining a healthy weight may delay the onset of arthritis. More research is needed to determine the effect of weight loss on the progression of arthritis in overweight individuals.     

Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis

ObjectiveIn recent years, many original studies have shown that skipping breakfast has been associated with overweight and obesity; however, the results of different studies are inconsistent. Therefore, we conducted a systematic review and meta-analysis of observational studies to synthesize the associations between skipping breakfast and the risk of overweight/ obesity.MethodsWe did a systematic search using Pubmed, and Ovid searched up to August 2019. Observational studies (cohort studies and cross-sectional studies) reporting adjusted Odds Ratio or Risk Ratio estimates for the association between breakfast skipping and overweight/obesity (including abdominal obesity). Summary odds ratio (or Risk Ratio) and 95% confidence intervals calculated with a random-effects model.Results45 observational studies (36 cross-sectional studies and 9 cohort studies) were included in this meta-analysis. In cross-sectional studies, The ORs of low frequency breakfast intake per week versus high frequency were 1.48 (95% CI 1.40–1.57; I² = 54.0%; P = 0.002) for overweight/obesity, 1.31 (95% CI 1.17–1.47; I² = 43.0%; P = 0.15) for abdominal obesity. In cohort studies, The RR of low-frequency breakfast intake per week versus high frequency was 1.44 (95% CI 1.25–1.66; I² = 61%; P = 0.009) for overweight/obesity.ConclusionsThis meta-analysis confirmed that skipping breakfast is associated with overweight/obesity, and skipping breakfast increases the risk of overweight/obesity. The results of cohort studies and cross-sectional studies are consistent. There is no significant difference in these results among different ages, gender, regions, and economic conditions.     

Interleukin-10 as a potential regulator of hepcidin homeostasis in overweight and obese children: A cross-sectional study in Taiwan

ObjectiveA sharp increase in the prevalence of obesity and a decline in iron deficiency in children was observed between the two consecutive Nutrition and Health Surveys in Taiwan. The aim of this study was to evaluate the distribution of hepcidin in relation to nutritional status in children.Methods648 children ages 7 to 13 y living in Taipei and New Taipei City were enrolled in this study. Parameters for obesity, iron status, and inflammatory markers were evaluated.ResultsThere were no differences in the prevalence of iron deficiency and iron depletion between normal and overweight/obese children. A V-sharp hepcidin distribution curve was seen in normal weight children and overweight/obese boys. Serum hepcidin levels remained stable in overweight/obese girls during transition from childhood to teenager. Overweight/obese children had increased serum nitric oxide (NO) and interleukin (IL)-1β but decreased IL-10 concentration compared with normal weight children. A strong inverse relationship was found between IL-10 and body mass index (BMI; odds ratio (OR), 0.86, 95% confidence interval [CI], 0.83–0.89). By contrast, positive correlations were observed between BMI and IL-1β (OR, 1.60; 95% CI, 1.29–1.98); and between BMI and NO (OR, 1.04, 95% CI, 1.02–1.07). Multivariate linear regression analysis showed serum hepcidin was significantly correlated with IL-10 (β = 0.26, P < 0.0001).ConclusionsOur results raise the possibility that IL-10 may play a role in iron homeostasis. Decreased circulating IL-10 concentration may temporary protect young overweight/obese girls against the development of iron deficiency. However, long-term decrease in hepcidin concentration may increase the risk for iron overload in overweight/obese children.     

Eating Competence Among Caregivers of Toddlers: Associations With Caregiver and Child Overweight/Obesity

ObjectiveTo examine the association between caregiver eating competence and child overweight/obesity and caregiver obesity.DesignLongitudinal cohort.SettingA large US children's hospital.ParticipantsCaregiver–child dyads (n = 288 with complete data at 2 time points) were sampled in 2017–2019 from those who received care at Nationwide Children's Hospital.Main Outcome Measure(s)Child overweight/obesity at 24 months of age (body mass index [BMI]) z-score >2 per World Health Organization standards and caregiver weight status (underweight/healthy [BMI < 25 kg/m²], overweight [BMI ≥ 25 and < 30 kg/m²], or obese [BMI ≥ 30 kg/m²]).AnalysisLog-binomial models examined the relationship between caregiver eating competence (ecSatter Inventory) at 18 months and child overweight/obesity at 24 months of age. Proportional odds models investigated the relationship between caregivers’ eating competence and weight status.ResultsEating competent caregivers had more than twice the odds (odds ratio, 2.11; 95% confidence interval, 1.30–3.42) of having a lower BMI category and had lower average BMI than noneating competent caregivers. Child overweight/obesity at 24 months did not differ by caregiver eating competence.Conclusions and ImplicationsAlthough child overweight/obesity did not vary by caregiver eating competence, caregiver eating competence was related to their weight status. Longer-term studies are needed to clarify the role of caregiver eating competence as children develop. Promoting caregivers’ eating competence may translate into healthier behaviors and skills for caregivers and their children long term.     

Pre-pregnancy metabolic syndrome and insulin administration in gestational diabetes: A nationwide population-based cohort study

BackgroundThe present study aimed to evaluate whether mothers with obesity/central obesity and metabolic syndrome before gestation are at higher risk of insulin administration in gestational diabetes mellitus (GDM) to diminish the burden of insulin use during pregnancy.MethodsThis was a population-based retrospective cohort study conducted using data from the National Health Information Database of Korea. We identified all deliveries from January 1, 2011 to December 31, 2015 (N = 1,214,655). Among the deliveries, we identified mothers with pre-pregnancy health checkup records and without previous diabetes history (N = 325,208). Hazards of insulin use in GDM were calculated based on pre-pregnancy obesity/central obesity and metabolic syndrome.ResultsHazards of insulin use in GDM increased proportionately with an increase in the pre-pregnancy body mass index (BMI) and waist circumference (WC). After the adjustment for clinical factors, high BMI group (≥30 kg/m²) and high WC group (≥100 cm) were significantly associated with higher hazard ratios (HRs) (HR 4.161, 95% Confidence interval [CI] 3.381–5.121, P < 0.001 and HR 2.563, 95% CI 1.769–3.712, P < 0.001, respectively). The presence of pre-pregnancy metabolic syndrome significantly increased the hazard of insulin use in GDM (0.54% vs. 5.04%). In the presence of obesity (BMI ≥ 25 kg/m²) or central obesity (WC ≥ 85 cm), HRs of insulin use in GDM were 2.637 (95% CI 2.275–3.056) and 1.603 (95% CI 1.023–2.511), respectively, after adjustment for clinical factors.ConclusionsThe presence of pre-pregnancy obesity/central obesity and metabolic syndrome in Korean mothers is associated with increased risk of insulin use in GDM.     

Frailty status is related to general and abdominal obesity in older adults

The association between frailty and obesity may differ according to the heterogeneity of body mass index (BMI) and waist circumference (WC) phenotypes in older adults. We hypothesized that the use of simple indicators of general and abdominal obesity combined, may more accurately represent obesity and allow to further elucidate on how frailty status and its criteria are related to obesity. A sample of 1444 older adults, aged ≥65 years (Nutrition UP 65 study) was included in a cross-sectional analysis. General and abdominal obesity were defined according to World Health Organization BMI and WC cut-offs, and frailty by Fried et al. phenotype. A cluster analysis defined groups according to BMI and WC levels. Overweight (BMI between 25.0 and 29.9 kg/m²; 44.6%), general obesity (BMI ≥30.0 kg/m²; 39.0%), and abdominal obesity (WC >102 cm for men and >88 cm for women) were highly frequent (66.5%). Prefrailty (odds ratio [OR]: 2.33; 95% confidence interval [CI]: 1.52-3.57) and frailty (OR: 2.87; 95% CI: 1.58-5.22) were directly associated with the “general and abdominal obesity” cluster. Regarding frailty criteria, low handgrip strength (OR: 2.29; 95% CI: 1.55-3.38) and weight loss (OR: 0.27; 95% CI: 0.14-0.52) were also associated with this cluster. In this sample of older adults presenting a high frequency of overweight and obesity, prefrailty and frailty are linked to higher levels of adiposity, but only when both general and abdominal obesity are present. Present results emphasize the importance of the evaluation of both BMI and WC in the geriatric clinical practice and suggest that older adults presenting both general and abdominal obesity should be routinely screened for frailty.     

Associations of allostatic load with sleep apnea,insomnia, short sleep duration,and other sleep disturbances: findings from the National Health and Nutrition Examination Survey 2005 to 2008

PurposeTo examine whether allostatic load (AL), a measure of cumulative physiologic dysregulation across biological systems, was associated with sleep apnea, insomnia, and other sleep disturbances.MethodsData from the National Health and Nutrition Examination Survey 2005–2008 were used. AL was measured using nine biomarkers representing cardiovascular, inflammatory, and metabolic system functioning. A total of 3330 US adults aged 18 years and older were included in this study.ResultsThe prevalence of high AL (AL score ≥3) was the highest among African Americans (26.3%), followed by Hispanic Americans (20.3%), whites (17.7%), and other racial/ethnic group (13.8%). After adjustment for sociodemographic and lifestyle factors, high AL was significantly associated with sleep apnea (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.40–2.63), snoring (OR, 2.20; 95% CI, 1.79–2.69), snorting/stop breathing (OR, 2.16; 95% CI, 1.46–3.21), prolonged sleep latency (OR, 1.42; 95% CI, 1.08–1.88), short sleep duration (<6 hours) (OR, 1.35; 95% CI, 1.00–1.82), and diagnosed sleep disorder (OR, 2.26; 95% CI, 1.66–3.08). There was no clear evidence that observed associations varied by sociodemographic characteristics.ConclusionsThis study suggests significant associations of high AL with sleep apnea, sleep apnea symptoms, insomnia component, short sleep duration, and diagnosed sleep disorder among US adults.     

Impact of obesity on influenza compared to pneumonia hospitalization outcomes

ObjectivesPrevious literature has suggested that obesity impacts mortality risk differently in bacterial versus viral infections. This study sought to further elucidate this association in pneumonia versus influenza.DesignRetrospective cohort study.Setting and participantsData were collected from the US Nationwide Readmission Database from 2013 to 2014.MethodsPatients were categorized into three weight groups: normal weight (BMI 18.5–25.0 kg/m²), obese (BMI 30–40.0 kg/m²), and morbidly obese (BMI ≥ 40 kg/m²). To minimize confounding, we excluded patients with a history of smoking, alcoholism, or chronic wasting conditions, as suggested by the Global BMI Mortality Collaboration. To further isolate obesity from baseline differences across cohorts, we performed a three-way propensity matching analysis. The association between body weight and in-hospital all-cause 30-day mortality was assessed using Cox proportional hazard regression analysis.Results132,965 influenza and 34,177 pneumonia hospitalizations were identified. For patients with influenza, obesity (hazard ratio [HR]: 1.51; 95% CI: 1.01–2.26) and morbid obesity (HR: 1.64; 95% CI: 1.10–2.44) were associated with higher in-hospital 30-day mortality compared to normal weight. For pneumonia, obesity (HR, 0.41; 95% CI, 0.20–0.84) and morbid obesity (HR, 0.49; 95% CI, 0.25–0.96) were associated with reduced 30-day mortality compared to normal weight.Conclusions and implicationsObesity may increase 30-day mortality risk during influenza hospitalization but provide mortality benefit in pneumonia, a divergent effect not adequately explained by lower admission threshold.     

Metabolically healthy overweight/obesity and cancer risk: A representative cohort study in Taiwan

ObjectiveMany cancers are caused by overweight; however, cancer risk varies among individuals with obesity. Few studies are addressing the relationship between metabolic obesity phenotypes and cancer. This study investigates the association between metabolically healthy overweight (MHOW) or metabolically healthy obesity (MHO) and cancer incidence.MethodsIn a nationwide, representative community-based prospective cohort study, 5734 Taiwanese adults were classified into eight phenotypes according to body mass index (underweight <18.5; normal weight 18.5–23.9; overweight 24–26.9; and obese ≥27 kg/m²) and metabolic status (healthy/unhealthy). Participants with healthy cardiometabolic blood profiles included in the metabolic syndrome criteria and an absence of hypertension, diabetes, and hyperlipidemia were considered metabolically healthy. We used the Cox proportional hazards models to estimate the adjusted hazard ratio (HR) and 95% confidence intervals (95% CI).ResultsDuring 73,389 person-years of follow-up, 428 incident cancers were identified. Compared to the participants with metabolically healthy normal weight, participants with MHOW (adjusted HR 1.39, 95% CI, 0.90–2.13) or MHO (adjusted HR 1.07, 95% CI, 0.51–2.22) had a tendency toward a higher risk of cancer. These associations were stronger in MHOW (adjusted HR 1.77, 95% CI, 1.09–2.86) or MHO (adjusted HR 1.39, 95% CI, 0.66–2.93) participants younger than 65 years.ConclusionsThis study was the first to investigate the impact of metabolic obesity phenotype on the incidence of cancer in the Taiwanese population. Even in the absence of metabolic abnormalities, overweight, and obesity may cause a modest increase in the risk of developing cancer.     

Excess weight and abdominal obesity in postmenopausal Brazilian women: a population-based study

Background

The menopause is associated with a tendency to gain weight. Several alterations in fat deposits occur, leading to changes in the distribution of body fat. There are strong indications that, in middle age, obesity is associated with increased mortality. This study set out to determine the factors associated with the prevalence of overweight and abdominal obesity in postmenopausal women in a population-based study in Brazil.

Methods

The sample included 456 women, aged 45–69 years, residing in the urban area of Maringa, Parana. Systematic sampling, with a probability proportional to the size of the census sector, was performed. Behavioral, economic, and sociodemographic data were collected, and body mass index (BMI) and waist circumference (WC) were determined.

Results

According to BMI criteria (≥25.0 kg/m²), 72.6% of the women were overweight, and according to WC (≥88 cm), 63.6% had abdominal obesity. Based on logistic regression analysis, the factors that were most closely associated with overweight were: having three or more children (odds ratio (OR): 1.78; 95% confidence interval (CI): 1.06–3.00); and not taking hormone replacement therapy (OR: 1.69; 95% CI: 1.06–2.63). The prevalence of abdominal obesity was positively associated with greater parity (OR: 1.34, 95% CI: 1.05–1.72) and age older than 65 years (OR: 1.50; 95% CI: 1.03–2.19).

Conclusions

This study found that the prevalences of overweight and abdominal obesity were higher for postmenopausal women who had three or more children. Age over 65 years was also a risk factor for abdominal obesity and no use of hormonal replacement therapy was a risk factor for overweight.

     

Elevated body mass index increases the risk of cardiovascular events in hypertensive patients accompanied with obstructive sleep apnea: A cohort study

BackgroundEffects of body mass index (BMI) on cardiovascular events are inconsistent. We aimed to investigate the association of BMI with cardiovascular events in hypertensives with obstructive sleep apnea (OSA).MethodsHypertensives with OSA diagnosed with polysomnography between 2011 and 2013 in UROSAH cohort were followed up till Jan 2021. Outcomes were non-fatal cardiovascular events and cardiac death. Cox regression was used to estimate the relationship of continuous and categorical BMI with total and specific outcomes. Sensitivity analyses were performed by excluding those on OSA treatment or underweight patients. Stratified analyses were conducted by parameters including sex and age.Results2239 hypertensives with OSA were included with 405 normal weight (BMI<25 kg/m²), 1164 overweight (25–29.9 kg/m²) and 670 obesity (≥30 kg/m²). 206 non-fatal cardiovascular events and 18 cardiac death were recorded during 6.6 years follow-up. Compared with normal weight group, overweight (HR=1.53, 95%CI: 1.01–2.32, P = 0.047) and obesity groups (1.85, 1.19–2.86, P = 0.006) showed increased risk for cardiovascular events, significant in obesity group and marginal in overweight group in fully-adjusted model. In specific events, obesity showed significantly elevated HR for non-fatal cardiovascular events (1.64, 1.04–2.60, P = 0.035). Continuous BMI showed significantly increased HR for total and specific events in all models. Sensitivity analysis yielded consistent results. In stratification analysis, stronger association between obesity and cardiovascular events was observed in the young (HR=5.97, P interaction=0.030).ConclusionsBMI is in positive association with cardiovascular events in hypertensives with OSA, emphasizing importance of maintaining healthy BMI for prevention of adverse events in this population, on the basis of guideline-recommended treatment.     

Additive interactions of maternal prepregnancy BMI and breast-feeding on childhood overweight

OBJECTIVE: To examine the interactions of maternal prepregnancy BMI and breast-feeding on the risk of overweight among children 2 to 14 years of age. RESEARCH METHODS AND PROCEDURES: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI >/=95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI >/=30 kg/m(2). The duration of breast-feeding was measured as the weeks of age from birth when breast-feeding ended. RESULTS: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m(2); p < 0.001 for linear trend). Breast-feeding for >/=4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast-feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast-fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). DISCUSSION: The combination of maternal prepregnancy obesity and lack of breast-feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast-feeding in developing childhood obesity intervention programs.     

Medical costs attributable to overweight and obesity in Japanese individuals

ObjectiveWe aimed to reveal the association between body mass index (BMI) and medical costs in the current Japanese population, and to estimate the population attributable fraction (PAF) of medical costs due to overweight and obesity.MethodsA generalized linear mixed model with log link function and gamma distribution was used to evaluate the association between BMI and medical costs in 34,537 beneficiaries of the National Health Insurance aged 40–69 years in Chiba City. Medical cost data were obtained from insurance claims submitted between April 2012 and March 2016. PAFs due to overweight (BMI ≥25.0 and <30.0 kg/m²) and obesity (BMI ≥30.0 kg/m²) were calculated.ResultsOverweight and obesity were significant predictors of excessive medical costs in all age and sex groups. PAF due to overweight and obesity was estimated to be 9.62% (95% confidence interval, 8.52–10.73%). Additionally, PAFs in 40–59-year-old individuals (12.76% in men and 11.63% in women) were greater than those in 60–69-year-old subjects (6.55% in men and 7.80% in women) for both sexes.ConclusionsIn the Japanese population, overweight and obesity are an excessive financial burden with an estimated PAF of 9.62% of total medical costs.