Physical activity in U.S. older adults with diabetes mellitus: prevalence and correlates of meeting physical activity recommendations

OBJECTIVES: To compare the prevalence and correlates of meeting current recommendations for physical activity in older adults with and without diabetes mellitus (DM) in the United States. DESIGN: A cross‐sectional, population‐based sample. SETTING: The 2007 Behavioral Risk Factor Surveillance Survey, which employs random‐digit dialing to interview noninstitutionalized U.S. adults. PARTICIPANTS: Ninety‐nine thousand one hundred seventy‐two adults (18,370 with DM) aged 65 and older. MEASUREMENTS: The age‐adjusted prevalence and the odds ratios for physical activity patterns (defined on the basis of the physical activity guidelines from the American Diabetes Association (ADA 2007) and the Department of Health and Human Services (DHHS 2008)) were obtained using multiple logistic regression analyses. The correlates of meeting physical activity recommendations were assessed using log‐binomial regression analyses. RESULTS: Overall, 25% and 42% of older adults with diabetes mellitus met recommendations for total physical activity based on the ADA 2007 and the DHHS 2008 guidelines, respectively. Adults with DM were 31% to 34% (P<.001) less likely to engage in physical activity at recommended levels and 13% to 19% (P<.001) less likely to be physically active at insufficient levels than those without DM. Analyses limited to participants who reported no disability yielded similar results. In adults with DM, older age (≥75); being female; being non‐Hispanic black; and having obesity, coronary heart disease, and disability were associated with less likelihood, whereas advanced educational status was associated with greater likelihood of meeting physical activity recommendations. CONCLUSION: In the United States, efforts to boost physical activity participation in older adults with DM are needed.     

Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China

BACKGROUND: Over the past two decades, China has enjoyed impressive economic development, and her citizens have experienced many remarked changes in their lifestyle. These changes are often associated with an increase in obesity and chronic disease. METHODS: In this meta-analysis, based on nationally representative data, we studied the current prevalence of obesity and the trends in obesity, mortality and morbidity in China. RESULTS: Between 1992 and 2002, the prevalence of overweight and obesity increased in all gender and age groups and in all geographic areas. Using the World Health Organization body mass index cut points, the combined prevalence of overweight and obesity increased from 14.6 to 21.8%. The Chinese obesity standard shows an increase from 20.0 to 29.9%. The annual increase rate was highest in men aged 18-44 years and women aged 45-59 years (approximately 1.6 and 1.0% points, respectively). In general, male subjects, urban residents, and high-income groups had a greater increase. With the increase in overweight and obesity, obesity-, and diet-related chronic diseases (e.g., hypertension, cardiovascular disease (CVD), and type 2 diabetes) also increased over the past decade and became a more important preventable cause of death. Hypertension increased from 14.4% in 1991 to 18.8% in 2002 in adults; in older adults aged 35-74 years, it increased from 19.7 to 28.6%. Between 1993 and 2003, the prevalence of CVD increased from 31.4 to 50.0%; diabetes increased from 1.9 to 5.6%. During 1990-2003, although total mortality rate (per 100 000) decreased, overall the mortality rate and contribution (as percentages) to total death of obesity-related chronic disease increased, in particular, in rural areas. Mortality rate (per 100 000) of CVD increased from 128 to 145 and its contribution to total death, 27 to 32%, in rural areas; the figures decreased slightly in urban areas. The mortality rate of 'nutrition, endocrinology and metabolism-related disease' (NEMD) increased in both rural and urban areas between 1990 and 2000, 8.0 to 10.6 and 4.9 to 5.3, respectively. The current prevalence of hypertension, dyslipidaemia, metabolic syndrome, and diabetes among Chinese adults is approximately 20, 20, 15, and 3%, respectively. CONCLUSION: The prevalence of overweight and obesity and obesity-related chronic diseases have increased in China in the past decade. Our findings provide useful information for the projection of future trends and the formulation of national strategies and programmes that can address the challenges of the growing obesity and chronic disease epidemic.     

Prevalence of falls among older adults in the Gulf Cooperation Council countries: A systematic review and meta-analysis

AimThe aim of this study was to conduct a systematic review and meta-analysis for studies that have examined the prevalence and risk factors of falls in older adults living in the Gulf Cooperation Council countries (GCC).MethodsA literature search was performed using PubMed, Web of Science, Physiotherapy Evidence Database; and SCOPUS up to October 2018 to identify studies that have examined prevalence, risk factors, or consequences of falls in older adults living in the GCC.ResultsA total of 6 studies met the inclusion criteria. The pooled prevalence of falls among older adults residing in GCC countries was 46.9%. Falls among included studies were associated with older age, female gender, low educational level, and number of medications.ConclusionsThe study shows a high prevalence of falls in older adults living in the GCC countries. The risk factors in the current study must be interpreted with caution, since some of the included studies did not report any risk factors. Due to the limited number of evidence evaluating risk factors and consequences of falls in the GCC countries population, a further longitudinal research is needed.     

The prevalence and trends of overweight,obesity and nutrition‐related non‐communicable diseases in the Arabian Gulf States

This paper reviews studies on the prevalence of overweight, obesity and related nutrition‐related non‐communicable diseases in Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and the UAE. Obesity is common among women; while men have an equal or higher overweight prevalence. Among adults, overweight plus obesity rates are especially high in Kuwait, Qatar and Saudi Arabia, and especially among 30–60 year olds (70–85% among men; 75–88% among women), with lower levels among younger and elderly adults. The rate of increase in obesity was pronounced in Saudi Arabia and Kuwait. Prevalence of obesity is high among Kuwaiti and Saudi pre‐schoolers (8–9%), while adolescent overweight and obesity are among the highest in the world, with Kuwait having the worst estimates (40–46%); however, comparison of child data is difficult because of differing standards. Among nutrition‐related non‐communicable diseases, hypertension and diabetes levels are very high and increase with age, with the UAE performing the worst because of a rapid rate of increase between 1995 and 2000. Additional monitoring of the prevalence of metabolic syndrome and cancers is necessary. Nationally representative longitudinal surveys with individual, household and community‐level information are needed to determine the importance of various factors that contribute to these troubling trends.     

深圳市福田区老年人慢性病患病现况调查

目的分析深圳市福田区老年人慢性疾病患病情况。方法采用随机抽样、集中调查和入户调查相结合的方法对福田区20个社区60岁以上常住居民慢性病患病现况进行调查。结果高血压患病率为61.6%,血脂异常患病率为79.3%,糖尿病患病率为20.2%,肾功能下降患病率9.1%,男女慢性病患病率差异均无统计学意义（P〉0.05）,各年龄组差异有统计学意义（P〈0.01）。慢性病危险因素水平：肥胖率21.8%、缺乏锻炼率72.5%,吸烟率12.6%,吸烟、饮酒在不同性别患病率差异均有统计学意义（P〈0.01）,各年龄组患病率差异均无统计学意义（P〉0.05）。结论福田区老年人慢性病患病率及危险因素患病率较高,应采取综合健康管理干预措施,加强危险因素的前期干预,减少慢性疾病的发生,提高生活质量。     

Childhood obesity in developing countries: epidemiology, determinants, and prevention

Rapidly changing dietary practices and a sedentary lifestyle have led to increasing prevalence of childhood obesity (5-19 yr) in developing countries recently: 41.8% in Mexico, 22.1% in Brazil, 22.0% in India, and 19.3% in Argentina. Moreover, secular trends indicate increasing prevalence rates in these countries: 4.1 to 13.9% in Brazil during 1974-1997, 12.2 to 15.6% in Thailand during 1991-1993, and 9.8 to 11.7% in India during 2006-2009. Important determinants of childhood obesity include high socioeconomic status, residence in metropolitan cities, female gender, unawareness and false beliefs about nutrition, marketing by transnational food companies, increasing academic stress, and poor facilities for physical activity. Childhood obesity has been associated with type 2 diabetes mellitus, the early-onset metabolic syndrome, subclinical inflammation, dyslipidemia, coronary artery diseases, and adulthood obesity. Therapeutic lifestyle changes and maintenance of regular physical activity through parental initiative and social support interventions are the most important strategies in managing childhood obesity. Also, high-risk screening and effective health educational programs are urgently needed in developing countries.     

Epidemiology of glucose intolerance and associated factors in Uzbekistan: a survey in Sirdaria province.

Prevalence of glucose intolerance and other noncommunicable diseases has been examined in subjects aged 35 years and over in a rural community in Sirdaria, which lies in the central part of Uzbekistan. Diabetes and impaired glucose tolerance (IGT) were diagnosed according to the recommendations of the latest WHO Study Group on diabetes. The overall response to the survey was 82%. Crude prevalence of diabetes was 4% in women and 11% in men. However, young men were under-represented and the age-standardised prevalence was 7.5% in women and 10.0% in men. Subjects with abnormal glucose tolerance had higher mean body mass index (BMI), waist-hip ratio (WHR), systolic and diastolic blood pressures and prevalence of hypertension, and were less physically active than those with normal glucose tolerance. Women were younger, had higher mean BMI, similar WHR, lower mean systolic and diastolic blood pressures and were less physically active than men. Approximately one-third of all subjects were centrally obese (WHR 0.85 or above for women and 0.95 or above for men). Of these, one-third had coexisting glucose intolerance. It is concluded that glucose intolerance and central obesity are common in this rural Central Asian community.     

Prevalence of obesity in India: A systematic review

Recent studies have reported that globally, more than 1.9 billion adults are overweight and 650 million are obese. Approximately 2.8 million deaths are reported as a result of being overweight or obese. Due to the consumption of energy dense food (i.e. unhealthy food habits), sedentary life style, lack of health care services and financial support, the developing countries are facing high risk of obesity and their adverse consequences (i.e. diabetes, ischemic heart disease, etc). In India, more than 135 million individuals were affected by obesity. The prevalence of obesity in India varies due to age, gender, geographical environment, socio-economic status, etc. According to ICMR-INDIAB study 2015, prevalence rate of obesity and central obesity are varies from 11.8% to 31.3% and 16.9%–36.3% respectively. In India, abdominal obesity is one of the major risk factors for cardiovascular disease (CVDs). Various studies have shown that the prevalence of obesity among women were significantly higher as compared to men. Obesity is one of the main medical and financial burdens for the government. This problem of obesity can be preventable by spreading public awareness about obesity and its health consequences. Governmental agencies should promote the benefits of healthy life style, food habits and physical activity. The aim of this article is to report the prevalence of obesity in different regions of India and highlight the problem areas.     

Prevalence and associated factors of cardiovascular diseases among men and women aged 45 years and above: Analysis of the longitudinal ageing study in India, 2017–2019

ObjectiveEpidemiological studies on the prevalence and associated factors of cardiovascular diseases (CVDs) representative of all states of India among middle-aged and elderly are not much reported. The present study estimates the prevalence and associated factors of cardiovascular diseases across Indian states among men and women aged ≥45 years.MethodsWe used data from the Longitudinal Ageing Study in India wave 1 (2017–2019), which included a final analytical sample size of 56,935 adults and their spouses aged 45 years and above. We estimated CVDs prevalence for sociodemographic and behavioural variables, and multivariable logistic regression was used to assess the association between behavioural factors and CVDs in both men and women.ResultsThe prevalence of CVDs was 5.2% among adults ≥45 years (women: 4.6%; men: 5.9%), hypertension was 46.7% (women:48.9%; men:44%). Men and women have a similar prevalence of diabetes (11.9%) and cholesterol (2.3%). Prevalence of physical inactivity was 30.3% (women:27%; men:34.1%). Hypertension (adjusted odds ratio; aOR women:2.60, 95% CI: 2.08–3.25, men:1.88, 95% CI 1.54–2.29), hypercholesterolemia (aOR women:1.70; 95% CI 1.07–2.69, men 3.55; 95% CI 2.66–4.74), diabetes (aOR women:2.53; 95% CI 1.83–3.51, men:1.77 95% CI 1.44–2.17), obesity, physical inactivity, and smoking in men were significantly associated with CVDs.ConclusionThe prevalence of CVDs and lifestyle risk factors among middle-aged and elderly poses severe concerns regarding noncommunicable disease (NCD) healthcare services provided in a lower-middle-income country like India. The key to preventing CVDs is controlling hypertension, diabetes, hypercholesterolemia, and increasing physical activity among adults aged ≥45 years.     

Self-Reported Asthma Prevalence in Adults in California

Data from the 1998 California Behavioral Risk Factor Surveillance System (BRFSS) were examined. The BRFSS is an ongoing statewide telephone survey of randomly selected adults. The prevalence of self-reported lifetime asthma was 13.6% and the prevalence of active asthma was 6.6%. Prevalence rates were highest among African-Americans and lowest among Hispanics. Associations between asthma and gender, obesity, smoking, depression, migraine, and income were also examined. Active asthma was associated with low income, smoking, obesity, migraine, and depression in women, but not in men. The relationships observed suggest complex interactions between asthma and other chronic conditions, gender, and life-style.     

Prevalence and associated factors of overweight and obesity in older rural Chinese

Background:  The elderly obese are at increased risk of mortality and morbidity of many obesity-related chronic diseases, such as hypertension, diabetes and coronary heart disease. This study was designed to investigate the epidemiological features of overweight and obesity in older rural Chinese.
Methods:  A cross-sectional survey was conducted during 2004–2005, which undertook multistage cluster sampling method to select a representative sample in Fuxin county, Liaoning province, China. A total of 6643 elderly persons with age ≥60 years was examined. At baseline, lifestyle and other factors were obtained. Overweight and obesity were defined according to the World Health Organization classification and Chinese criteria, respectively.
Results:  Overall, using World Health Organization criteria, the prevalence of overweight and obesity were 13.8 and 1.7%, respectively. Using Chinese criteria, the corresponding figures were 21.2 and 4.0%, respectively. Multivariate logistic regression showed that women, Mongolian nationality, high levels of education and current drinking status were risk factors for overweight or obese participants. Increasing age, high levels of physical activity and current smoking status were shown as protective factors. A positive association was also observed between body mass index and female sex, Mongolian nationality, education levels and current drinking status. However, there was an inverse association between body mass index and age, physical activity levels and current smoking status.
Conclusion:  Although the prevalence of obesity was low, the prevalence of overweight was relatively high in older rural Chinese, especially in female adults. Unfavourable lifestyles, gender, age, ethnicity, education levels and physical activity were associated with the prevalence of these health conditions.     

云南省布朗族成人非酒精性脂肪性肝病流行特点研究

目的 调查云南省勐海县布朗族成人非酒精性脂肪性肝病(NAFLD)的流行特点及其它代谢性疾病的患病情况.方法 2017年2～3月对布朗族聚集且交通便利的5个行政村、18岁及以上3365名居民进行普查,纳入研究3258名.采用问卷调查、体格检查、实验室检测和超声检查.以2010年第六次全国人口普查的人口构成为标准人口构成,...     

Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns

The purposes of this systematic review were to present and compare recent estimates of the prevalence of overweight and obesity in school‐aged youth from 34 countries and to examine associations between overweight and selected dietary and physical activity patterns. Data consisted of a cross‐sectional survey of 137 593 youth (10–16 years) from the 34 (primarily European) participating countries of the 2001–2002 Health Behaviour in School‐Aged Children Study. The prevalence of overweight and obesity was determined based on self‐reported height and weight and the international child body mass index standards. Logistic regression was employed to examine associations between overweight status with selected dietary and physical activity patterns. The two countries with the highest prevalence of overweight (pre‐obese + obese) and obese youth were Malta (25.4% and 7.9%) and the United States (25.1% and 6.8%) while the two countries with the lowest prevalence were Lithuania (5.1% and 0.4%) and Latvia (5.9% and 0.5%). Overweight and obesity prevalence was particularly high in countries located in North America, Great Britain, and south‐western Europe. Within most countries physical activity levels were lower and television viewing times were higher in overweight compared to normal weight youth. In 91% of the countries examined, the frequency of sweets intake was lower in overweight than normal weight youth. Overweight status was not associated with the intake of fruits, vegetables, and soft drinks or time spent on the computer. In conclusion, the adolescent obesity epidemic is a global issue. Increasing physical activity participation and decreasing television viewing should be the focus of strategies aimed at preventing and treating overweight and obesity in youth.     

Prevalence and correlates of overweight and obesity among older adults: findings from the Canadian National Population Health Survey

BACKGROUND: The prevalence of obesity among elderly persons in industrialized countries ranges from 15% to 20%. Little is known about variations of overweight within subgroups of the elderly population. This study examined the factors associated with overweight and obesity among older men and women. METHODS: Data for 12,823 community-dwelling persons aged 65 and older from the 1996-1997 Canadian National Population Health Survey were examined. Predictors of overweight (body mass index [BMI] = 25.0-29.9 kg/m2) and obesity (BMI = >30 kg/m2) relative to normal weight (BMI = 20.0-24.9 kg/m2) were examined using logistic regression analyses. Analyses were stratified by gender. The predictor variables included age, education, marital status, place of birth, region, smoking status, alcohol use, chronic conditions, physical activity, functional limitations, self-rated health, social support, and psychological distress. RESULTS: Overall, 39% and 13% of Canadian older adults were classified as overweight and obese, respectively. Some of the risk factors for overweight were male gender, low education, being married, Canadian born, residence in the Atlantic provinces, no use of alcohol, comorbidity, physical inactivity, and limited functional status. Risk factors for obesity were similar to those for overweight except for being unmarried; American, European, and Australian born; lower and higher levels of alcohol use; poor self-rated health; and psychological distress. CONCLUSIONS: The results could lead to more effective weight-control interventions that are designed to promote increased physical activity and healthy eating habits among obese older individuals.     

Obesity as a poverty‐related emerging nutrition problems: the case of Indonesia

Obesity is a major contributor to the global burden of chronic disease and disability. In developing countries like Indonesia, obesity often co‐exists with undernutrition. Data from national basic health research 2007 showed that overnutrition was found among all age groups, on a double digit scale, with similar magnitude in urban and rural areas and higher prevalence in adult female. In contrary to 14% undernourished children under the age of 5 years, 12% of their counterparts were overnourished; for 6–14 years 10% vs. 6%; and for 15 years and above 15% vs. 19%. The purpose of the review is to raise awareness on the increasing obesity problem and to set recommendations to prevent obesity. Stunted adults in developing countries are 1.2 times more likely to be overweight than non‐stunted adults. Approaches to overcoming obesity in adulthood emphasize dietary changes, increasing physical activity and behaviour modification. It is important for Indonesia to target nutrition intervention for female adolescents, pregnant woman to first 2 years of life, initiate nutrition education for school‐age children and disseminate Holistic Healthy Framework Approach with key message ‘Initiate healthier food choices’. Prompt Nutrition Guidelines and the use of lower body mass index cut‐off should be considered.     

Risk factors associated with the dramatic increase in the prevalence of diabetes in the adult Chinese population in Qingdao,China

Objective To investigate the major risk factors and their association with the dramatic increase in the prevalence of diabetes from 2001–2002 to 2006 in Qingdao, China. Methods Population‐based cross‐sectional studies on diabetes were performed in 4598 men and 7026 women aged 35–74 years. The 2006 World Health Organization diagnostic criteria for diabetes were used. Results The crude prevalence of diabetes was 11.3% in both men and women in urban areas and 5.3% and 8.9% in rural areas in 2001–2002. This increased to 19.2% and 16.1% in urban areas and 14.2% and 13.8% in rural areas in 2006 for men and women, respectively. The increase in diabetes prevalence from 2001–2002 to 2006 was paralleled by an increased body mass index in rural areas but not in urban areas. The major risk factors associated with diabetes were age, family history of diabetes, obesity, hypertension and high triglycerides. The multivariate adjusted odds ratio and 95% confidence interval for diabetes corresponding to a one standard deviation increase in waist circumference was 1.81 (1.47, 2.23) in urban men, 1.64 (1.26, 2.13) in rural men, 1.98 (1.66, 2.37) in urban women and 2.02 (1.63, 2.51) in rural women. Low socio‐economic classes had a higher risk for diabetes in urban areas but a lower risk in rural areas, both associated with increased waist circumference. Conclusion Established risk factors are of great importance for the prevalence of diabetes in the urban and rural Chinese populations and changes in these factors could explain the recent dramatic increase in diabetes prevalence, particularly in rural areas. Considering the high prevalence of obesity and physical inactivity, intervention is urgently required in China.     

Health correlates of overweight and obesity in adults aged 50 years and over: results from the Survey of Health, Ageing and Retirement in Europe (SHARE). Obesity and health in Europeans aged > or = 50 years

QUESTIONS UNDER STUDY: To examine the association between overweight/obesity and several self-reported chronic diseases, symptoms and disability measures. METHODS: Data from eleven European countries participating in the Survey of Health, Ageing and Retirement in Europe were used. 18,584 non-institutionalised individuals aged 50 years and over with BMI > or = 18.5 (kg/m2) were included. BMI was categorized into normal weight (BMI 18.5-24.9), overweight (BMI 25.0-29.9) and obesity (BMI > or = 30). Dependent variables were 13 diagnosed chronic conditions, 11 health complaints, subjective health and physical disability measures. For both genders, multiple logistic regressions were performed adjusting for age, socioeconomic status and behaviour risks. RESULTS: The odds ratios for high blood pressure, high cholesterol, diabetes, arthritis, joint pain and swollen legs were significantly increased for overweight and obese adults. Compared to normal-weight individuals, the odds ratio (OR) for reporting > or = 2 chronic diseases was 2.4 (95% CI 1.9-2.9) for obese men and 2.7 (95% CI 2.2-3.1) for obese women. Overweight and obese women were more likely to report health symptoms. Obesity in men (OR 0.5, 95% CI 0.4-0.6), and overweight (OR 0.5, 95% CI 0.4-0.6) and obesity (OR 0.4, 95% CI 0.3-0.5) in women, were associated with poorer subjective health (i.e. a decreased risk of reporting excellent, very good or good subjective health). Disability outcomes were those showing the greatest differences in strength of association across BMI categories, and between genders. For example, the OR for any difficulty in walking 100 metres was non-significant at 0.8 for overweight men, at 1.9 (95% CI 1.3-2.7) for obese men, at 1.4 (95% CI 1.1-1.8) for overweight women, and at 3.5 (95% CI 2.6-4.7) for obese women. CONCLUSIONS: These results highlight the impact of increased BMI on morbidity and disability. Healthcare stakeholders of the participating countries should be aware of the substantial burden that obesity places on the general health and autonomy of adults aged over 50.     

Prevalence of obesity and overweight among adults in Iran

The prevalence of overweight and obesity in most developed and developing countries have been increasing markedly over the past two decades. This increase includes all ages, genders, racial and ethnic groups, income, and educational levels. This study examined the prevalence of overweight and obesity among adults aged 25–55 years in Shiraz (Southern Iran). The data are based on a random multistage sample survey of 2282 married adults (1141 pairs) living is Shiraz, whose heights and weights were measured in the 2002–2003 academic year. The prevalence of overweight or obesity (body mass index ≥ 25) was 49.7% in men and 63.9% in women. The prevalence of obesity (body mass index ≥ 30) was 10.5% and 22.5% in men and women, respectively, which shows an increased secular change of 5.8% in men and 17.4% in women during a 14‐year period. Overweight and obesity are common in Iran. Obesity and overweight were significantly more common among women than among men (P‐valve = 0.000). There is a need to establish programmes for prevention and treatment of obesity especially Iranian's women.     

Prevalence and correlates of physical inactivity among older adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015

Malaysia has an increasingly aging population. Despite the substantial benefits of physical activity for healthy aging, older adults are considered the most physically inactive segment of the Malaysian population. The purpose of this study was to determine the prevalence of physical inactivity among older adults in Malaysia and its correlates. We analysed data on adults aged ≥60 years (n = 3790) from the National Health and Morbidity Survey (NHMS) 2015, a cross-sectional, nationwide population-based survey covering information on socio-demographic characteristics, physical activity and other lifestyle-related variables, health conditions, and functional limitations. Individuals included in this study were classified as physically active or physically inactive. Logistic regression was used to determine factors associated with physical inactivity. The overall prevalence of physical inactivity among older adults aged ≥60 years old was 48.8%. Physical inactivity was significantly more prevalent among females, older age groups, Indians, those being single/widowed/divorced, those with no formal education, those who reported high sedentary time (≥7 h/day), those with diabetes, anaemia, and functional limitations (p < 0.001). In fully adjusted analyses, females, older age, high household income (≥MYR4000), inadequate fruits and vegetables consumption (<5 servings/day), high sedentary time, having diabetes, and having mobility impairment were all associated with physical inactivity. Approximately half of the Malaysian older population are physically inactive. Identifying the correlates of physical inactivity among Malaysian older adults will help to develop public health policies and interventions that encourage active living among older people and promote healthy aging in Malaysia.     

Roles of gender, obesity, and lifestyle-related diseases in alcoholic liver disease: Obesity does not influence the severity of alcoholic liver disease

Aim: To elucidate gender differences and the influence of obesity and/or metabolic syndrome‐related fatty liver on alcoholic liver disease (ALD), we analyzed characteristic features of ALD. Methods: We investigated 266 ALD patients (224 males and 42 females) without hepatocellular carcinoma stratified by gender and the presence of cirrhosis. Male and female patients matched for age and total ethanol intake were also analyzed. A diagnosis of ALD was based on alcohol intake (>70 g daily for more than 5 years), clinical features, and exclusion of other liver diseases. The prevalence of obesity, lifestyle‐related diseases, and psychological disorders were assessed. Results: The prevalence of psychological disorders showed a significant gender difference among all ALD patients (12% in males versus 43% in females, P < 0.001), as well as in patients matched for age and total ethanol intake. There were 156 cirrhotic patients. Absence of dyslipidemia, presence of diabetes, and high total ethanol intake were selected as independent predictors of cirrhosis in males by multivariate analysis after excluding laboratory data of liver function tests. The prevalence of obesity was significantly lower in cirrhotic male patients than in non‐cirrhotic male patients (34% vs. 20%, P = 0.023). Among females, there were no significant predictors of cirrhosis on multivariate analysis after eliminating liver function tests. The prevalence of obesity and diabetes was similar in non‐cirrhotic and cirrhotic female patients. The prevalence of psychological disorders was 47% in cirrhotic females with ALD. Conclusions: Obesity was not common in cirrhotic ALD. Psychological disorders seem to be important for female ALD.