Temporal Eating Patterns and Eating Windows among Adults with Overweight or Obesity

We aim to describe temporal eating patterns in a population of adults with overweight or obesity. In this cross-sectional analysis, data were combined from two separate pilot studies during which participants entered the timing of all eating occasions (>0 kcals) for 10–14 days. Data were aggregated to determine total eating occasions, local time of the first and last eating occasions, eating window, eating midpoint, and within-person variability of eating patterns. Eating patterns were compared between sexes, as well as between weekday and weekends. Participants (n = 85) had a median age of 56 ± 19 years, were mostly female (>70%), white (56.5%), and had a BMI of 31.8 ± 8.0 kg/m². The median eating window was 14 h 04 min [12 h 57 min–15 h 21 min], which was significantly shorter on the weekend compared to weekdays (p < 0.0001). Only 13.1% of participants had an eating window <12 h/d. Additionally, there was greater irregularity with the first eating occasion during the week when compared to the weekend (p = 0.0002). In conclusion, adults with overweight or obesity have prolonged eating windows (>14 h/d). Future trials should examine the contribution of a prolonged eating window on adiposity independent of energy intake.     

Eating Behavior,Physical Activity and Exercise Training: A Randomized Controlled Trial in Young Healthy Adults

Regular physical activity (PA) is an important part of the treatment of several medical conditions, including overweight and obesity, in which there may be a weakened appetite control. Eating behaviour traits influence weight control and may be different in active and sedentary subjects. This paper reports the relationships between the time spent in sedentary behaviour and physical activity (PA) of different intensity, and eating behaviour traits in young, healthy adults. Additionally, it reports the results of a six-month-long, randomized, controlled trial to examine the effect of an exercise intervention on eating behaviour traits. A total of 139 young (22.06 ± 2.26 years) healthy adults (68.35% women) with a Body Mass Index (BMI) of 24.95 ± 4.57 kg/m² were enrolled. Baseline assessments of habitual PA were made using wrist-worn triaxial accelerometers; eating behaviour traits were examined via the self-reported questionnaires: Binge Eating, Three-Factor Eating Questionnaire-R18 and Control of Eating Questionnaire. The subjects were then randomly assigned to one of three groups: control (usual lifestyle), moderate-intensity exercise (aerobic and resistance training 3¨C4 days/week at a heart rate equivalent to 60% of the heart rate reserve (HRres) for the aerobic component, and at 50% of the 1 repetition maximum (RM) for the resistance component), or vigorous-intensity exercise (the same training but at 80% HRres for half of the aerobic training, and 70% RM for the resistance training). At baseline, sedentary behaviour was inversely associated with binge eating (r = −0.181, p < 0.05) and with uncontrolled eating (r = −0.286, p = 0.001). Moderate PA (MPA) was inversely associated with craving control (r = −0.188, p < 0.05). Moderate-to-vigorous PA (MVPA) was directly associated with binge eating (r = 0.302, p < 0.001) and uncontrolled eating (r = 0.346, p < 0.001), and inversely associated with craving control (r = −0.170, p < 0.015). Overall, PA was directly associated with binge eating (r = 0.275, p = 0.001), uncontrolled eating (r = 0.321, p < 0.001) and emotional eating (r = 0.204, p < 0.05). Additionally, only emotional eating was modified by the intervention, increasing in the vigorous-intensity exercise group (p < 0.05). In summary, we observed that time spent in sedentary behaviour/PA of different intensity is associated with eating behaviour traits, especially binge eating in young adults. In contrast, the six-month exercise intervention did not lead to appreciable changes in eating behaviour traits.     

Analysis of the Correlation between Meal Frequency and Obesity among Chinese Adults Aged 18–59 Years in 2015

This study aimed to investigate the relationship between meal frequency and obesity in Chinese adults aged 18 to 59 years. The data came from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance (CACDNS 2015) and provincial dietary environment data from the 2015 National Statistical Yearbook. A total of 34,206 adults aged 18 to 59 who took part in the diet survey were selected as the study participants. A two-level multivariate logistic regression model was used to adjust for the socioeconomic and nutritional status of individuals. For parameter estimation, a numerical integral approach was used to analyze the relationship between meal frequency (including meals at home, the workplace or school dining halls, and eating away from home) and obesity. A two-level “provincial–individual” logistic multivariate regression analysis was performed with obesity as the dependent variable. The two-level multivariate analysis of variance model fitting results showed that after adjusting for the effects of gender, age, occupation, education, marital status, family per capita annual income, provincial gross domestic product (GDP), restaurant industry turnover, consumer price index of EAFH food, and energy intake, the frequency of eating at home was not associated with obesity (all p > 0.05); the frequency of eating at dining halls ≥1 to <2 times per day (OR = 0.784, p = 0.0122) showed a negative association with obesity; the frequency of eating away from home < 1 times per day and ≥1 to <2 times per day were positively correlated with obesity (<1 time per day: OR = 1.123, p = 0.0419; ≥1 to <2 times per day: OR = 1.249, p = 0.0022). The results of the two-level random-intercept logistic multivariate mixed-effects prediction model for obesity in adults aged 18 to 59 years showed that no statistical association was noticed between the frequency of eating at home and obesity in adults aged 18 to 59 years. However, adults who ate out < 1 time and ≥1 to <2 times a day showed higher risks of obesity than those who did not eat out, with OR = 1.131 (95% CI 1.012–1.264) and OR = 1.258 (95% CI 1.099–1.440), while adults who ate at school and workplace dining halls ≥1 to <2 times a day may have a reduced risk of obesity, with OR = 0.790 (95% CI 0.656–0.951). This result could not be found based on the definition of eating out in previous studies. Therefore, it is recommended to exclude nonprofit collective canteens such as school and workplace dining halls from the definition of eating away from home, and to redefine eating out in terms of health effects. At the same time, it is also recommended to strengthen collective nutritional interventions around canteens, improve the nutritious meal system in school and workplace canteens, and create healthy canteens.     

Zinc Nutritional Status and Risk Factors of Elderly in the China Adult Chronic Disease and Nutrition Surveillance 2015

Objectives: To analyze the serum zinc nutrition status of the Chinese elderly, and to assess the risk factor for zinc deficiency. Methods: 3727 elderly people over 60 years old were randomly selected from 302 monitoring points in 31 provinces of China Adult Chronic Disease and Nutrition Surveillance (CACDNS) 2015. Blood samples were selected from the biological sample bank of CACDNS 2015 and the basic information were collected by questionnaires. The criteria of serum zinc deficiency recommended by the International Zinc Nutrition Consulting Group (IZiNCG) were adopted, and the related factors were also analyzed. Results: The median serum zinc concentration of Chinese elderly was 99.2 (84.3~118.7) μg/dL. The overall adjusted prevalence of zinc deficiency was 8.68%, with a 95% confidence interval (CI) of 7.74% and 9.61%. Significant differences were found in different sex, age groups, Body Mass Index (BMI), residence region, race and education level in terms of serum zinc status in the elderly (p < 0.05). Participants who are males, aged above 70y, with BMIs of less than 18.5 kg/m², living in rural areas, minority, and with the lowest income had a higher prevalence of zinc deficiency in the subgroups under different classifications. The risk of zinc deficiency in the elderly over 70y was 1.44 higher than those aged 60–69y (OR = 1.44, 95%CI 1.14–1.82), and the minority elderly has a 1.39 higher risk than Han nationality (OR = 1.39, 95%CI 1.01–1.91), while overweight/obesity and female elderly were at lower risk (OR < 1, p < 0.05). Conclusions: The overall prevalence of zinc deficiency in the elderly was highest in all adults in the CACDNS. It is recommended that the male elderly, over 70 years, and the minority elderly should pay more attention to the zinc nutrition status of their own.     

Eating Speed Is Associated with the Presence of Sarcopenia in Older Patients with Type 2 Diabetes: A Cross-Sectional Study of the KAMOGAWA-DM Cohort

To determine the relationship between eating speed and the presence of sarcopenia in older patients with type 2 diabetes (T2D), in this cross-sectional study, patient eating speeds were classified as “fast-”, “normal-” and “slow-speed eating.” A multifrequency impedance analyzer was used to evaluate patient body compositions. Sarcopenia was defined as having both low muscle strength, a handgrip strength <28 kg for men and <18 kg for women, and low skeletal muscle mass as a skeletal muscle mass index <7.0 kg/m² for men and <5.7 kg/m² for women. Among 239 individuals, the frequencies of fast-, normal-, and slow-speed eating were 47.3%, 32.2%, and 20.5%, respectively; and the prevalence of sarcopenia was 15.9%. Patients with a slow eating speed had greater prevalence of low skeletal muscle mass, low muscle strength, and sarcopenia than those with a fast or normal eating speed. After adjusting for covariates, compared to slow eaters, the odds ratio of having sarcopenia among fast- and normal-speed eaters was 0.31 [95% CI: 0.12–0.80] and 0.18 [95% CI: 0.06–0.53], respectively. Having a slow eating speed is associated with a heightened risk of sarcopenia in older patients with T2D.     

Sarcopenia,Obesity, Sarcopenic Obesity and Risk of Poor Nutritional Status in Polish Community-Dwelling Older People Aged 60 Years and Over

Poor nutritional status (PNS) is a modifiable factor determining abnormalities in body composition-sarcopenia, obesity, and sarcopenic obesity (SO). We aimed to assess the prevalence of these conditions and their association with PNS in 211 community-dwelling older adults. Sarcopenia was diagnosed based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recommendations. Obesity was diagnosed with the Percent Body Fat (>42% in women and >30% in men). Subjects fulfilling the criteria for obesity and concomitantly with reduced lower and/or upper limbs muscle strength and muscle mass (ALM/BMI < 0.512 in women and <0.789 in men) were classified as SO phenotype. Participants without obesity and sarcopenia were categorized as ‘normal’ phenotype. Nutritional status was estimated with the Mini Nutritional Assessment, and a score of <24 indicated PNS. In total, 49.8% participants had abnormal body composition (60.7% men and 42.5% women; p = 0.001). Sarcopenia, obesity, and SO were diagnosed in 10%, 32.7%, and 7.1% of subjects. PNS was found in 31.3% of the study sample. Its prevalence differed between phenotypes: 81% in sarcopenia, 60% in SO, 14.5% in obesity, and 28.3% in the ‘normal’ phenotype group (p = 0.000). Based on the results, abnormal body composition is prevalent in elderly subjects. Sarcopenia and SO are often associated with PNS.     

河北省儿童青少年在外就餐相关因素及与超重肥胖的关系

  目的  分析河北省6~17岁儿童青少年在外就餐现状及其与超重肥胖的关系,为指导儿童青少年建立健康的饮食习惯和遏制肥胖流行趋势提供参考。  方法  调查数据来自2016—2017年中国儿童与乳母营养健康状况监测,通过问卷调查和体格检查收集河北省12个监测点3 330名6~17岁儿童青少年最近1周的就餐情况、家庭基本情况和体检信息等资料。采用多因素Logistic逐步回归的方法,对调查对象在外就餐情况,在外就餐影响因素及与超重肥胖的关系进行分析。  结果  河北省6~17岁儿童青少年在外就餐率为16.19%,超重肥胖率为29.43%。多因素Logistic回归分析显示,年龄较大(初中生:OR=1.36,高中生OR=3.57,P值均＜0.05)和家庭人均收入高的儿童青少年(1~＜2万元:OR=1.48,≥2万元:OR=2.93,P值均＜0.05)在外就餐的可能性更高;居住地为农村(OR=0.20)、非独生子女(OR=0.76)、走读生(OR=0.21)以及主要抚养人为老人的儿童青少年(OR=0.69)在外就餐的可能性更低(P值均＜0.05)。在外就餐与超重肥胖风险增高存在统计学关联(OR=1.31,P＜0.01)。  结论  河北省6~17岁儿童青少年在外就餐现象较为普遍。居住地、年龄段、人均年收入、是否为独生子女、是否住校、主要抚养人是在外就餐的相关因素,在外就餐可能会增加儿童青少年超重肥胖的风险。     

Eating Speed,Physical Activity,and Cardiorespiratory Fitness Are Independent Predictors of Metabolic Syndrome in Korean University Students

Background: Little is known regarding the role of eating quickly, physical inactivity, and poor cardiorespiratory fitness (CRF) in assessing the onset of metabolic syndrome (Mets) in Korean young adults. Objectives: This study examined the association between the three risk factors and Mets in 1891 Korean university students (30% female) aged 18–29 years. Methods: Eating speed (slow vs. fast) and physical activity (active vs. inactive) were assessed with a standardized questionnaire. Maximal oxygen uptake as an indicator of CRF was assessed with graded exercise testing. Components of Mets were waist circumference, systolic and diastolic blood pressures, fasting blood glucose (FBG), triglycerides (TG), and high-density lipoprotein cholesterol (HDLC). Results: All the three exposures were positively associated with abdominal obesity, elevated blood pressures, elevated FBG, elevated TG, and decreased HDLC. Logistic regression analysis showed that the odds ratio (OR) of Mets was incremental in the order of physical inactivity (odds ratio, OR = 1.666; 95% confidence interval, CI = 1.024–2.708; p = 0.040), fast eating (OR = 1.687; 95% CI = 1.094–2.601; p = 0.018), and poor CRF (OR = 5.378; 95% CI = 3.475–8.325; p < 0.001). Conclusions: The current findings suggest that a multifaceted intervention targeting at promotion of physical activity and CRF in concert with healthy eating behaviors should be implemented as a preventive strategy against Mets in Korean university students.     

Pre-Pregnancy Weight Status Is Associated with Diet Quality and Nutritional Biomarkers during Pregnancy

Although the positive association between pre-pregnancy overweight and obesity with excessive gestational weight gain is well known, it is not clear how pre-pregnancy weight status is associated with gestational weight gain through maternal diet during pregnancy. This study aimed to examine the relationship between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Our study included 795 U.S. pregnant women from the National Health and Nutrition Examination Survey, 2003–2012. Pre-pregnancy body mass index (BMI) was calculated based on self-reported pre-pregnancy weight and height. The cutoff points of <18.5 (underweight), 18.5–24.9 (normal), 25.0–29.9 (overweight), and 30 kg/m² (obese) were used to categorize pregnant women’s weight status. Diet quality during pregnancy was assessed by the Healthy Eating Index (HEI)-2010 based on a 24-h recall. Multivariable logistic regressions were used to estimate the odds ratios (OR) and 95% confidence intervals (CI). For all pregnant women included in this study, the mean HEI-2010 (±standard error of the mean (SEM)) was 50.7 (±0.9). Women with obese pre-pregnancy BMI demonstrated significantly lower HEI-2010 compared to those with underweight and normal pre-pregnancy BMI, respectively. In an unadjusted model, women with pre-pregnancy obesity BMI had increased odds for being in the lowest tertile of HEI-2010 (33.4 ± 0.5) compared to those with underweight pre-pregnancy BMI (OR 5.0; 95% CI 2.2–11.4). The inverse association between pre-pregnancy overweight and obesity status and diet quality during pregnancy persisted even after we controlled for physical activity levels (adjusted OR (AOR) 3.8; 95% CI 1.2–11.7, AOR 5.4; 95% CI 2.0–14.5, respectively). Serum folate concentration (ng/mL) was significantly higher in underweight women compared to overweight women (23.4 ± 1.7 vs. 17.0 ± 0.8, p < 0.05). Serum iron concentration (ng/dL) was significantly higher in normal weight women compared to overweight women (86.2 ± 5.0 vs. 68.9 ± 3.0, p < 0.05). An inverse association was found between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Poor diet quality as measured by HEI-2010 was shown among overweight and obese women. Nutrition education and interventions need to be targeted to those women entering pregnancy as overweight and obese.     

A Smartphone Intervention to Promote Time Restricted Eating Reduces Body Weight and Blood Pressure in Adults with Overweight and Obesity: A Pilot Study

The goal of this study was to test the feasibility of time restricted eating (TRE) in adults with overweight and obesity. Participants (n = 50) logged all eating occasions (>0 kcal) for a 2-week run-in period using a smartphone application. Participants with eating duration ≥14 h enrolled in an open label, non-randomized, prospective 90-day TRE intervention, with a self-selected reduced eating window of 10 h. No dietary counseling was provided. Changes in anthropometrics, eating patterns and adherence after TRE were analyzed using t-tests or Wilcoxon Rank-Sum Test. The mean duration of the baseline eating window was 14 h 32 m ± 2 h 36 m (n = 50) with 56% of participants with duration ≥14 h. TRE participants (n = 16) successfully decreased their eating window from 16 h 04 m ± 1 h 24 m to 11 h 54 m ± 2 h 06 m (p < 0.001), and reduced the number of daily eating occasions by half (p < 0.001). Adherence to logging and to the reduced eating window was 64% ± 22% and 47% ± 19%, respectively. TRE resulted in decreases in body weight (−2.1 ± 3.0 kg, p = 0.017), waist circumference (−2.2 ± 4.6 cm, p = 0.002) and systolic blood pressure (−12 ± 11 mmHg, p = 0.002). This study demonstrates the feasibility and efficacy of TRE administered via a smartphone, in adults with overweight and obesity.     

Positive Association between High Protein Food Intake Frequency and Physical Performance and Higher-Level Functional Capacity in Daily Life

Nutritional factors, including low protein intake and poor dietary variety, affect age-associated impairment in physical performance resulting in physical frailty. This cross-sectional study investigated the association between intake frequency of major high protein foods and both physical performance and higher-level functional capacity using the food frequency score (FFS) and high protein food frequency score (PFFS) among community-dwelling older adults. The data of 1185 older adults categorized into quartiles based on FFS and PFFS were analyzed. After adjusting for covariates, FFS and PFFS were significantly associated with physical performance [FFS, usual gait speed (p for trend = 0.007); PFFS, usual gait speed (p for trend < 0.001), maximum gait speed (p for trend = 0.002), timed up and go (p for trend = 0.025)], and higher-level functional capacity [FFS (p for trend < 0.001); PFFS (p for trend < 0.001)]. After excluding PFFS data, the participants’ scores were associated with only higher-level functional capacity. Multi-regression analysis with higher-level functional capacity as the covariate showed that FFS and PFFS were significantly correlated with physical performance. Hence, improving food intake frequency, particularly that of high protein foods, and dietary variety may help maintain higher-level functional capacity and physical performance in community-dwelling older adults.     

Utilization of the Healthy Eating Index in Cystic Fibrosis

(1) Background: Malnutrition has been a hallmark of cystic fibrosis (CF) for some time, and improved nutritional status is associated with improved outcomes. While individuals with CF historically required higher caloric intake than the general population, new CF therapies and improved health in this population suggest decreased metabolic demand and prevalence of overweight and obesity have increased. This study aimed to (a) examine diet quality in a population of young adults with CF using the Healthy Eating Index, a measure of diet quality in accordance with the U.S. Dietary Guidelines for Americans and (b) evaluate and describe how subcomponents of the HEI might apply to individuals with CF (2) Methods: 3-day dietary recalls from healthy adolescents and young adults with CF were obtained and scored based on the Healthy Eating Index (3) Results: Dietary recalls from 26 (14M/12F) adolescents and young adults with CF (ages 16–23), were obtained. Individuals with CF had significantly lower HEI scores than the general population and lower individual component scores for total vegetables, greens and beans, total fruits, whole fruits, total protein, seafood and plant protein and sodium (p values < 0.01 for all). (4) Conclusion: Dietary quality was poor in these healthy adolescents and young adults with CF. Given the increased prevalence of overweight and obesity in CF, updated dietary guidance is urgently needed for this population. The Healthy Eating Index may be a valuable tool for evaluating dietary quality in CF.     

Eating Behaviour among University Students: Relationships with Age,Socioeconomic Status,Physical Activity,Body Mass Index,Waist-to-Height Ratio and Social Desirability

Eating behaviour is of particular interest for research focusing on body weight status. However, little is known about the relationships of certain factors, especially social desirability, with self-reported eating behaviour such as cognitive restraint, uncontrolled eating, and emotional eating among young adult males and females. This study aimed to evaluate the relationships between eating behaviour and age, socioeconomic status (SES), physical activity (PA), body mass index (BMI), waist-to-height ratio (WHtR), and social desirability among university students. A cross-sectional study was conducted among 353 university students (59.2% females). Eating behaviour was assessed using the 13-item Three-Factor Eating Questionnaire (TFEQ-13). SES and PA were determined using self-reporting, and the Marlowe–Crowne Social Desirability Scale assessed social desirability. BMI and WHtR were calculated based on measured parameters. Associations between self-reported eating behaviour and other variables were assessed using Pearson’s correlation coefficient and multivariate general linear models. Cognitive restraint was positively correlated with BMI and WHtR in both males (r = 0.174, P = 0.036 and r = 0.194, P = 0.020, respectively) and females (r = 0.239, P < 0.001 and r = 0.165, P = 0.017, respectively), and emotional eating was positively correlated with BMI among females (r = 0.184, P = 0.008). Social desirability was negatively correlated with uncontrolled eating (r = −0.287, P < 0.001) and emotional eating (r = −0.301, P < 0.001) among females. There were no significant correlations between eating behaviour and age or socioeconomic status (P > 0.05). Multivariate analysis showed that, among males, PA had a main effect on emotional eating (ηp² = 0.044, F = 6.276, P = 0.013). Among females, cognitive restraint was positively associated with PA (ηp² = 0.034, F = 7.127, P = 0.008) and BMI (ηp² = 0.038, F = 7.959, P = 0.005), and emotional eating with BMI (ηp² = 0.032, F = 6.638, P = 0.011). Social desirability had the highest main effect on eating behaviour among females, being negatively associated with uncontrolled eating (ηp² = 0.077, F = 16.754, P < 0.001) and emotional eating (ηp² = 0.082, F = 18.046, P < 0.001). This study showed that PA, BMI, WHtR, and social desirability were associated with self-reported eating behaviour among university students. Social desirability bias should be considered when evaluating uncontrolled eating and emotional eating among females.     

Effect of a High-Intensity Dietary Intervention on Changes in Dietary Intake and Eating Pathology during a Multicomponent Adolescent Obesity Intervention

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents’ changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m², 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200–1800 kcal/day; number of “Go” foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected p-values are reported as q-values. Energy intake decreased (−292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (−0.5 ± 1.3; q = 0.004) and weight (−0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents’ dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment.     

Association between Suboptimal 25-Hydroxyvitamin D Status and Overweight/Obesity in Infants: A Prospective Cohort Study in China

This study aimed to investigate whether 25-hydroxyvitamin D (25(OH)D) concentrations are correlated to overweight/obesity in infants and to explore a threshold of 25(OH)D. A total of 1205 six-month-old infants from two community hospitals in Shanghai were randomly recruited, and 925 of them were followed up at 12 months. Concentration of 25(OH)D, weight, and length were measured at two time points. Overweight/obesity was defined as a weight-for-length Z-score >97th percentile. The prevalence of overweight/obesity at 6 and 12 months was 6.88% and 5.26%, respectively. The occurrence of vitamin D (VitD) deficiency (<20 ng/mL) at 6 and 12 months was 6.56% and 2.05%, respectively. Concentration of 25(OH)D at the corresponding age was negatively associated with weight-for-length percentile (WLP) at both 6 (adjusted β: −0.14; 95% CI: −0.27, −0.02; p = 0.02) and 12 months (adjusted β: −0.22; 95% CI: −0.41, −0.02; p = 0.03), while the relationship between 25(OH)D at 6 months and WLP at 12 months was nonlinear, where 35 ng/mL was identified as an inflection point. Those with a concentration of 25(OH)D <35 ng/mL at 6 months had a higher risk of overweight/obesity (adjusted OR: 1.42; 95% CI: 1.06, 1.91; p = 0.02) compared to the group with a concentration of 25(OH)D ≥35 ng/mL. Moreover, a concentration of 25(OH)D <35 ng/mL at two time points significantly increased the risk of overweight/obesity at 12 months compared to the group with 25(OH)D concentration ≥35 ng/mL at two time points (adjusted OR: 2.91; 95% CI: 1.13, 7.46; p = 0.03). A suboptimal 25(OH)D concentration <35 ng/mL significantly increases the risk of overweight/obesity in infants.     

北京市小学生进食行为与超重肥胖的关系

分析北京市三~五年级小学生进食行为与超重肥胖的关系,为儿童超重肥胖预防和控制提供依据.方法 采取整群抽样的方法,选取北京市某城区12所小学三~五年级的学生1 788名,测量身高、体重,计算身体质量指数(BMI),通过问卷调查了解学生的进食行为、膳食摄入频率、身体活动情况,分析进食行为与超重肥胖之间的关系.结果男生的超重肥胖率为47.8%,女生为25.6%,差异有统计学意义(x2=94.54,P<0.01);男生在家吃饭时用碗大小和进食速度分布与女生的差异均有统计学意义(x2值分别为6.75,57.33,P值均<0.01).在Logistic回归模型中,控制年龄、性别、膳食评分、身体活动能量消耗值因素后,在家吃饭时用碗比大人小、吃饭速度比同班同性别的同学快是儿童超重肥胖的危险因素(OR值分别为1.55,2.50,95%CI=1.14~2.11,1.51~4.16).结论 小学生的用碗大小和吃饭速度快慢可能与超重肥胖有关.为预防和控制儿童超重肥胖,应提倡小学生和家长使用一样大小的碗,并减慢进食速度.     

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     

Diet Quality and Health in Older Americans

Adequate nutrition is an essential component of healthy ageing. This study documents the quality of diets among older Americans and implications of healthy eating for their physical and mental health. Using a nationally representative longitudinal sample of adults aged ≥50 years, from the Health and Retirement Study (HRS) 2010–2016 and food intake data from the 2013 Health Care and Nutrition Study (HCNS), the study evaluates the onset of health problems along the spectrum of diet quality measured by the Healthy Eating Index (HEI)-2015. Older adults adhering to healthier diets, in the high HEI group, have a significantly lower risk of developing limitations in activities of daily living (15.2% vs. 19.6%, p < 0.01) and depression (11.8% vs. 14.9%, p < 0.01), as compared to participants with low HEI scores. Consuming healthier diets also predicts more favorable health outcomes, as measured by blood-based biomarkers, including C-reactive protein (3.3 vs. 3.8, p < 0.05), cystatin C (1.1 vs. 1.2, p < 0.1), total cholesterol (192.1 vs. 196.4, p < 0.1), and high-density lipoprotein (57.2 vs. 53.8, p < 0.01). Most older Americans can benefit from improving diet to reduce their risk of disability, chronic disease, and depression.     

Peer Reviewed: Oportunidades Program Participation and Body Mass Index,Blood Pressure,and Self-Reported Health in Mexican Adults

Introduction

Governments around the world are seeking to address the increasing prevalence of obesity and hypertension. Our objective was to evaluate the effect of an incentive-based development program (Oportunidades, formerly Progresa) on body mass index (BMI), blood pressure, and self-reported health.

Methods

An intervention group of low-income (below the 20th percentile nationally), rural, Mexican adults (aged 30–65 years) (n = 5280) received program benefits (cash transfers contingent on positive changes in health behavior such as regular health checkups) for 3.5 to 5.0 years. They were compared with a newly recruited control group of adults (n = 1063) who had not yet begun receiving benefits. Analyses were adjusted for almost 50 social and economic covariates.

Results

Age- and sex-adjusted BMI was lower in adults from intervention communities than in those from control communities (26.57 kg/m² vs 27.16 kg/m², P < .001), as was the prevalence of obesity (20.28% vs 25.31%, P < .001) and overweight (59.24% vs 63.04%, P = .03); these results were attenuated after covariates were included. Adults in intervention communities had a lower combined prevalence of uncontrolled hypertension (33.80% vs 34.52%, P = .008) when adjusting for all covariates. Mean systolic (β = –2.60, P < .001) and diastolic (β = –2.84, P < .001) blood pressures were significantly lower in the intervention communities after all covariates were included, and self-reported health outcomes were better.

Conclusion

Participation in Oportunidades, a large-scale cash-transfer program, was associated with lower prevalence of obesity and hypertension and better self-reported health in adults in rural Mexico.     

Breastfeeding and Overweight in European Preschoolers: The ToyBox Study

The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.