The Effects of Marriage and Being a Parent on Prenatal Physician Visits for Chamorro, Filipino, White and Other Asian and Pacific Island Women on Guam

PURPOSE OF THE PAPER: The purpose of this study was to examine the effect of marital status, parental status, and ethnicity on the frequency of prenatal physician visitations reported by Chamorro, Filipino, White, and other Asian and Pacific Island women residing in Guam. SUMMARY OF METHODS UTILIZED: Data were extracted from birth records and analyzed using ordinary least squares multiple regression. PRINCIPAL FINDINGS: We found that ethnic effects remained even when age, education, and region of residence on Guam were held constant. Marriage had a significant and positive effect on prenatal visitations, and a number of previoius children had significant negative effect on prenatal visitations. CONCLUSIONS: We conclude that spouses encourage positive health behaviors while the expectations of parenting detract significantly from the amount of time women can devote to caring for themselves. RELEVANCE TO ASIAN AND PACIFIC ISLANDER AMERICAN POPULATIONS: Our results indicate that marital status may be more important than educational levels for understanding the health care behaviors of Chamorro, Filipina, and other Asian and Pacific Island women on Guam. KEY WORDS: Chamorro, Filipino, prenatal visitations, marital status, parental status.     

Prevalence of metabolic syndrome among Filipino adults aged 20 years and over

This study sought to determine the prevalence of metabolic syndrome, using data collected from 4,541 adults aged 20 years and over covered in the Fifth National Nutrition Survey conducted in 1998. The metabolic variables analyzed were: total cholesterol, LDL-c, HDL-c, triglycerides and fasting blood glucose. In addition, measurements of obesity such as body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) as well as blood pressure were taken. Comparing the mean metabolic characteristics of the non-obese, total obese and the android obese, results showed significant differences in almost all the variables except for the HDL-c. By gender, non-significant differences were observed between males and females in the non-obese group in terms of the BMI and glucose levels and in the android group, in terms of total cholesterol. In all three groups, the biggest difference was observed in the mean triglycerides, where males had significantly higher mean than the females. Comparing adults with >125 mg/dl fasting blood sugar (FBS) there were higher rates of hypertension, high waist-to-hip ratio (WHR), high cholesterol, high triglycerides, high LDL-c, low HDL-c, among the overweight and obese than among those with normal BMI. In general, the proportion of subjects with co-morbid factors increased with higher levels of FBS, except for high cholesterol wherein no pattern was established. The highest prevalence of high FBS was found in both males (35.8%) and females (14.5%) with the following combined characteristics: high BMI, high WHR and high WC. Males with co-existing high BMI, high WHR, and high WC were observed to have the highest prevalence rate of hypertension (66.5%). Among females, the highest prevalence rate of hypertension (37.9%) was seen among those with high fasting blood sugar. The proportion of subjects with hypertension generally increased with age irrespective of the BMI status. One of the significant correlates of high FBS is waist-hip ratio. Males with WHR of equal or greater than 1 have almost six times the risk of having high FBS, while females with WHR of equal or greater than 0.85 have five times the risk of having high FBS compared to those with normal WHR. Among females with triglyceride levels of equal or greater than 200 mg/dL, the risk of having high FBS is five times compared to those with triglyceride levels below 200 mg/dL. Univariate analysis to see the effect of the type of obesity to dyslipidaemia and hypertension revealed that females with high waist circumference generally provided greater risk compared to those who were overweight and obese as well as those with android obesity. For males, high waist circumference had greater risk of developing high triglyceride and high LDL-c. Android obese males had greater risk to high FBS. The results showed that the prevalence rate of metabolic syndrome is 0.28%, based on the number of individuals with the following characteristics: high FBS, hypertensive, android obese, with body mass index (BMI) of > or =25.0 and high WC. Females had a higher rate than males - almost twice. Considering that metabolic syndrome, with its co-morbidity factors is prevalent among some Filipino adults aged 20 years and over, it is recommended that health programs geared towards minimizing the morbid risk factors be properly developed, promoted and fully implemented.     

Smoking trends among Filipino adults in California, 1990-2002

OBJECTIVES: Filipinos comprise about 18% of the Asian/Pacific Islander American (APIA) population and are increasing. Few studies have examined Filipino current smoking prevalence rates (CSPR) and none have described trends over time. METHODS: Trends in CSPR were estimated for Filipinos and non-Hispanic whites (NHW) from 1990-2002 from the California Tobacco Surveys (N>42,000/year). RESULTS: CSPR for Filipino males declined: 23.7% (95% CI: 18.7, 28.7) in 1990 to 18.7% (15.3, 22.1) in 2002 (p<0.05). The decline in CSPR for Filipino women was non-significant (p=0.24), 9.8% (5.5, 14.1) in 1990 and 7.7% (5.3, 10.1) in 2002. During the same period, CSPR among NHW males declined: 24.4% (23.8, 25.0) in 1990 to 18.8% (18.1, 19.4) in 2002 (p<0.01). For female NHW, CSPR were 21.3% (20.5, 22.0) in 1990 and 15.0% (14.4, 15.6) in 2002 (p<0.01). Adjusted logistic regression for Filipinos suggest that English language use is associated with current smoking among females (p<0.01) and that, overall, 18-29 year-olds were more likely to be current smokers than those 45+ years old (p<0.01). CONCLUSION: Trends for male Filipino current smokers declined similarly to male NHW from 1990-2002; female rates were lower but did not decline. Future smoking prevention and cessation programs would benefit by taking into account important differences in smoking rates between genders and age groups.     

中国学龄儿童青少年1985 — 2000年超重、肥胖流行趋势动态分析

  目的  了解北京市6～18岁智力障碍儿童青少年超重与肥胖现状,为智力障碍儿童青少年超重和肥胖的预防提供科学依据。  方法  采用整群随机抽样方法,以北京市15所特殊教育学校的343名学生为对象,对其进行体格检查,以中国肥胖问题工作组（WGOC）推荐的中国学龄儿童青少年超重及肥胖筛查体质指数值作为评价超重、肥胖的参考标准。  结果  北京市6～18岁智力障碍儿童青少年超重率为21.57 %,肥胖率为22.74 %。男、女生超重率分别为24.14 %、13.41 %,超重率差异有统计学意义（P < 0.05）,肥胖率分别为24.52 %、17.07 %,肥胖率差异无统计学意义。10～12岁超重率最高,为26.83 %,6～9岁肥胖率最高,为36.54 %,不同年龄组超重率和肥胖率差异均有统计学意义（P < 0.05）,随着年龄增长超重肥胖合并检出率有下降趋势。中度智障组超重率最高,为20.93 %,不同智障程度组超重率差异无统计学意义。轻度智障组肥胖率最高,为33.33 %,不同智障程度组肥胖率差异有统计学意义（P < 0.05）。  结论  北京市6～18岁智力障碍儿童青少年超重和肥胖有较高的检出率,超重和肥胖呈现低龄化趋势,残联、疾病预防控制中心、特殊教育学校、家庭应采取相关预防措施应对智障儿童青少年的超重肥胖问题。     

Cancer on Guam, especially among Micronesians

The Guam Cancer Registry (GCR) collects data on cases of cancer in Guam residents whether their initial diagnosis is made on Guam or as a result of a referral to an off-island medical facility. It also collects data on cancer of non-residents diagnosed on Guam. Although including non-Guam resident cancer cases in statistical tables will have the effect of raising local cancer rates, this probably only partially compensates for the number of Guam-resident cancer cases that are diagnosed off-island and not reported to the registry. Cases are also collected by a periodic review of death certificates filed with the Guam Office of Vital Statistics. To test this hypothesis GCR records were reviewed to determine the number of reported cancer cases for each ethnic group that claimed to be Guam residents. Since a high proportion of cancers seen among Micronesians on Guam represent cases referred from their home islands, it may also be that these cases only represent those cancers most likely to be referred to Guam rather than being representative of the cancers most commonly occurring within these ethnic groups in their home islands.     

中国成年居民就餐行为及其与肥胖的关系

目的 了解中国成年居民就餐行为及其与肥胖的关系。方法 利用2013年中国慢性病及其危险因素监测数据,经过数据清理,本研究共纳入171 040名调查对象。采用复杂抽样设计的Rao-Scott χ²检验比较不同特征调查对象的就餐行为及肥胖率的差异。以是否肥胖为因变量,使用基于复杂抽样设计的二分类logistic回归模型分别探讨早、午、晚餐就餐行为与肥胖的关系。结果 我国成年居民一日三餐中不吃早餐的比例最高,为3.3%。早、午、晚餐在外就餐比例分别为16.4%、21.4%、11.7%。午餐在家就餐、在外就餐和不吃午餐的男性肥胖率分别为13.2%、16.1%、15.9%,女性肥胖率分别为14.5%、9.8%、19.6%。多因素logistic回归结果显示,在男性中,午餐或晚餐在外就餐者和不吃午餐或晚餐者发生肥胖的风险均高于在家就餐者;女性不吃午餐或晚餐者发生肥胖的风险高于在家就餐者,女性午餐在外就餐与是否肥胖的关联无统计学意义,晚餐在外就餐发生肥胖的风险低于在家就餐者。结论 我国成年居民不同餐次就餐行为存在差异,午餐在外就餐比例最高,晚餐在外就餐比例最低。男性午餐和晚餐在外就餐者发生肥胖的风险较高;无论男性还是女性,不吃午餐或晚餐者发生肥胖的风险均较高。     

Education and obesity at age 40 among American adults

Although many have studied the association between educational attainment and obesity, studies to date have not fully examined prior common causes and possible interactions by race/ethnicity or gender. It is also not clear if the relationship between actual educational attainment and obesity is independent of the role of aspired educational attainment or expected educational attainment. The authors use generalized linear log link models to examine the association between educational attainment at age 25 and obesity (BMI ≥ 30) at age 40 in the USA's National Longitudinal Survey of Youth 1979 cohort, adjusting for demographics, confounders, and mediators. Race/ethnicity but not gender interacted with educational attainment. In a complete case analysis, after adjusting for socioeconomic covariates from childhood, adolescence, and adulthood, among whites only, college graduates were less likely than high school graduates to be obese (RR = 0.69, 95%CI: 0.57, 0.83). The risk ratio remained similar in two sensitivity analyses when the authors adjusted for educational aspirations and educational expectations and analyzed a multiply imputed dataset to address missingness. This more nuanced understanding of the role of education after controlling for a thorough set of confounders and mediators helps advance the study of social determinants of health and risk factors for obesity.     

Relation between local food environments and obesity among adults

Background  

Outside of the United States, evidence for associations between exposure to fast-food establishments and risk for obesity among adults is limited and equivocal. The purposes of this study were to investigate whether the relative availability of different types of food retailers around people's homes was associated with obesity among adults in Edmonton, Canada, and if this association varied as a function of distance between food locations and people's homes.     

辽宁省成人超重与肥胖流行病学调查

目的调查辽宁省城乡20周岁以上居民超重与肥胖的流行状况,为有针对性地开展肥胖防治提供科学依据.方法对4个城市及农村和两个大型国有企业部分职工进行自填式问卷调查,采用WHO诊断标准,以1990年全国人口普查年龄别人口比例计算超重和肥胖调整现患率.结果共调查37 070人,超重及肥胖调整现患率男性为24.77%和2.87%,明显高于全国平均水平;女性为17.24%和1.96%,明显低于全国平均水平.男女超重现患率在各年龄组间有显著性差异,均随年龄增加而上升.男性商业与交通运输业人员肥胖现患率最高,待业人员及农民最低;女性中家庭妇女和农民超重现患率明显高于其他职业.女性超重和肥胖现患率均随着文化程度的增高而明显降低,而男性则呈现相反趋势.本次调查所发现的年轻及知识女性超重与肥胖现患率较低是否与调查方式有关值得进一步研究.结论辽宁省超重及肥胖调整现患率男性明显高于全国平均水平,存在显著的性别、年龄、职业和文化间差别.     

Incidence and potential risk factors of obesity among Tehranian adults

AimEvaluating the incidence of obesity and its risk factors among Tehranian adults.Material & methodsIn this population-based cohort, non-obese participants, aged ≥ 20 years, were followed for development of obesity (Body Mass Index (BMI) ≥ 30). Incidence density and cumulative incidence rates of obesity were calculated for each sex. Cox proportional hazard regression was used to determine the association of potential obesity risk factors including: age, BMI, metabolic syndrome, waist circumference (WC), smoking, marital status, education, and physical activity.ResultA total of 7257 participants (3536 men) were followed for a median of 8 years. At baseline, mean age, BMI and WC were 41.3 ± 14.6 years, 25.1 ± 2.9 kg/m² (24.9 ± 3 kg/m² men and 25.2 ± 3 kg/m² women), and 84.8 ± 9.8 cm (87.06 ± 9.2 cm men and 82.6 ± 9.9 cm women) respectively. During the follow-up, 1345 participants (876 women) developed obesity contributing to cumulative incidences of 31.3% (CI: 29.9%–32.7%), 38.1% (CI: 36.2%–40.1%), and 23.4% (CI: 21.6%–25.3%) for the whole population, women, and men, respectively. Corresponding incidence density rates per 1000 person-year were 25.9 (CI: 24.5–27.3), 33.67 (CI: 31.5–36.0), and 18.0 (CI: 16.5–19.7), respectively. Highest incidence rates were observed during their 40s and 20s for women and men, respectively. Participants with metabolic syndrome, lower educational level, higher BMI and WC, were at higher risk of obesity development in both sexes.ConclusionHigh incidence of obesity was observed among Tehranian adults with higher incidence of obesity in women. Different modifiable variables may act as risk factors for obesity development which should be targeted to control the epidemic of obesity.     

天津市社区成年人超重及肥胖现况分析

目的 了解天津市成年人超重和肥胖流行现状,为制定相应干预措施提供科学依据。方法 按分层整群随机抽样方法,抽取天津市内24个社区≥18岁常住居民进行问卷调查及身体检查。结果 调查对象超重率为34.3%(8 072/23 533),肥胖率为10.7%(2 518/23 533),按2000年全国人口标化后,标化超重率为30.2%,标化肥胖率为9.2%。高于2002年中国居民营养与健康状况调查结果;中年组超重率最高,为41.7%(3 099/7 431),老年组肥胖率最高,为13.9%(932/6 703),青年组超重率和肥胖率均为最低;中、老年组超重和肥胖合计>50%;调查对象腹型肥胖率最高,老年组腹型肥胖率男性为22.1%,女性为25.5%。结论 天津市社区居民超重和肥胖患病率较高,男性中老年人群应为防治重点。     

Association between obesity and medical care expenditure among Taiwanese adults

The aim of this study is to evaluate the relationships between obesity and medical care expenditure among Taiwanese adults and to assess the influence of sex, age and socioeconomic status. Our study sample consisted of 12,250 adults aged 18 years or older from the 2001 National Health Interview Survey (NHIS), who had consented to the linking of their survey responses with their NHI claims records. Obesity was defined by Body Mass Index based on the WHO-Asia Pacific categories. Adjusted expenditure for obese class II and class I men were, respectively, 44.6% (95%CI: 27.1%-68.7%) and 39.5% (95%CI: 39.4%-41.2%) greater than normal weight men. For obese class II and class I women, the adjusted expenditure were, respectively, 93.3% (95%CI: 69.9%-114.6%) and 56.1% (95%CI: 50.4%-61.4%) greater than normal weight women. After adjusting for other factors, higher medical care expenditure was associated with a higher BMI for each age group. The relative magnitude of the association became more apparent as age increased. Annual medical care expenditure increased as the BMI increased among women, which was particularly apparent among low socioeconomic status women. On the other hand, the relationship between BMI and medical care expenditure in men varied by household income. In conclusion, there is a strong positive relationship between higher BMI and increased medical care expenditure and this varies according to sex, age and socioeconomic status. Our findings suggest that projections of future health care costs attributable to obesity will need to take into consideration the demographic make-up of the obese population.     

2018年深圳市成人肥胖和向心性肥胖现状及影响因素

目的  了解深圳市成年居民肥胖和向心性肥胖现状及其影响因素。方法  于2018年在深圳市对常住居民开展慢性病及其危险因素调查,采用多阶段分层随机抽样抽取10 046名常住深圳市成年居民作为调查对象,分析肥胖与向心性肥胖的流行病学特征及影响因素。结果  调查人群的肥胖率和向心性肥胖率分别为8.65%、38.04%,性别、年龄和吸烟均是影响肥胖率和向心性肥胖的主要因素(均有P＜0.05),男性、中老年人和吸烟是肥胖和向心性肥胖的危险因素(OR=1.411, 95% CI: 1.115~1.725, P=0.001; OR=1.155, 95% CI: 1.010~1.321, P=0.036),中强度职业性体力活动是向心性肥胖的保护因素(OR=0.856, 95% CI: 0.775~0.946, P=0.002)。结论  虽然深圳市成年居民肥胖、向心性肥胖率略有降低,但仍有改善空间,相关部门应针对性的采取干预措施预防肥胖,尤其是向心性肥胖。     

Prevalence of abdominal obesity among Chinese adults in 2011

Background

The prevalence of abdominal obesity is increasing dramatically worldwide. This study aimed to estimate the current prevalence of abdominal obesity from the 2011 China Health and Nutrition Survey (CHNS) and compare the data with other countries.

成年居民每日膳食盐摄入量与肥胖关系

目的 探讨成人膳食盐摄入量与肥胖关系。方法 于2013年4月采用多阶段整群随机抽样方法抽取徐州市≥18岁常住人口30 572人进行调查。结果 30 572名成年居民平均膳食盐摄入量（14.53±11.04）g/d,超重率为32.17%（9 834/30 572）,肥胖率为7.09%（2 169/30 572）,中心性肥胖率为45.58%（13 934/30 572）;校正潜在的混杂因素后,膳食盐摄入量对肥胖和中心性肥胖的OR值（95%CI）分别为1.467（1.267~1.698）、1.155（1.080~1.234）。结论 膳食盐摄入量与肥胖的发生有关联。降低膳食盐摄入量有助于减少肥胖的发生,对居民进行低盐饮食相关健康教育刻不容缓。