Relation between neighborhood environments and obesity in the Multi-Ethnic Study of Atherosclerosis

This study investigated associations between neighborhood physical and social environments and body mass index in 2,865 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) aged 45-84 years and residing in Maryland, New York, and North Carolina. Neighborhood (census tract) environments were measured in non-MESA participants residing in MESA neighborhoods (2000-2002). The neighborhood physical environment score combined measures of a better walking environment and greater availability of healthy foods. The neighborhood social environment score combined measures of greater aesthetic quality, safety, and social cohesion and less violent crime. Marginal maximum likelihood was used to estimate associations between neighborhood environments and body mass index (kg/m(2)) before and after adjustment for individual-level covariates. MESA residents of neighborhoods with better physical environments had lower body mass index (mean difference per standard deviation higher neighborhood measure = -2.38 (95% confidence interval (CI): -3.38, -1.38) kg/m(2) for women and -1.20 (95% CI: -1.84, -0.57) kg/m(2) for men), independent of age, race/ethnicity, education, and income. Attenuation of these associations after adjustment for diet and physical activity suggests a mediating role of these behaviors. In men, the mean body mass index was higher in areas with better social environments (mean difference = 0.52 (95% CI: 0.07, 0.97) kg/m(2)). Improvement in the neighborhood physical environment should be considered for its contribution to reducing obesity.     

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。     

Neighbourhood food environments and obesity in southeast Louisiana

Supermarkets might influence food choices, and more distal outcomes like obesity, by increasing the availability of healthy foods. However, recent evidence about their effects is ambiguous, perhaps because supermarkets also increase the availability of unhealthy options. We develop an alternative measure of food environment quality that characterizes urban neighborhoods by the relative amounts of healthy (e.g. fruits and vegetables) to unhealthy foods (e.g. energy-dense snacks). Using data from 307 food stores and 1243 telephone interviews with residents in urban southeastern Louisiana, we estimate a multilevel multinomial logistic model for overweight status. We find that higher quality food environments - but not food store types - decrease the risk of obesity (RR 0.474, 95% CI 0.269-0.835) and overweight (RR 0.532, 95% CI 0.312-0.907). The findings suggest a need to move beyond a sole consideration of food store types to a more nuanced view of the food environment when planning for change.     

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.     

Effect of food prices on the prevalence of obesity among young adults

Objective

To examine the extent to which various food prices were associated with the obesity status of young adults.

Study design

Retrospective cohort study of 6537 men and 5324 women in the USA using panel data from the Monitoring the Future Surveys (1992-2003), which were merged with two food-at-home and one food-away-from-home price measures from the American Chamber of Commerce Researchers Association.

Methods

Longitudinal individual random effect and fixed effect models were estimated.

Results

This study found that food prices did not have a significant effect on the prevalence of obesity among young female adults. For young adult men, an individual random effect estimator suggested that a 10% increase in the price of fast food was associated with a 13.2% decrease in the probability of obesity, but this effect lost its economic and statistical significance once individual fixed effects were controlled for in the estimation.

Conclusions

Overall, the results imply that observed time-varying individual characteristics, such as working status, marital status and school enrolment status, may over-ride the effect of changes in food prices for young adults. More research employing longitudinal data is necessary to determine if food subsidies or taxes, particularly soft drink and fast food taxes or subsidies for fruit and vegetables, could be effective policy measures to curtail the increasing prevalence of obesity among young adults.     

Associations between food insecurity and healthy behaviors among Korean adults

BACKGROUND/OBJECTIVESFood insecurity has been suggested as being negatively associated with healthy behaviors and health status. This study was performed to identify the associations between food insecurity and healthy behaviors among Korean adults.SUBJECTS/METHODSThe data used were the 2011 Community Health Survey, cross-sectional representative samples of 253 communities in Korea. Food insecurity was defined as when participants reported that their family sometimes or often did not get enough food to eat in the past year. Healthy behaviors were considered as non-smoking, non-high risk drinking, participation in physical activities, eating a regular breakfast, and maintaining a normal weight. Multiple logistic regression and multinomial logistic regression analyses were used to identify the association between food insecurity and healthy behaviors.RESULTSThe prevalence of food insecurity was 4.4% (men 3.9%, women 4.9%). Men with food insecurity had lower odds ratios (ORs) for non-smoking, 0.75 (95% CI: 0.68-0.82), participation in physical activities, 0.82 (95% CI: 0.76-0.90), and eating a regular breakfast, 0.66 (95% CI: 0.59-0.74), whereas they had a higher OR for maintaining a normal weight, 1.19 (95% CI: 1.09-1.30), than men with food security. Women with food insecurity had lower ORs for non-smoking, 0.77 (95% CI: 0.66-0.89), and eating a regular breakfast, 0.79 (95% CI: 0.72-0.88). For men, ORs for obesity were 0.78 (95% CI: 0.70-0.87) for overweight and 0.56 (95% CI: 0.39-0.82) for mild obesity. For women, the OR for moderate obesity was 2.04 (95% CI: 1.14-3.63) as compared with normal weight.CONCLUSIONSFood insecurity has a different impact on healthy behaviors. Provision of coping strategies for food insecurity might be critical to improve healthy behaviors among the population.     

The relationship between obesity and injuries among U.S. adults

PURPOSE: To quantify the relationship between body mass index (BMI) and rates of medically attended injuries by mechanism (overall, fall, motor vehicle, and sport-related) and by nature (strain/sprain, lower extremity fracture, and dislocations), and between BMI and injury treatment costs. DESIGN: Cross-sectional analysis. SETTING. The noninstitutionalized population of the United States. SUBJECTS: The 1999-2000, 2000-2001, and 2001-2002 waves of the Medical Expenditure Panel Survey, a large, nationally representative dataset, were combined to create the analysis sample. The final sample included 42,304 adults. MEASURES. Medically attended injury rates by mechanism and nature of injury and related treatment costs. ANALYSIS: Logistic regressions were used to separately estimate the odds of sustaining any injury by mechanism or by nature for overweight (25 < BMI : 29.9) and three categories of obese individuals compared with those who were normal weight. A second set of regressions tested whether, given that an injury occurred, obese individuals had greater injury treatment costs. RESULTS. Slightly more than one in five adults sustain an injury each year that requires medical treatment. The odds of sustaining an injury are 15% (overweight) to 48% (Class III obesity) greater among those with excess weight. Conditional on sustaining an injury, BMI did not have a significant impact on injury treatment costs. CONCLUSION: Our findings show a clear association between BMI and the probability of sustaining an injury. If increasing BMI is causing the rise in injury rates, then the incidence of injuries, including those related to falls, sprains/strains, lower extremity fractures, and joint dislocations, are likely to increase as the prevalence of obesity increases.     

The role of local food availability in explaining obesity risk among young school-aged children

In recent years, research and public policy attention has increasingly focused on understanding whether modifiable aspects of the local food environment - the types and composition of food outlets families have proximate access to - are drivers of and potential solutions to the problem of childhood obesity in the United States. Given that much of the earlier published research has documented greater concentrations of fast-food outlets alongside limited access to large grocery stores in neighborhoods with higher shares of racial/ethnic minority groups and residents living in poverty, differences in retail food contexts may indeed exacerbate notable child obesity disparities along socioeconomic and racial/ethnic lines. This paper examines whether the lack of access to more healthy food retailers and/or the greater availability of "unhealthy" food purveyors in residential neighborhoods explains children's risk of excessive weight gain, and whether differential food availability explains obesity disparities. I do so by analyzing a national survey of U.S. children followed over elementary school (Early Childhood Longitudinal Study - Kindergarten Cohort) who are linked to detailed, longitudinal food availability measures from a comprehensive business establishment database (the National Establishment Time Series). I find that children who live in residentially poor and minority neighborhoods are indeed more likely to have greater access to fast-food outlets and convenience stores. However, these neighborhoods also have greater access to other food establishments that have not been linked to increased obesity risk, including large-scale grocery stores. When examined in a multi-level modeling framework, differential exposure to food outlets does not independently explain weight gain over time in this sample of elementary school-aged children. Variation in residential food outlet availability also does not explain socioeconomic and racial/ethnic differences. It may thus be important to reconsider whether food access is, in all settings, a salient factor in understanding obesity risk among young children.     

The influence of local food environments on adolescents' food purchasing behaviors

This study examined the relationship between the neighborhood food environment and the food purchasing behaviors among adolescents. Grade 7 and 8 students (n = 810) at 21 elementary schools in London, Ontario, Canada completed a questionnaire assessing their food purchasing behaviors. Parents of participants also completed a brief questionnaire providing residential address and demographic information. A Geographic Information System (GIS) was used to assess students' home and school neighborhood food environment and land use characteristics. Logistic regression analysis was conducted to assess the influence of the home neighborhood food environment on students' food purchasing behaviors, while two-level Hierarchical Non-Linear Regression Models were used to examine the effects of school neighborhood food environment factors on students' food purchasing behaviors. The study showed that approximately 65% of participants reported self-purchasing foods from fast-food outlets or convenience stores. Close proximity (i.e., less than 1 km) to the nearest fast-food outlet or convenience store in the home neighborhood increased the likelihood of food purchasing from these food establishments at least once per week by adolescents (p < 0.05). High fast-food outlet density in both home and school neighborhoods was associated with increased fast-food purchasing by adolescents (i.e., at least once per week; p < 0.05). In conclusion, macro-level regulations and policies are required to amend the health-detracting neighborhood food environment surrounding children and youth's home and school.     

Association of food environment and food retailers with obesity in US adults

The food environment has been shown to be a factor affecting the obesity rate. We studied the association of density of food retailer type with obesity rate in U.S. adults in local regions controlling for socioeconomic factors. Parametric nonlinear regression was used on publically available data (year=2009) at the county level. We used the results of this association to estimate the impact of the addition of a new food retailer type in a geographic region. Obesity rate increased in supercenters (0.25–0.28%) and convenience stores (0.05%) and decreased in grocery stores (0.08%) and specialized food stores (0.27–0.36%). The marginal measures estimated in this work could be useful in identifying regions where interventions based on food retailer type would be most effective.     

江苏省35岁及以上成人超重、肥胖、中心性肥胖与高血压的相关性研究

目的  了解江苏省成人超重、肥胖、中心性肥胖与高血压之间的关系,为制定肥胖及高血压的干预策略提供科学依据。方法  2016年1月22日―2019年4月8日对江苏省8个项目点117 691名35~75岁常住居民进行问卷调查、体格检查、实验室检测,非条件logistic回归分析模型分析超重、肥胖、中心性肥胖与高血压的关系。结果  高血压患病率为57.79%,标化后患病率为26.79%。在调整混杂因素后,超重和肥胖、中心性肥胖增加了高血压患病风险;与既无超重肥胖又无中心性肥胖人群相比,单纯超重肥胖人群高血压患病风险增加了90.7%(OR=1.907,95% CI: 1.849~1.968),单纯中心性肥胖人群高血压患病风险增加了69.2%(OR=1.692,95% CI: 1.566~1.828),既有超重肥胖又有中心性肥胖人群高血压患病风险增加了2.171倍(OR=3.171,95% CI: 3.075~3.270)。结论  江苏省≥35岁及成人高血压患病率较高,超重、肥胖、中心性肥胖增加了高血压患病风险。     

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。     

民航飞行员健康状况调查

  目的  了解某地区民航空勤人员的健康状况,为飞行人员健康管理及常见病防治提供依据。  方法  以2015年1 — 12月在民航某管理局医学中心参加健康体检的空勤人员为研究对象,采用t检验、Wilcoxon秩和检验、χ²检验对空勤人员体检指标、患病率进行比较。  结果  体检人群中高尿酸血症患病率最高为29.2 %,脂肪肝、超重次之,其患病率分别为28.9 %、18.2 %。在 < 35岁组及35～45岁组中安全员总体健康状况好于驾驶员（P < 0.05）;各年龄组安全员与驾驶员心电图异常及听力异常患病率差异均有统计学意义（P < 0.05）,与安全员比较,驾驶员高尿酸血症、高脂血症、脂肪肝等代谢性疾病患病率较高（P < 0.05）。  结论  某地区民航空勤人员总体健康水平较低,空勤人员的健康主要受高尿酸血症、脂肪肝、超重等疾病威胁;应有针对性的制订健康管理方案,加强不同工种空勤人员的健康管理。     

Major increase in prevalence of overweight and obesity between 1987 and 2001 among Danish adults

OBJECTIVE: The aim of the study was to examine the secular trends in the prevalence of obesity (BMI >or= 30.0 kg/m(2)) and overweight (25.0 相似文献