Short-term predictors of abdominal obesity in children

BACKGROUND: The aim of this study was to examine the short-term tracking of abdominal adiposity in children. METHODS: A total of 918 children (477 boys) aged 6-12 years at baseline were followed-up for 2 years. Central obesity was assessed by waist circumference (WaistC), whereas body fat distribution by waist-to-hip ratio. Maturity was assessed by the Khamis-Roche method. Parental fatness and children's cardiorespiratory fitness (CRF) were also evaluated. Multiple and logistic regressions were employed to identify the predictors of BMI and WaistC. RESULTS: Tracking of body fatness and body fat distribution was high (r = 0.69-0.86, P < 0.01). More boys remained obese than girls (P < 0.05), whereas a greater percentage of boys moved to a higher quartile of WaistC after the 2-year follow-up (22.0 vs 14.1%, P < 0.01). Sex, child's maturity and WaistC at baseline, CRF, and maternal BMI explained 76% of the variability in BMI and WaistC at the follow-up (n = 290). Children with high WaistC at baseline and low CRF presented 1.9- and 4.3-fold increased risk of remaining in the upper quartile of WaistC at the follow-up (P < 0.01; n = 552). CONCLUSION: Youth with increased WaistC at baseline and low CRF presented an increased chance of maintaining central obesity at the follow-up. More boys than girls moved into a higher quartile of abdominal obesity during the 2-year follow-up period and this should be taken into account in designing programmes for childhood obesity.     

中国7~18岁汉族学生2010-2014年腹型肥胖变化及其影响因素分析

目的 分析我国7~18岁汉族学生2010-2014年的腹型肥胖变化情况,探索学生腹型肥胖的影响因素。方法 选取2010年和2014年中国学生体质与健康调研库中7~18岁汉族学生作为研究对象,筛出腰围、身高信息不完整以及腰围和腰围身高比异常样本,纳入分析共计228 562名。采用国内制定的腰围界值点和国际常用腰围身高比≥0.5判定腹型肥胖;采用问卷调查收集影响因素的信息。采用t检验、χ²检验比较腹型肥胖年份差异,多因素Logistic回归模型分析腹型肥胖的影响因素。结果 2010年7~18岁中国汉族学生的腰围和腰围身高比均值分别为(64.96±9.79)cm 和0.428±0.048,2014年分别为(65.90±10.07)cm 和0.434±0.051,2014年显著高于2010年(P＜0.001)。2010-2014年7~18岁中国汉族学生的腹型肥胖检出率显著上升(腰围界值:13.84%＜17.13%;腰围身高比界值:8.91%＜11.23%,P均＜0.001)。2014年腹型肥胖检出率男生高于女生,城市高于乡村,东中部高于西部,低年龄段高于高年龄段(P均＜0.001)。多因素Logistic回归结果显示,男生(OR=2.37,95%CI: 2.26~2.48)、城市(OR=1.25,95%CI: 1.20~1.31),东部和中部(东部:OR=1.29,95%CI: 1.22~1.37;中部:OR=1.08,95%CI: 1.02~1.15),7~9岁和10~12岁(7~9岁:OR=1.89,95%CI: 1.77~2.03;10~12岁:OR=2.07,95%CI: 1.89~2.26)、早餐＜3~5次/周(OR=1.17,95%CI: 1.07~1.28)、不愿意长跑锻炼(OR=1.72,95%CI: 1.64~1.80)、每天电视时间≥1 h(OR=1.06,95%CI: 1.01~1.13)可能是腹型肥胖的危险因素(P<0.05或<0.01)。睡眠时间、每天锻炼时间、每天做作业时间可能与腹型肥胖无关(P＞0.05)。结论 2010-2014年7~18岁中国汉族学生的腹型肥胖检出率显著上升,学生腹型肥胖可能具有多种影响因素,应开展有针对性的综合干预。     

太原社区非糖尿病人群血清维生素D与腹型肥胖的相关性

目的　旨在评估太原社区非糖尿病人群的维生素D水平状况,探讨血清25-羟基维生素D3［25(OH)D3］与肥胖、腹型肥胖的相关性。方法　纳入2011年7至9月太原社区非糖尿病者417名［男225名,女192名,平均年龄（47.6±7.8）岁］,所有对象均完成一般体格检查、病史询问及血糖、血脂、25(OH)D3、空腹胰岛素（Fins）检测,计算胰岛素抵抗指数（HOMA-IR),双能X线吸收测量法（DEXA）测定体脂含量（%）,采集第4到第5腰椎间盘水平的MRI图像并计算腹内脂肪组织（IAAT）和腹部皮下脂肪组织（SCAT）,IAAT≥80 cm2即为腹型肥胖。分析血清25(OH)D3与各生化指标及体脂的相关性。结果　417名研究对象平均血25(OH)D3水平为44.5 nmol/L,其中维生素D缺乏和不足分别为62.6%（261例）和26.1%（109例）。维生素D缺乏和不足人群中,根据腹内脂肪面积,腹型肥胖（IAAT≥.80 cm2）占77.6%。Pearson 相关分析显示lg 25(OH)D3与.lg Fins、.lg HOMA-IR、腰围、收缩压、舒张压、腹部脂肪组织（TAAT）、IAAT呈显著负相关（均P＜0.05）;与腰臀比、体质量指数及体脂含量（%）呈负相关,但差异无统计学意义（均P＞0.05）。逐步多元线性回归分析显示lg HOMA-IR（t=-4.278,P=0.001）、TAAT（t=-5.146,P=0.002）与.lg 25(OH)D3独立相关。结论　太原社区非糖尿病人群约90%存在维生素D缺乏和不足,在维生素D缺乏和不足人群中约4/5为腹型肥胖。血清25(OH)D3水平与腹部脂肪面积呈显著负相关,而与体质量指数无明显相关。HOMA-IR、.TAAT.是25(OH)D3缺乏的独立危险因素。     

Prevalence of obesity and abdominal obesity in the Lausanne population

Background  

Obesity can be defined using body mass index (BMI) or waist (abdominal obesity). Little information exists regarding its prevalence and determinants in Switzerland. Hence, we assessed the levels of obesity as defined by BMI or waist circumference in a Swiss population-based sample.     

广东食管癌高低发区烟酒消费与食管癌的关系

目的研究南方食管癌高发区及低发区人群烟酒消费与食管癌的关系。方法在广东高发区南澳县、低发区汕尾市采用整群抽样方法调查608名居民的吸烟、饮酒习惯。采用构筑式logistic回归及协方差分析法研究烟酒消费与食管癌的联系。结果南澳男性居民吸烟率比汕尾高13.3%,但女性吸烟率两地相同。消除年龄影响后,南澳男性居民人均累计吸烟量比汕尾多4 582包;男性人均累计吸烟量每增加1 000包,发生高食管癌死亡率的估计危险性增加1.196倍。结论吸烟量可能在南澳男性居民食管癌病因学中起着一定作用。     

Impact of changes in distilled spirits availability on alcohol distribution

An important change in the distribution and availability of distilled spirits in North Carolina has resulted from a move to liquor-by-the-drink. Previously drinkers had to plan to bring distilled spirits with them to eating establishments and purchase mixers and ice; LBD eliminates the need for such planning and makes liquor more easily available. The shift from more restrictive to less restrictive availability does not occur immediately after a local election but is gradual over a two-year period following a local election.     

Sugary drink consumption behaviours among young adults at university

Aim: Sugary drink consumption is associated with weight gain, and young adults are the highest consumers. To inform a university healthy beverage intervention, we studied the settings and the types and amounts of sugary drinks consumed by a sample drawn from the student population. Methods: Fifty university students (24 male) were recruited to keep records of all beverages consumed over four consecutive days. The records were analysed by gender, drink category and consumption setting. Results: Males drank marginally more sugary drinks than females (median daily intake of 526 mL compared with 300 mL, P = 0.06). Median energy intake from sugary drinks was 928 kJ for males and 481 kJ for females. Carbonated soft drinks and fruit‐based drinks accounted for 64% of energy from sugary drinks for males; and fruit and sweetened milk‐based drinks accounted for 68% of energy for females. Half of all sugary drink consumption occurred at home followed by social settings. Conclusion: Health promotion programmes aiming to reduce sugary drink consumption in this group would benefit from gender‐differentiated strategies with respect to types of drinks consumed with a focus on the home and social settings.     

饮酒与三种转氨酶关系的探讨

目的 探讨长期饮酒人群中酒精摄入量与丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)三种转氨酶的关系.方法 采用自行编制的调查问卷对云南省楚雄彝族自治州的彝族居民进行饮酒行为调查,根据纳入标准(平均每周饮酒次数≥3次或平均每次饮酒折合成高度白酒2.5两或以上),按照随机原则在以上饮酒者中选取124人,对其生化指标进行分析.结果 平均酒精摄入量与饮酒者的log ALT(r=0.378,P＜0.01)、log AST(r=0.406,P＜0.01)、log GGT(r=0.468,P＜0.01)水平均呈正相关;按不同酒精摄入量分组,各组在三项转氨酶水平上差异有统计学意义,随着酒精摄入量的增加,三项转氨酶水平也随之增高.结论 肝细胞转氨酶水平与酒精摄入量有一定的关系,因此对长期饮酒者进行血清转氨酶检测有着重要意义.     

Intended and unintended consequences of a proposed national tax on sugar-sweetened beverages to combat the U.S. obesity problem

Monthly data derived from the Nielsen Homescan Panel for calendar years 1998 through 2003 are used to estimate the effects of a proposed tax on sugar-sweetened beverages (SSBs). Most arguments in describing the ramifications of a tax fail to consider demand interrelationships among various beverages. To circumvent this shortcoming we employ a variation of Quadratic Almost Ideal Demand System (QUAIDS) model. The consumption of isotonics, regular soft drinks and fruit drinks, the set of SSBs, is negatively impacted by the proposed tax, while the consumption of fruit juices, low-fat milk, coffee, and tea is positively affected. Diversion ratios are provided identifying where the volumes of the SSBs are directed as a result of the tax policy. The reduction in the body weight as a result of a 20% tax on SSBs is estimated to be between 1.54 and 2.55 lb per year. However, not considering demand interrelationships would result in higher weight loss. Unequivocally, it is necessary to consider interrelationships among non-alcoholic beverages in assessing the effect of the tax.     

The association between age at first use of alcohol and alcohol consumption levels among adult general drinking population

Aim

The goal of the study was to investigate the association between age at first alcohol use and current levels of alcohol consumption among the adult Australian general drinking population.

Subject and methods

A retrospective cohort study was performed using self-report data collected by the 2004 and 2007 Australian National Drug Strategy Household surveys. Participants were selected using a multi-stage, stratified-area, random sample design. Male and female participants aged 20–49?years at the time of the survey, who were current drinkers and consumed their first full serve of alcohol before the age of 25?years, were included in this study. Poisson regression models (with robust estimations of variance) were used to explore associations between age when a full serve of alcohol was first consumed and relative likelihood of consuming alcohol above low risk levels at the time of survey, while adjusting for a number of potential confounders.

Results

Younger age at first use of alcohol was associated with increased likelihood of consuming alcohol at levels associated with increased risk of long- and short-term harms in adulthood, even among a subsample of participants with good mental health status as measured by the Kessler Psychological Distress Scale.

Conclusion

Younger age at first use of alcohol was associated with increased likelihood of high level alcohol use in adulthood. Effective strategies to delay onset of alcohol use are needed in order to reduce the future prevalence of high risk drinking adults.     

Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk

Background

Diet, smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation. We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study, a randomized dietary primary prevention trial conducted in Spain.

Methods

7000 subjects at high cardiovascular risk were assessed cross-sectionally. A healthy lifestyle pattern (HLP) was determined using a score including: adherence to the Mediterranean diet, moderate alcohol consumption, expending ≥ 200 kcal/day in leisure-time physical activity, and non-smoking.

Results

Inverse linear trends were observed between the HLP-score and body-mass-index (BMI) or waist circumference (p < 0.001). The BMI and waist circumference of participants with a HLP-score = 4 were, respectively, 1.3 kg/m² (95% CI: 0.9 to 1.7) and 4.3 cm (3.1 to 5.4) lower than those of subjects with an HLP ≤ 1. The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score ≤ 1 were 0.50 (0.42 to 0.60) and 0.51 (0.41 to 0.62), respectively

Conclusion

A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk.     

Protein intake is inversely associated with abdominal obesity in a multi-ethnic population

Abdominal obesity is related to significant morbidity and mortality and differs by ethnicity; however, the relation between diet and abdominal obesity has not been extensively studied. The aim of this study was to evaluate the dietary and lifestyle determinants of abdominal obesity in a multi-ethnic population. We conducted a cross-sectional study among 617 Canadians of Aboriginal, South Asian, Chinese, and European origins, with diet evaluated using validated, culture specific, interviewer-administered FFQs, and abdominal obesity measured as waist-hip ratio (WHR). The mean proportion of energy intake from protein in the diet was 17.4 vs. 15.8% comparing the lowest and highest tertiles of WHR. Energy-adjusted protein substituted for an equivalent amount of carbohydrate was associated with a reduction in WHR (difference in WHR for every g/d increase in protein intake = -0.0005, P = 0.01) after accounting for age, sex, ethnicity, smoking status, BMI, alcohol intake, height, physical activity, and total energy. Fat or total energy were not related to WHR in the same linear regression model. Smoking was positively and physical activity inversely related to WHR in the multivariate model independent of BMI and other potential confounders. Substituting a modest amount of protein for carbohydrate may reduce abdominal obesity in a diverse multi-ethnic population. Smoking was positively related to abdominal obesity after accounting for BMI.     

济南市城区7~17岁儿童青少年腹型肥胖流行现状分析

目的 采用腰围和腰围身高比的不同诊断标准,全面描述济南市城区儿童青少年腹型肥胖流行状况,为儿童青少年肥胖的防治提供基础依据。方法 数据来源于2012年9月-2014年9月进行的十二五国家科技支撑计划项目“儿童心血管疾病的预警、诊治技术研究”分课题济南调查点。腹型肥胖分别采用腰围和腰围身高比的不同标准进行评价。采用χ²检验比较不同年龄段男女的腹型肥胖检出率差异,并计算kappa值,比较腰围与腰围身高比(WHtR)不同诊断标准之间的一致性。结果 济南市城区7~17岁儿童青少年的腹型肥胖检出率分别为28.1%(WC-中国标准)、22.2%(WC-北京标准)、17.7%(WHtR-国际标准)和27.3%(WHtR-中国标准)。低学龄组(7~11岁)腹型肥胖检出率随年龄增加表现为上升趋势,高学龄组(12~17岁)腹型肥胖检出率随年龄增加呈现下降趋势。无论采用何种标准,高学龄组(12~17岁)中男生腹型肥胖检出率明显高于女生。结论 济南市城区7~17岁儿童青少年腹型肥胖处于流行状态,应当引起政府和教育相关部门的重点关注。     

不同肥胖指标对糖尿病风险预测效果分析

目的 探讨体质指数(BMI)、腰围(WC)、腰臀比(WHR)、腰围身高比(WHtR)4种肥胖指标对预测糖尿病风险的效果.方法 利用四川成都市2008年调查5 205名40～70岁人群数据,分析4种指标及身高的相关关系;应用受试者特性曲线(ROC)、Logistic回归分析比较4个指标对糖尿病的预测效果.结果 WHtR与腰围相关性最高(男性r=0.938 4,女性r=0.956 2,P<0.05);4个指标中,ROC曲线下面积男性WHR最大,女性WHtR最大(男性c=0.641 5,女性c=0.669 2);Logistic回归分析中,男性WHR,女性WC预测价值最佳(男性OR=3.107,女性OR=2.684),调整4个指标交互作用后,BMI结合WC、WHR、WHtR并不能明显提高模型预测效果.结论 本研究人群糖尿病风险模型中,男性选择WHR作为肥胖评定指标,最佳切点为0.90,女性选择WC作为肥胖评定指标,最佳切点为83 cm,但在不同地区和人群的应用需要进一步研究.     

Smoking and alcohol consumption in a UK Chinese population

Little research has been conducted on health in Chinese communities in the UK and there are few representative data on smoking, alcohol consumption or other aspects of lifestyle. We undertook a cross sectional population-based study of 380 Chinese and 625 European men and women aged 25 to 64 y, using self-completion and interview questionnaires in Newcastle upon Tyne, UK between 1991 and 1995. We measured self-reported prevalence of cigarette smoking, number of cigarettes smoked per week and age at starting smoking; self-reported prevalence of alcohol consumption and units of alcohol consumed per week. In age-adjusted comparisons smoking was less common in Chinese (24%) than European men (35%) (P=0.00002) and among Chinese (1%) compared with European women (33%) (P<0.00001). Number of cigarettes smoked was similar among Chinese and European male smokers. Median age at starting smoking was higher among Chinese (18.5 y) compared with European men (15 y) (P=0.00001). Smoking was commonest in older Chinese and in younger Europeans.The prevalence of alcohol consumption was lower among Chinese (63%) than European men (93%) (P<0.00001) and among Chinese (29%) compared to European women (89%) (P<0.00001). Median alcohol consumption was significantly lower among Chinese (2 units/week) than European men (16 units/week) (P<0.00001), and among Chinese (1 unit/week) compared to European women (6 units/week) (P<0.00001). Among those who drank alcohol, Chinese men were less likely to drink above recommended limits than European men (1% vs 39%; P<0.00001). Chinese men and women currently have relatively favourable patterns of smoking compared to European adults in Newcastle. Average alcohol consumption among Chinese who drink is lower than among Europeans, and a substantial proportion of the Chinese population in Newcastle drink no alcohol. Patterns of health related behaviour should be tracked over time in ethnic minority populations to identify changes that pose risk to health and which deserve appropriate intervention.     

Sensory‐enhanced beverages: Effects on satiety following repeated consumption at home

Growing research suggests that a consumer's experience of satiety is influenced by information present at the time of, or before, food consumption. For example, making small modifications to the sensory characteristics of a high‐energy beverage (specifically thickness and creaminess) enhances its impact on subsequent satiety. Previous research has examined these sensory‐enhanced satiety effects in the laboratory but not in the ‘real world’. Therefore, the present study, using a cross‐over design, compared the effects of ‘real world’ consumption of two high‐energy versions of a beverage (sensory‐enhanced and unenhanced) and a low‐energy control beverage on satiety. Thirty‐four volunteers were provided with shelf‐stable dry powder mixes for the three test beverages, which varied in energy content and sensory characteristics, to which they added a commercially available juice. The volunteers prepared and consumed each beverage on eight occasions over a 3‐week period at home. Controlled satiety testing occurred in the laboratory either side of this exposure period. Focus groups were also conducted to assess consumer attitudes towards ‘enhanced satiety’ products and claims. Results of the satiety study indicate that appetite sensations and subsequent food intake were lower following consumption of the sensory‐enhanced high‐energy beverage relative to the unenhanced and control versions, and that these effects were maintained following repeated product consumption in the ‘real world’. The focus groups highlighted that consumers are aware of sensory and cognitive influences on satiety, though noted that dieting populations might benefit most from enhanced satiety products. Implications for further research and the role of satiety for consumers and manufacturers are discussed.