Alcohol drinking frequency in relation to subsequent changes in waist circumference

BACKGROUND: Cross-sectional studies have reported a lower prevalence of abdominal obese persons among frequent drinkers than among nonfrequent drinkers. OBJECTIVE: We tested the hypothesis that drinking frequency is associated with subsequent changes in waist circumference. DESIGN: Data come from a prospective cohort study conducted in 1993-1997 (baseline) and 1999-2002 (follow-up) and included 43 543 men and women. Baseline information on alcohol drinking frequency was related to 1) change in waist circumference by linear regression and 2) major gain and major loss in waist circumference (defined as waist change in the lowest or highest quintile of waist changes) by polytomous logistic regression, also taking into account amount of alcohol intake. RESULTS: Drinking frequency was inversely associated with changes in waist circumference in women and was unassociated with changes in waist circumference in men. Drinking frequency was unassociated with major waist loss but was inversely associated with major waist gain: odds ratios among men were 0.97 (95% CI: 0.73, 1.28), 0.95 (95% CI: 0.81, 1.12), 0.88 (95% CI: 0.77, 0.99), 0.82 (95% CI: 0.71, -0.95), and 0.79 (95% CI: 0.69, 0.9) for never drinking, drinking on 1, 2-4, 5-6, and 7 d/wk, respectively, compared with men who drank alcohol on <1 d/wk (P for trend < 0.0001). Results for women were similar. Adjustment for the amount of alcohol intake or total energy intake did not affect results considerably. CONCLUSIONS: Drinking pattern may be associated with development of abdominal obesity; in this prospective study, drinking frequency was inversely associated with major waist gain and was unassociated with major waist loss.     

Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death

BACKGROUND: Guidelines for optimal weight in older persons are limited by uncertainty about the ideal body mass index (BMI) or the usefulness of alternative anthropometric measures. OBJECTIVE: We investigated the association of BMI (in kg/m(2)), waist circumference, and waist-hip ratio (WHR) with mortality and cause-specific mortality. DESIGN: Subjects aged >/=75 y (n = 14 833) from 53 family practices in the United Kingdom underwent a health assessment that included measurement of BMI and waist and hip circumferences; they also were followed up for mortality. RESULTS: During a median follow-up of 5.9 y, 6649 subjects died (46% of circulatory causes). In nonsmoking men and women (90% of the cohort), compared with the lowest quintile of BMI (<23 in men and <22.3 in women), adjusted hazard ratios (HRs) for mortality were <1 for all other quintiles of BMI (P for trend = 0.0003 and 0.0001 in men and women, respectively). Increasing WHR was associated with increasing HRs in men and women (P for trend = 0.008 and 0.0002, respectively). BMI was not associated with circulatory mortality in men (P for trend = 0.667) and was negatively associated in women (P for trend = 0.004). WHR was positively related to circulatory mortality in both men and women (P for trend = 0.001 and 0.005, respectively). Waist circumference was not associated with all-cause or circulatory mortality. CONCLUSIONS: Current guidelines for BMI-based risk categories overestimate risks due to excess weight in persons aged >/=75 y. Increased mortality risk is more clearly indicated for relative abdominal obesity as measured by high WHR.     

Central obesity is common in renal transplant recipients and is associated with increased prevalence of cardiovascular risk factors

Aim: Obesity following renal transplantation is common and may be associated with cardiovascular disease. We sought to investigate the prevalence of central obesity in renal transplant recipients (RTR) and its association with cardiovascular risk factors. Methods: Weight, height, body mass index (BMI), waist and hip circumference, and biochemical cardiovascular risk factors were prospectively measured in 199 RTR, and were compared against published data from the Australian general population. Results: When obesity was defined by BMI, there was no difference between RTR and the Australian population irrespective of age. Significantly more female RTR had central obesity (defined as waist circumference ≥90 cm for men and ≥80 cm for women) when compared with the general population, and this was apparent at a younger age. In younger women (<45 years), 76% of RTR had central obesity compared with 17% of women from the general population (P < 0.0001). This trend was also seen in older female RTR. Younger male RTR (<45 years) had a greater prevalence of central obesity than aged‐matched men in the general population (66% vs 44%, respectively, P < 0.001). This trend was not seen in older male RTR. Centrally obese RTR gained significantly more weight post transplant than those who were lean (9.5 kg vs 2.4 kg, respectively, P < 0.0001), and were more likely to have a history of childhood obesity (P = 0.04). On multivariate analysis, central obesity was independently associated with weight gain post transplant (P < 0.001), a history of hyperlipidaemia (P = 0.01) and a history of hypertension (P = 0.02). Conclusion: Central obesity is a common problem for all RTR, particularly women and men aged below 45 years. Measures of central obesity should be used for RTR in clinical practice. BMI is not a suitable measure to determine central obesity. Central obesity is associated with cardiovascular risk factors, and further studies targeting multidisciplinary lifestyle interventions are recommended.     

Effects of obesity and body fat distribution on lipids and lipoproteins in nondiabetic American Indians: The Strong Heart Study

OBJECTIVES: To examine the relationship between obesity and lipoprotein profiles and compare the effects of total obesity and central adiposity on lipids/lipoproteins in American Indians. RESEARCH METHODS AND PROCEDURES: Participants were 773 nondiabetic American Indian women and 739 men aged 45 to 74 years participating in the Strong Heart Study. Total obesity was estimated using body mass index (BMI). Central obesity was measured as waist circumference. Lipoprotein measures included triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein AI (apoAI), and apolipoprotein B (apoB). Partial and canonical correlation analyses were used to examine the associations between obesity and lipids/ lipoproteins. RESULTS: Women were more obese than men in Arizona (median BMI 32.1 vs. 29.2 kg/m2) and South Dakota and North Dakota (28.3 vs. 28.0 kg/m2), but there was no sex difference in waist circumference. Men had higher apoB and lower apoAI levels than did women. In women, when adjusted for center, gender, and age, BMI was significantly related to HDL cholesterol (r = -0.24, p < 0.001). There was a significant but weak relation with apoAI (r = -0.14, p < 0.001). Waist circumference was positively related to triglycerides (r = 0.14, p < 0.001) and negatively related to HDL cholesterol (r = -0.23, p < 0.001) and apoAI (r = -0.13, p < 0.001). In men, BMI was positively correlated with triglycerides (r = 0.30, p < 0.001) and negatively correlated with HDL cholesterol (r = -0.35, p < 0.001) and apoAI (r = -0.23, p < 0.001). Triglycerides increased with waist circumference (r = 0.30, p < 0.001) and HDL cholesterol decreased with waist circumference (r = -0.36, p < 0.001). In both women and men there was an inverted U-shaped relationship between obesity and waist with LDL cholesterol and apoB. In canonical correlation analysis, waist circumference received a greater weight (0.86) than did BMI (0.17) in women. However, the canonical weights were similar for waist (0.46) and BMI (0.56) in men. Only HDL cholesterol (-1.02) carried greater weight in women, whereas in men, triglycerides (0.50), and HDL cholesterol (-0.64) carried a large amount of weight. All the correlation coefficients between BMI, waist circumference, and the first canonical variable of lipids/lipoproteins or between the individual lipid/lipoprotein variables and the first canonical variable of obesity were smaller in women than in men. Triglycerides and HDL cholesterol showed clinically meaningful changes with BMI and waist circumference in men. All lipid/lipoprotein changes in women in relation to BMI and waist circumference were minimal. DISCUSSION: The main lipoprotein abnormality related to obesity in American Indians was decreased HDL cholesterol, especially in men. Central adiposity was more associated with abnormal lipid/lipoprotein profiles than general obesity in women; both were equally important in men.     

General obesity and central adiposity in a representative sample of Tehranian adults: prevalence and determinants

AIMS: To determine the prevalence and associations of general and central obesity in adults residing in district 13 of Tehran and to examine the associations of obesity with certain factors. DESIGN: Population-based cross sectional study. SETTING: Tehran, the capital of Iran. SUBJECTS: A total of 9984 subjects (4164 men and 5820 women) aged 20-70 years. METHODS: Demographic data were collected and anthropometric indices including weight, height, and waist and hip circumference were measured, according to standard protocols. Dietary intake was assessed by means of two 24-hour dietary recall forms. To determine the prevalence and association of general and central obesity, the suggested cut-off for Tehranian people, adjusted for their age group, was used. A body mass index (BMI) of > or =24 for men and > or =25 for women was used to determine the characteristic of obesity. Central obesity was determined as a waist-hip ratio (WHR) of > 0.86 for men and WHR > or = 0.78 for women. To determine the associations between general and central obesity and other factors, logistic regression was used. RESULTS: The means of BMI, waist circumference (WC), and WHR were 25.8 +/- 4.1 kg/m2, 88.3 +/- 11.4 cm, and 0.91 +/- 0.07 in men and 27.3 +/- 5.4 kg/m2, 87.5 +/- 12.9 cm, and 0.83 +/- 0.08 in women, respectively. Obesity and central obesity were higher in women than in men; 67% vs. 29% for obesity and 93% vs. 74.1% for central obesity, respectively. Illiteracy (OR = 1.65; 95% CI = 1.13-2.41 in men; OR = 1.87, 95% CI = 1.59-2.21 in women), marriage (OR = 3.84, 95% CI = 3.63-4.29 in men; OR = 3.20, 95% CI = 3.63-4.19 in women), and very low physical activity (OR = 1.35, 95% CI = 1.09-1.53 in men; OR = 1.39, 95% CI = 1.10-1.76 in women) were factors associated with obesity. The risk of being centrally obese for men in the fourth quartile of legumes intake was lower than men in other quartiles (p < 0.05). Women in the first quartile of dairy consumption had the highest risk of being generally and centrally obese (OR = 2.16, 95% CI = 1.72-2.48 for general obesity and OR = 3.01, 95% CI = 2.36-3.67 for central obesity). The risk of obesity for women in the fourth quartile of energy and saturated fatty acid consumption was higher than for those in the first quartile (OR = 2.69, 95% CI = 2.39-3.11 for energy and OR = 1.36, 95% CI= 1.10-1.64 for saturated fatty acids). The risk of being centrally obese was higher for women in the first quartile of protein intake compared with women in the fourth quartile (OR = 1.71, 95% CI = 1.02-2.32). CONCLUSIONS: The results from this national population-based study in Iran show high prevalence of obesity in Tehranian adults. The strong associations between obesity and certain life style factors confirm the necessity of multifactorial intervention.     

Prevalence of obesity in a Canarian community. Association with type 2 diabetes mellitus: the Guía Study

OBJECTIVE: We sought to estimate the prevalence of obesity and central obesity, and their association with type 2 diabetes mellitus in the Canarian community of Guía. DESIGN AND SETTING: Population-based study. SUBJECTS: A random sample of 691 subjects over 30 y old (stratified by age and sex) was studied. DATA AND MEASURES: Age, sex, family history of diabetes and medication use were obtained, height, weight and waist circumference were measured and standard oral glucose tolerance tests were performed RESULTS: The prevalences of obesity/central obesity were 36.5%/66.5% (women) and 23.6%/32.0% (men). The prevalence of diabetes was 21.0% (women) and 18.4% (men). These rank among the highest in Europe. Bivariate analyses show a strong association of both obesity and central obesity with diabetes mellitus (P<0.001), but in a multivariate model, waist circumference (P<0.001) but not body mass index (P=0.212) was retained as an independent predictor of diabetes. CONCLUSION: The prevalences of obesity, central obesity and diabetes in our community are extremely high, and central obesity is a better predictor of diabetes than obesity.     

中国育龄女性腹型肥胖相关因素的纵向多水平分析

目的纵向分析身体活动、静坐时间和膳食摄入水平对中国育龄女性腰围、腹型肥胖的影响。方法在"中国健康与营养调查"于2004、2006、2009、2011、2015年的五轮调查中,选择至少参加过两轮调查的2951名15~49岁的育龄女性为研究对象,采用问卷调查收集身体活动和静坐时间数据、采用连续3天24小时回顾法收集食物消费数据。采用方差分析对连续性变量的时间差异进行分析,采用卡方检验对分类变量的时间分布差异进行分析,采用线性多水平模型分析不同身体活动、静坐时间和膳食摄入水平与腰围的关系,采用Logistic多水平模型分析不同身体活动、静坐时间和膳食摄入水平与腹型肥胖的患病风险。结果将身体活动、静坐时间和膳食摄入水平分别纳入多水平模型后,与低水平休闲身体活动相比,中等水平休闲身体活动组的腰围增加了0.47 cm(P=0.025);与低水平电视时间相比,中、高水平电视时间组的腰围分别增加0.49 cm(P=0.033)和0.58 cm(P=0.013),发生腹型肥胖的相对危险度分别是1.13(P=0.049)和1.17(P=0.010);与深色蔬菜摄入不足组相比,摄入充足组的腰围减少0.82 cm(P<0.001),发生腹型肥胖的相对危险度是0.87(P=0.028);与低水平糕点摄入组相比,高水平摄入组的腰围增加1.16 cm(P<0.001),发生腹型肥胖的相对危险度是1.33(P<0.001)。将身体活动、静坐时间和膳食摄入水平同时纳入多水平模型后,电视时间和膳食摄入水平与腰围及腹型肥胖仍然存在统计学意义,且统计值相差不大。与低水平电视时间相比,中、高水平电视时间组的腰围分别增加0.54 cm (P=0.028)和0.58 cm (P=0.025),发生腹型肥胖的相对危险度为1.15(P=0.034)和1.18(P=0.011);与深色蔬菜摄入不足组相比,摄入充足组的腰围减少0.80 cm(P<0.001),发生腹型肥胖的相对危险度是0.87(P=0.027);与低水平糕点摄入组相比,高水平摄入组的腰围增加1.13 cm(P<0.001),发生腹型肥胖的相对危险度是1.32(P<0.001)。身体活动水平与腰围及腹型肥胖无统计学意义。结论电视时间、膳食因素(深色蔬菜摄入不足、糕点摄入过多)是影响中国育龄女性腹型肥胖的独立危险因素。除了加强体育活动外,预防育龄女性腹型肥胖还应该加强减少电视时间、推广适当膳食行为(增加深色蔬菜摄入、减少糕点摄入)的干预措施。     

Obesity and the risk of Parkinson's disease

Dopamine is involved in the regulation of food intake, and obese persons have decreased dopamine D2 receptor availability in the striatum. Furthermore, midlife triceps skinfold thickness has been found to be positively associated with the risk of Parkinson's disease (PD) among Japanese-American men in Hawaii. The authors prospectively investigated whether obesity was associated with PD risk in two large cohorts of US men and women. They documented 249 cases of PD in men (1986-2000) and 202 cases in women (1976-1998). Neither baseline body mass index (weight (kg)/height (m)(2)) nor early adult body mass index was associated with PD risk. The multivariate relative risk for a baseline body mass index of > or = 30 versus <23 was 0.8 (95% confidence interval (CI): 0.6, 1.2; p for trend = 0.3). Overall, waist circumference and waist-to-hip ratio were not related to PD risk. However, among never smokers, both variables showed significantly positive associations with PD risk. The relative risks for comparisons of extreme quintiles were 1.9 (95% CI: 1.0, 3.4; p for trend = 0.03) for waist circumference and 2.0 (95% CI: 1.1, 3.6; p for trend = 0.03) for waist-to-hip ratio. The results do not support a role of overall obesity in PD pathogenesis; however, central obesity may be associated with higher PD risk among never smokers, and this finding merits further investigation.     

Nutritional status and dietary habits of the population of the Calchaqui Valleys of Tucuman, Argentina

ObjectiveTo assess the nutritional status and dietary habits of the adult population of the Calchaqui Valleys of Tucuman.MethodsA cross-sectional nutritional survey that included one 24-h recall, a semiquantitative food-frequency questionnaire, and anthropometric measurements was conducted in a representative sample of 113 adult participants. Pregnant and lactating women were excluded. Overweight and obesity were assessed according to body mass index, and the percentage of individuals with cardiovascular risk according to waist circumference and waist-to-hip circumference ratio was determined. Dietary habits were described according to the mean nutrient and food intakes of men and women.ResultsMeans ± standard deviations for total energy intake of men and women were 1856 ± 859 and 1589 ± 799 kcal/d, respectively. The average body mass indices of men and women were 26.8 and 26.7 kg/m², respectively. Thirty-seven percent of the population was overweight and 22.8% was obese, whereas 1.8% of the population was undernourished. Central adiposity was high (mean waist circumferences 99.8 and 87.3 cm in men and women, respectively).ConclusionsDespite the low average energy intake, the population under study showed a high prevalence of overweight and obesity and a high risk of cardiovascular disease according to the central adiposity values. These findings could be explained by the introduction of new high-energy foods and a sedentary lifestyle or the possibility that the biological characteristics of these individuals make them more predisposed to a rapid increase in adiposity.     

Serum concentrations of beta-carotene and alpha-tocopherol are associated with diet, smoking, and general and central adiposity

BACKGROUND: Previous studies of associations between diet, obesity, and blood concentrations of alpha-tocopherol and beta-carotene have been equivocal. Furthermore, most studies used only body mass index (BMI) as an obesity measure. OBJECTIVES: Our objectives were to examine the associations between energy and nutrient intakes, alcohol consumption, tobacco use, and serum cholesterol and serum concentrations of alpha-tocopherol and beta-carotene, and to examine the associations between different measures of general and central adiposity and serum concentrations of alpha-tocopherol and beta-carotene. DESIGN: This was a cross-sectional, population-based study of 253 men and 276 women aged 46-67 y. Nutrient data were collected by a modified diet history method. Measures of obesity included BMI, percentage of body fat (impedance analysis), waist-to-hip ratio, and waist circumference. The associations between serum nutrient concentrations and the other factors were examined by multiple linear regression. RESULTS: Twenty-one percent of men and 34% of women used antioxidant supplements. The mean BMI was 26.1 in men and 25.4 in women. Serum beta-carotene concentration was positively associated with serum cholesterol concentration, fiber intake, and beta-carotene intake, and negatively associated with smoking and all measures of obesity. In men, serum beta-carotene concentration was not significantly associated with central adiposity after adjustment for body fat. Serum alpha-tocopherol concentration was positively correlated with serum cholesterol, obesity, and vitamin E intake. In women, serum alpha-tocopherol concentration was also positively associated with intakes of ascorbic acid and selenium. Serum alpha-tocopherol concentration was associated with central adiposity after adjustment for body fat. CONCLUSION: Serum beta-carotene and alpha-tocopherol concentrations have different associations with diet, smoking, general adiposity, and central adiposity.     

Prospective effect of job strain on general and central obesity in the Whitehall II Study

Positive energy balance is the major cause of obesity, and chronic stress may be a contributory factor. The authors examined cumulative work stress, using the Job Strain Questionnaire on four occasions, as a predictor of obesity in a prospective 19-year study of 6,895 men and 3,413 women (aged 35-55 years) in the Whitehall II cohort in London, United Kingdom (baseline: 1985-1988). A dose-response relation was found between work stress and risk of general obesity (body mass index > or =30 kg/m(2)) and central obesity (waist circumference >102 cm in men, >88 cm in women) that was largely independent of covariates. The imputed odds ratios of body mass index obesity for one, two, and three or more reports of work stress adjusted for age, sex, and social position were 1.17, 1.24, and 1.73 (trend p < 0.01), respectively. For waist obesity, the corresponding findings were 1.17, 1.41, and 1.61 (trend p < 0.01). Work stress effect was modestly attenuated after exclusion of obese individuals at baseline and further adjustments for smoking; intakes of dietary fiber, fruits and vegetables, and alcohol; and levels of physical activity during follow-up. This study provides prospective, population-based evidence that chronic work stress predicts general and central obesity.     

Nutritional status of Japanese-Brazilian subjects: comparison across gender and generation

The present paper describes a nutritional survey carried out among Japanese-Brazilian subjects living in Bauru, south-eastern Brazil. Data were from a cross-sectional population-based study of 1283 first-generation Japanese-Brazilian subjects (Japan-born; 127 men and 121 women) and second-generation Japanese-Brazilian subjects (Brazil-born; 456 men and 573 women) aged 30-90 years. Anthropometric measurements and % body fat were measured and BMI and waist:hip ratio calculated. Dietary assessment was performed using a validated food-frequency questionnaire. A considerable proportion of men (51 %) and women (47 %) had excess weight (BMI>24.9 kg/m2). A greater waist circumference in men and women (age-adjusted by covariance analysis) was observed among Brazil-born participants. In general, only 10 % of the participants reported current practice of sports or other vigorous physical activity. Age-adjusted mean energy intakes and % energy from macronutrients were found to be similar across generations. The age-adjusted mean daily % energy intake from fat were similar across generations: among Japan-born participants, they were 31.5 (95 % CI 30.6, 32.4) % for men and 32.6 (95 % CI 31.7, 33.5) % for women. The respective figures for Brazil-born subjects were 32.1 (95 % CI 31.6, 32.6) % and 33.2 (95 % CI 32.7, 33.5) %. These values are quite different from the usual intakes reported in Japan during the last decades (about 25 %). Taking into account the traditional Japanese diet, a high energy density diet and a sedentary lifestyle may be implicated in the high prevalence of central obesity and metabolic syndrome observed among Japanese-Brazilian subjects across gender and generations.     

Intake of water from foods, but not water from beverages, is related to lower body mass index and waist circumference in free-living humans [corrected

OBJECTIVE: Experimental trials using test meals suggest that water promotes satiety and decreases subsequent intake, thus possibly working to prevent obesity, when it is consumed as an integral component of a food, but not when consumed alone or alongside a food. We examined the associations of intake of water from beverages and intake of water from foods with body mass index (BMI) and waist circumference in free-living humans consuming self-selected diets. METHODS: This observational cross-sectional study included 1136 female Japanese dietetic students 18-22 y of age. Dietary intake was assessed with a validated, self-administered, comprehensive, diet-history questionnaire. BMI was calculated using measured body height and weight. Waist circumference was measured at the level of the umbilicus. RESULTS: Means +/- standard deviations of BMI, waist circumference, intake of water from beverages, and intake of water from foods were 21.3 +/- 2.7 kg/m(2), 72.9 +/- 7.1 cm, 569 +/- 318 g/1000 kcal, and 476 +/- 110 g/1000 kcal, respectively. After adjustment for potential confounding factors, intake of water from beverages was not associated with BMI (P for trend = 0.25) or waist circumference (P for trend = 0.43). Conversely, intake of water from foods showed independent and negative associations with BMI (P for trend = 0.030) and waist circumference (P for trend = 0.0003). CONCLUSION: Intake of water from foods, but not water from beverages, was independently associated with lower BMI and waist circumference in free-living humans consuming self-selected diets.     

Associations of fat distribution and obesity with hypertension in a bi-ethnic population: the ARIC study. Atherosclerosis Risk in Communities Study

OBJECTIVE: To examine associations of hypertension with obesity and fat distribution among African American and white men and women. RESEARCH METHODS AND PROCEDURES: The analysis sample included 15,063 African American and white men and women between the ages of 45 and 64 years who were participants in the 1987 through 1989 examination of the Atherosclerosis Risk in Communities Study (ARIC). Odds ratios and adjusted prevalences of hypertension were calculated across sex-specific quintiles of body mass index (BMI), waist-to-hip ratio (WHR), waist circumference, and waist-to-height ratio (waist/ height) and adjusted for age, research center, smoking, education, physical activity, alcohol consumption, hormone replacement therapy, and menopausal status. RESULTS: The prevalence of hypertension was higher among African Americans than whites. In the lowest quintile of BMI, 41% of African American women and 43% of African American men had hypertension compared with 14% of white women and 19% of white men. Elevated BMI, WHR, waist circumference, and waist/height were associated with increased odds of hypertension in African American and white men and women. In women, but not in men, there were significant interactions between ethnicity and the anthropometric variables studied here. The direction of the interaction indicated larger odds ratios for hypertension with increasing levels of anthropometric indices in white compared with African American women. DISCUSSION: Obesity and abdominal fat preponderance were associated with increased prevalence of hypertension in African American and white men and women. Associations were similar among African American and white men, but obesity and fat patterning were less strongly associated with hypertension in African American than in white women.     

Longitudinal Association of Dietary Energy Density with Abdominal Obesity among Chinese Adults from CHNS 1993–2018

Few studies have explored the longitudinal association between dietary energy density and waist circumference and abdominal obesity in adults in China. This study aimed to analyze the relationship between dietary energy density and waist circumference and abdominal obesity in Chinese residents aged 18–64. Using data from the CHNS from 1993 to 2018, 25,817 adult residents aged 18 to 64 were selected for the study. Three consecutive 24-h dietary recalls and home-weighed seasonings were used to assess food intake. A multilevel model was used to analyze the relationship between dietary energy density and waist circumference and abdominal obesity. The results showed that compared with the lowest dietary energy density group, females had an increased risk of abdominal obesity (OR = 1.16, 95% CI: 1.05, 1.29), and females’ waist circumference increased significantly by 0.24 cm (95% CI: 0.39–1.09) in the highest dietary energy density group. No association between dietary energy density and waist circumference and abdominal obesity was observed in males. This study shows that higher dietary energy density is significantly associated with females’ waist circumference and abdominal obesity. Further research on high dietary energy density and abdominal obesity will provide scientific basis for the effective control of abdominal obesity.     

Sagittal abdominal diameter: no advantage compared with other anthropometric measures as a correlate of components of the metabolic syndrome in elderly from the Hoorn Study

BACKGROUND: The sagittal abdominal diameter has been proposed as a useful measure by which to estimate abdominal obesity and as being more strongly related to components of the metabolic syndrome than are other anthropometric measures. OBJECTIVE: The objective was to study which anthropometric measure (ie, sagittal abdominal diameter, waist circumference, waist-to-hip ratio, waist-to-height ratio, or body mass index) is the strongest correlate of components of the metabolic syndrome (ie, glucose and lipid concentrations and blood pressure) in the elderly. DESIGN: The Hoorn Study is a population-based cohort study in older Dutch men and women. Cross-sectional data were analyzed. Age-adjusted Pearson correlations of anthropometric measures with components of the metabolic syndrome were calculated in 826 subjects (389 men, 437 women) aged 56-83 y. Analyses were performed with adjustment for age and stratification for sex and age (<65 or >/=65 y). RESULTS: No single anthropometric measure was consistently correlated more strongly with components of the metabolic syndrome than were the other measures in either men or women. The associations were generally stronger in younger subjects than in older subjects and in women than in men. For example, the correlation between sagittal abdominal diameter and postload glucose was 0.35 (P < 0.001) in younger and 0.14 (P = 0.051) in older men, and the correlation between waist circumference and postload glucose was 0.33 (P < 0.001) in older women and 0.14 (P = 0.062) in older men. CONCLUSION: The use of sagittal abdominal diameter has no advantages over simpler and more commonly used anthropometric measures such as the waist circumference in older men and women.     

Obesity in South Africa: the South African demographic and health survey

OBJECTIVES: To ascertain the anthropometric profile and determinants of obesity in South Africans who participated in the Demographic and Health Survey in 1998. RESEARCH METHODS AND PROCEDURES: A sample of 13,089 men and women (age, > or =15 years) were randomly selected and then stratified by province and urban and nonurban areas. Height, weight, mid-upper arm circumference, and waist and hip circumference were measured. Body mass index (BMI) was used as an indicator of obesity, and the waist/hip ratio (WHR) was used as an indicator of abdominal obesity. Multivariate regression identified sociodemographic predictors of BMI and waist circumference in the data. RESULTS: Mean BMI values for men and women were 22.9 kg/m(2) and 27.1 kg/m(2), respectively. For men, 29.2% were overweight or obese (> or =25 kg/m(2)) and 9.2% had abdominal obesity (WHR > or =1.0), whereas 56.6% of women were overweight or obese and 42% had abdominal obesity (WHR >0.85). Underweight (BMI <18.5 kg/m(2)) was found in 12.2% of men and 5.6% of women. For men, 19% of the variation of BMI and 34% of the variation in waist circumference could be explained by age, level of education, population group, and area of residence. For women, these variables explained 16% of the variation of BMI and 24% of the variation in waist circumference. Obesity increased with age, and higher levels of obesity were found in urban African women. DISCUSSION: Overnutrition is prevalent among adult South Africans, particularly women. Determinants of overnutrition include age, level of education, ethnicity, and area of residence.     

Magnesium intake is related to improved insulin homeostasis in the framingham offspring cohort

OBJECTIVE: Higher dietary intake of magnesium may protect against development of type 2 diabetes. The aim of this study was to examine the association between dietary magnesium intake and metabolic risk factors for diabetes. METHODS: We examined cross-sectional associations between magnesium intake and fasting glucose and insulin, 2-hour post-challenge plasma glucose and insulin, and insulin resistance assessed by the homeostasis model (HOMA-IR) in 1223 men and 1485 women without diabetes from the Framingham Offspring cohort. Magnesium intake was assessed by a food frequency questionnaire and magnesium intake was categorized into quintile categories. Geometric mean insulin, glucose, 2-hour post challenge plasma glucose and insulin concentrations and HOMA-IR were estimated across quintile categories of magnesium intake using Generalized Linear Models. RESULTS: After adjustment for potential confounding factors, magnesium intake was inversely associated with fasting insulin (mean: 29.9 vs 26.7 microU/mL in the lowest vs highest quintiles of magnesium intake; P trend <0.001), post-glucose challenge plasma insulin (86.4 vs 72 microU/mL; P trend <0.001), and HOMA-IR (7.0 vs 6.2; P trend <0.001). No significant association was found between magnesium intake and fasting glucose or 2-hour post challenge glucose. CONCLUSIONS: Improved insulin sensitivity may be one mechanism by which higher dietary magnesium intake may reduce the risk of developing type 2 DM.     

Prospective study of zinc intake and the risk of age-related macular degeneration

PURPOSE: Zinc is found in high concentrations in the retina and is hypothesized to reduce the risk of age-related macular degeneration (AMD). Any long-term benefit associated with dietary zinc intake has not been evaluated. METHODS: We followed 66,572 women and 37,636 men who were > or = 50 years old and had no diagnosis of AMD or cancer. Zinc intake from food, multivitamins, and supplements was assessed with a semiquantitative food-frequency questionnaire at baseline (in 1984 for women and in 1986 for men) and repeated during follow-up (twice for women, once for men). RESULTS: During 10 years of follow-up for women and 8 years of follow-up for men, we confirmed 384 incident cases of AMD (195 cases of the early form and 189 cases of the late form) associated with a visual acuity loss of 20/30 or worse. After multivariate adjustment for potential risk factors, the pooled relative risk was 1.13 (95% confidence interval [CI], 0.82 to 1.57; p-value, test for trend, 0.74) among participants in the highest quintile of total zinc intake (energy-adjusted median; 25.5 mg/day for women and 40.1 mg/day for men) compared with those in the lowest quintile (energy-adjusted median; 8.5 mg/day for women and 9.9 mg/day for men). The relative risk for highest compared with lowest quintile was 1.04 (95% CI, 0.59 to 1.83; p-value, test for trend, 0.54) for zinc intake from food. Subjects who took zinc supplements had a pooled multivariate relative risk of 1.04 (95% CI, 0.75 to 1.45). CONCLUSIONS: In these two large prospective studies, moderate zinc intake, either in food or in supplements, was not associated with a reduced risk of AMD.     

Associations between general and abdominal adiposity and mortality in individuals with diabetes mellitus

Individuals with diabetes mellitus are advised to achieve a healthy weight to prevent complications. However, fat mass distribution has hardly been investigated as a risk factor for diabetes complications. The authors studied associations between body mass index, waist circumference, waist/hip ratio, and waist/height ratio and mortality among individuals with diabetes mellitus. Within the European Prospective Investigation into Cancer and Nutrition, a subcohort was defined as 5,435 individuals with a confirmed self-report of diabetes mellitus at baseline in 1992-2000. Participants were aged 57.3 (standard deviation, 6.3) years, 54% were men, the median diabetes duration was 4.6 (interquartile range, 2.0-9.8) years, and 22% of the participants used insulin. Body mass index, as indicator of general obesity, was not associated with higher mortality, whereas all measurements of abdominal obesity showed a positive association. Associations generally were slightly weaker in women. The strongest association was observed for waist/height ratio: In the fifth quintile, the hazard rate ratio was 1.88 (95% confidence interval: 1.33, 2.65) for men and 2.46 (95% confidence interval: 1.46, 4.14) for women. Measurements of abdominal, but not general, adiposity were associated with higher mortality in diabetic individuals. The waist/height ratio showed the strongest association. Respective indicators might be investigated in risk prediction models.