Body mass decrease after initial gain following smoking cessation

BACKGROUND: Although smoking cessation is strongly associated with subsequent weight gain, it is not clear whether the initial gain in weight after smoking cessation remains over time. METHOD: Cross-sectional analyses were made, using data from periodic health examinations for workers, on the relationship between body mass index (BMI) and the length of smoking cessation. In addition, linear regression coefficients of BMI on the length of cessation were estimated according to alcohol intake and sport activity, to examine the modifying effect of these factors on the weight of former smokers. RESULTS: Means of BMI were 23.1 kg/m2, 23.3 kg/m2, 23.6 kg/m2 for light/medium smokers, heavy smokers and never smokers, respectively. Among former smokers who had smoked > or = 25 cigarettes a day, odds ratio (OR) of BMI >25 kg/m2 were 1.88 (95% confidence interval [CI] : 1.05-3.35), 1.32 (95% CI : 0.74-2.34), 0.66 (95% CI: 0.33-1.31) for those with 2-4 years, 5-7 years, and 8-10 years of smoking cessation, respectively. The corresponding OR among those who previously consumed <25 cigarettes a day were 1.06 (95% CI: 0.58-1.94), 1.00 (95% CI: 0.58-1.71), and 1.49 (95% CI: 0.95-2.32). CONCLUSIONS: The results suggest that although heavy smokers may experience large weight gain and weigh more than never smokers in the few years after smoking cessation, they thereafter lose weight to the never smoker level, while light and moderate smokers gain weight up to the never smoker level without any excess after smoking cessation.     

Television, walking, and diet: associations with postpartum weight retention

BACKGROUND: For many women, pregnancy begets long-term weight gain. Modifiable behaviors that contribute to postpartum weight retention have not been well studied. METHODS: Prospective cohort study of 902 women enrolled in Project Viva, examining associations of postpartum television viewing, walking, and trans fat intake with weight retention equal to or greater than 5 kg at 12 months postpartum. Data were collected in 1999-2003 and analyzed in 2005-2006. RESULTS: At 6 months postpartum, women reported a mean (SD) of 1.7 (1.3) hours of television viewing, 0.7 (0.7) hours of walking, and 1.1% (0.5) of energy intake from trans fat per day. At 1 year, participants retained a mean of 0.6 kg (range: -17.3 to 25.5), and 12% retained at least 5 kg. In multivariate logistic regression models, adjusting for maternal sociodemographics, parity, prepregnancy body mass index, gestational weight gain, breastfeeding, and smoking, the odds ratio of retaining at least 5 kg was 1.24 (95% confidence interval [CI]: 1.06-1.46) per daily hour of television viewing, 0.66 (95% CI: 0.46-0.94) per daily hour of walking, and 1.33 (95% CI: 1.09-1.62) per 0.5% increment in daily energy intake from trans fat. Women who watched less than 2 hours of television, walked at least 30 minutes, and consumed trans fat below the median had an odds ratio of 0.23 (95% CI: 0.08-0.66) of retaining at least 5 kg. CONCLUSIONS: Postpartum television viewing, walking, and trans fat intake were associated with weight retention. Interventions to modify these behaviors may help reduce excess postpartum weight gain and prevent obesity among women.     

Individual,social and environmental factors and their association with weight in rural‐dwelling women

Objective: Obesity is a major public health concern and women living in rural settings present a high‐risk group. With contributing factors poorly explored, we evaluated their association with weight in rural Australian women. Methods: Women aged 18–50 years of any body mass index (BMI) were recruited between October 2012 and April 2013 as part of a larger, randomised controlled trial within 42 rural towns. Measured weight and height as well as self‐reported measures of individual health, physical activity, dietary intake, self‐management, social support and environmental perception were collected. Statistical analysis included linear regression for continuous variables as well as chi‐squared and logistic regression for categorical variables with all results adjusted for clustering. Results: 649 women with a mean baseline age and BMI of 39.6±6.7 years and 28.8±6.9 kg/m 2 respectively, were studied. Overall, 65% were overweight or obese and 60% overall reported recent weight gain. There was a high intention to self‐manage weight, with 68% attempting to lose weight recently, compared to 20% of women reporting health professional engagement for weight management. Obese women reported increased weight gain, energy intake, sitting time and prevalence of pre‐existing health conditions. There was an inverse relationship between increased weight and scores for self‐management, social support and health environment perception. Conclusions: Many women in rural communities reported recent weight gain and were attempting to self‐manage their weight with little external support. Implications for public health: Initiatives to prevent weight gain require a multifaceted approach, with self‐management strategies and social support in tandem with building a positive local environmental perception.     

Biosocial Correlates of Nutrition and Chronic Energy Deficiency among Adult Females of two Ecological Zones in Madhya Pradesh and Uttarakhand, India

The paper aims to draw out biosocial correlates of nutrition through body mass index (BMI) and chronic energy deficiency (CED). The findings are based on cross-sectional data of 446 women aged 18-60 years from six different endogamous groups of two ecological zones. The mean age of studied women varied from 31 to 36 years. The mean age at menarche was found to be 14.50±1.32 years. Similarly mean age at menopause was found to be 46.22±4.00 years. The mean of reproductive life span varied from 27 to 35 years. Average number of pregnancies per women was 4.44±2.52, average foetal loss was 0.11, children surviving per women was 3.61, whereas average child loss per women was found to be 0.62 and average family size was 9.51. Variations in mean BMI kg/m2 between populations ranged between 18.56 and 20.71. Prevalence of CED was highest among the Brahmin women of Uttarakhand (58.3%) followed by Ahirwar of Madhya Pradesh (47.1%). Incidence of CED was found lowest among Brahmin women of Madhya Pradesh (24.0%). Linear regression coefficient (b ± standard error) of BMI on Cormic Index for these women was 33.1 ± 8.1 (t=4.0, p=0.001), and correlation coefficient (R) was 0.189. Out of 6 anthropometric variables considered for regression analysis, 5, namely weight, hip circumference, waist circumference, mid arm circumference and sitting height showed significant correlations with BMI. Significant differences in sitting height and Cormic Index of women from the hills and plains indicate the role of ecology in shaping its habitants. Out of 9 demographic variables, only age of respondent and family size were found to have a significant impact on low BMI status. The present study postulates that the nutritional status of women has improved over the last decades.     

Weight change in relation to natural menopause and other reproductive and behavioral factors in Japanese women

PURPOSE: To evaluate the effect of menopause on weight change in Japanese women. METHODS: Community-based sample of 828 Japanese women who were premenopausal and aged 40 to 54 years completed a self-administered questionnaire asking information on demographic factors, body size, reproductive history and dietary and behavioral factors in 1992. They responded to a follow-up questionnaire asking weight and menopausal status in 1998. RESULTS: Women gained weight modestly, on average, 0.17 kg during the 6-year study period. Weight gain was significantly higher in women who remained premenopausal at follow-up than those who had natural menopause during the study period. Weight gain was significantly associated with early menarche in women who had natural menopause and with high parity in women remained premenopausal. CONCLUSION: Reproductive factors rather than sociodemographic and behavioral factors appeared to be associated with weight change during the perimenopausal period. Onset of menopause may diminish weight gain. In contrast, early menarche and high parity showed relationships with weight gain.     

Weight change and risk of endometrial cancer

BACKGROUND: Obesity is an established risk factor for endometrial cancer. Less well understood is the role of weight gain and weight change in determining risk. METHODS: We analysed data from a population-based case-control study to evaluate the associations of body mass index (BMI), weight gain, and weight cycling with risk of endometrial cancer. Cases (n=740) under age 80 with a new diagnosis of endometrial cancer were identified from Wisconsin's cancer registry. Controls (n=2342) were randomly selected from driver's license lists and Medicare beneficiary files. Body size at three time points and other risk factor information were ascertained by interview in 1992-95. RESULTS: Endometrial cases were more likely than controls to be nulliparous, have early ages at menarche and late ages at menopause, be diabetic, smoke cigarettes, and use post-menopausal hormones. After adjustment for these factors, increasing BMI was associated with increased risk (P-trend<0.001); women in the top quartile of BMI (>29 kg/m2) had a 3-fold greater risk of endometrial cancer [95% confidence interval (95% CI) 2.4-4.2] compared with women in the lowest quartile (<23 kg/-m2). For each 5 kg weight gain, the odds ratio (OR) for endometrial cancer risk equalled 1.2 (95% CI 1.2-1.3). History of weight cycling modestly increased risk after adjustment for BMI and other factors (OR=1.3; 95% CI 1.0-1.6). In addition, women who reported sustained weight loss had a reduced risk of endometrial cancer (OR=0.7; 95% CI 0.6-0.9). CONCLUSIONS: These results suggest that weight gain and lack of weight stability are associated with risk of endometrial cancer.     

Relationship between socio-demographic and behaviour variables, and body mass index in a population with high-normal blood pressure: Hypertension Prevention Trial

The relationship between socio-demographic and behaviour variables and body mass index (BMI: weight/height2) adjusted for age were studied in a population with high-normal blood pressure who participated in the Hypertension Prevention Trial. The BMI of the participants ranged from 19.1 to 35.1 kg/m2 in men and from 16.0 to 35.1 kg/m2 in women. The prevalence of obesity (BMI greater than or equal to 25.0 kg/m2) was 77 per cent in men and 61 per cent in women, with prevalence of severe obesity (BMI greater than or equal to 30.0 kg/m2) being 23 per cent and 19 per cent respectively. Stepwise regression was carried out to identify the most important correlates of BMI. In men, they were family income (+), occupation (-), leisure time exercise frequency (-), number of meals eaten out (-), alcohol intake (-), smoking (-), caffeinated drink intake (+), and meal planner. Men who planned meals with their partners had a higher BMI than men who planned their own meals or had someone else plan their meals. Correlates of little importance were marital status, race, education, number of members in household, energy intake, percentage of total calories from fat, occupation activity level, and vitamin/mineral supplement intake. In women the most important correlates of BMI were alcohol intake (-), caffeinated drink intake (+), and race. Black women had a higher mean BMI than white women. The important socio-demographic and behaviour variables in both men and women accounted for about 20 per cent of the variance in BMI which leaves about 80 per cent of the variation unexplained. This indicates the presence of other factor(s) which may be determining body weight.     

Weight and behavioral and psychosocial factors among ethnically diverse, low-income women after childbirth: II. Trends and correlates

OBJECTIVE: This paper presents a longitudinal analysis of behavioral and psychosocial correlates of weight trends during the first postpartum year. Data are derived from the Austin New Mothers Study (ANMS), a longitudinal study of a low-income, tri-ethnic sample of postpartum women that incorporated serial assessment of weight and behavioral and psychosocial variables. METHOD: Postpartum body mass index (BMI) was measured prospectively (post-delivery, 6 weeks, and 3, 6, and 12 months postpartum). The analytic sample consisted of 382 White, African American, and Hispanic women receiving maternity care funded by Medicaid who had at least three measured postpartum weights. Behavioral and psychosocial variables included energy intakes, fat intakes, physical activity, health related lifestyle, smoking, breastfeeding, contraception, depressive symptoms, emotional eating, body image, and weight-related distress. RESULTS: Using hierarchical linear modeling to incorporate baseline only and time-varying effects, significant associations with postpartum BMI were found for the following variables: ethnicity (p = .001), time of weight measurement (p < .001), the interaction of ethnicity and time (p = .005), pre-pregnant BMI (p < .001), gestational weight gain (p < .001), weight-related distress (p < .001), and energy intakes (p = .005). After adjusting for covariates, ethnic groups displayed differing trends in postpartum BMI resulting in White women having significantly lower BMIs at 12 months postpartum compared to ethnic minority women (p's < .01). CONCLUSION: Behavioral and psychosocial variables contribute to a fuller understanding of BMI status of low-income women during the first postpartum year.     

Physical activity, cardiorespiratory fitness and body mass index as predictors of substantial weight gain and obesity: the Canadian physical activity longitudinal study

BACKGROUND: Obesity is a growing health issue in Canada and the identification of the determinants of obesity is important for the development of prevention strategies. The purpose of this investigation was to determine the relationships between physical activity, cardiorespiratory fitness, body mass index (BMI), and the development of future obesity. METHODS: The sample included 459 adults (18+ y; 223 men, 236 women) from the Canadian Physical Activity Longitudinal Study (PALS; 2002-04). Data on physical activity, smoking, alcohol consumption, BMI, and cardiorespiratory fitness (VO2max) were collected in 1981 and 1988. The mean BMI, physical activity, and VO2max were calculated across the 1981 and 1988 measures. Self-reported height and weight were collected in the 2002-04 survey, and participants were classified as overweight (BMI 25 to 29.9 kg/m2) or obese (BMI 230 kg/m2). Logistic regression was used to predict overweight, obesity or substantial weight gain (10 kg or more) in 2002-04, controlling for age, sex, smoking and alcohol use. RESULTS: Higher VO2max in 1981-88 was associated with lower odds of obesity in 2002-04 (OR = 0.87; 95% Cl: 0.76-0.99, p < 0.05), and higher BMI in 1981-88 was associated with higher odds of obesity in 2002-04 (1.84; 1.52-2.20, p < 0.0001). In women, higher VO2max (0.82; 0.72-0.93) resulted in lower odds of a 10 kg weight gain. CONCLUSIONS: The results indicate that cardiorespiratory fitness and previous BMI are important predictors of future weight gain and obesity, and should be incorporated in strategies to identify individuals at increased risk of obesity.     

A new recommendation for maternal weight gain in Chinese women

OBJECTIVE: To characterize the distribution of maternal weight gain in Chinese women living in a well-nourished community, to recommend target weight gains from quartile values derived from women with good pregnancy outcomes, and to quantify the risk for adverse pregnancy outcomes encountered among subjects with weight gain outside these recommendations. DESIGN: A retrospective study on maternal anthropometry and pregnancy outcomes was conducted among Chinese women who delivered a singleton pregnancy in a university hospital in Hong Kong. SUBJECTS: Nine hundred eight women who delivered during the study period were identified. Among them, 754 (83%) had complete anthropometry data. The normative distribution of maternal weight gain was derived from 504 women who had a good pregnancy outcome. STATISTICS: Analysis of variance was used to compare total weight gain among women of different prepregnancy weight. Fisher exact test was used in the univariate analysis of the association between risk factors and corresponding adverse pregnancy outcomes. Adjusted odds ratios for adverse outcomes were determined by multiple logistic regression models controlling for the following factors: maternal age, duration of gestation, prepregnancy body mass index (BMI), height, parity, and smoking. RESULTS: A maternal weight-gain chart and recommendations for total weight gains in Chinese women were derived from the distribution of weight gain in subjects with good pregnancy outcomes. The recommended total weight gain was 13 to 16.7 kg, 11 to 16.4 kg, and 7.1 to 14.4 kg respectively for women of low (BMI < 19), moderate (BMI: 19 to 23.5), and high (BMI > 23.5) prepregnancy BMI. Women who did not achieve the lower quartile value had more than twice the risk of having low-birth-weight infants. Those with excessive weight gain were at risk for needing assisted delivery. APPLICATIONS: As maternal anthropometry differs across ethnic groups, different recommendations should be made for specific populations.     

Smoking cessation and body mass index of occupationally active men: the Israeli CORDIS Study

OBJECTIVES: This study estimated weight gain after smoking cessation and identified factors attenuating this gain. METHODS: We conducted a prospective follow-up of 1209 male factory workers for 2 to 4 years. The independent variables were smoking habits. age, sports activity, education, alcohol consumption, ethnicity, duration of follow-up, and body mass index (BMI, kg/m2) at entry. The dependent variable was increase in BMI during follow-up. RESULTS: The mean age-adjusted BMI at entry into the study was 26.6 kg/m2 among past smokers and 25.4 kg/m2 among current smokers. There were no differences in BMI between those who quit less than 3 years before entry and those who quit more than 6 years before entry. During follow-up, the average increase in BMI was 0.07 kg/m2 among never smokers, 0.19 kg/m2 among smokers who had stopped smoking before entry, 0.24 kg/m2 among current smokers, and 0.99 kg/m2 among those who stopped smoking after entry. Cessation of smoking after entry predicted an increased gain in BMI; older age, a higher BMI at entry, sports activity, and alcohol consumption attenuated this gain. CONCLUSIONS: The increased rate of weight gain after smoking cessation is transient. However, the weight gained is retained for at least 6 years.     

Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women

BACKGROUND: Although increased consumption of dietary fiber and grain products is widely recommended to maintain healthy body weight, little is known about the relation of whole grains to body weight and long-term weight changes. OBJECTIVE: We examined the associations between the intakes of dietary fiber and whole- or refined-grain products and weight gain over time. DESIGN: In a prospective cohort study, 74,091 US female nurses, aged 38-63 y in 1984 and free of known cardiovascular disease, cancer, and diabetes at baseline, were followed from 1984 to 1996; their dietary habits were assessed in 1984, 1986, 1990, and 1994 with validated food-frequency questionnaires. Using multiple models to adjust for covariates, we calculated average weight, body mass index (BMI; in kg/m(2)), long-term weight changes, and the odds ratio of developing obesity (BMI > or = 30) according to change in dietary intake. RESULTS: Women who consumed more whole grains consistently weighed less than did women who consumed less whole grains (P for trend < 0.0001). Over 12 y, those with the greatest increase in intake of dietary fiber gained an average of 1.52 kg less than did those with the smallest increase in intake of dietary fiber (P for trend < 0.0001) independent of body weight at baseline, age, and changes in covariate status. Women in the highest quintile of dietary fiber intake had a 49% lower risk of major weight gain than did women in the highest quintile (OR = 0.51; 95% CI: 0.39, 0.67; P < 0.0001 for trend). CONCLUSION: Weight gain was inversely associated with the intake of high-fiber, whole-grain foods but positively related to the intake of refined-grain foods, which indicated the importance of distinguishing whole-grain products from refined-grain products to aid in weight control.     

Combined effects of prepregnancy body mass index and weight gain during pregnancy on the risk of preterm delivery

BACKGROUND: The association between excessive gestational weight gain and preterm delivery is unclear, as is the association between low gestational weight gain and preterm delivery among overweight and obese women. METHODS: Using data from the Pregnancy Risk Assessment Monitoring System in 21 states, we estimated the risk of very (20-31 weeks) and moderately (32-36 weeks) preterm delivery associated with a combination of prepregnancy body mass index (BMI) and gestational weight gain among 113,019 women who delivered a singleton infant during 1996-2001. We categorized average weight gain (kilograms per week) as very low (<0.12), low (0.12-0.22), moderate (0.23-0.68), high (0.69-0.79), or very high (>0.79). We categorized prepregnancy BMI (kg/m) as underweight (<19.8), normal (19.8-26.0), overweight (26.1-28.9), obese (29.0-34.9), or very obese (>or=35.0). We examined associations for all women and for all women with no complications adjusting for covariates. RESULTS: There was a strong association between very low weight gain and very preterm delivery that varied by prepregnancy BMI, with the strongest association among underweight women (adjusted odds ratio = 9.8; 95% confidence interval = 7.0-13.8) and the weakest among very obese women (2.3; 1.8-3.1). Very low weight gain was not associated with moderately preterm delivery for overweight or obese women. Women with very high weight gain had approximately twice the odds of very preterm delivery, regardless of prepregnancy BMI. CONCLUSIONS: This study supports concerns about very low weight gain during pregnancy, even among overweight and obese women, and also suggests that high weight gain, regardless of prepregnancy BMI, deserves further investigation.     

Maternal obesity and the risk of infant death in the United States

BACKGROUND: Maternal obesity (defined as prepregnancy body mass index [BMI] >or=30 kg/m) is associated with increased risk of neonatal death. Its association with infant death, postneonatal death, and cause-specific infant death is less well-characterized. METHODS: We studied the association between maternal obesity and the risk of infant death by using 1988 US National Maternal and Infant Health Survey data. A case-control analysis of 4265 infant deaths and 7293 controls was conducted using SUDAAN software. Self-reported prepregnancy BMI and weight gain were used in the primary analysis, whereas weight variables in medical records were used in a subset of 4308 women. RESULTS: Compared with normal weight women (prepregnancy BMI = 18.5-24.9 kg/m) who gained 0.30 to 0.44 kg/wk during pregnancy, obese women had increased risk of neonatal death and overall infant death. For obese women who had weight gain during pregnancy of <0.15, 0.15 to 0.29, 0.30 to 0.44, and >or=0.45 kg/wk, the adjusted odds ratios of infant death were 1.75 (95% confidence interval = 1.28-2.39), 1.42 (1.07-1.89), 1.59 (1.00-2.51), and 2.87 (1.98-4.16), respectively. Nonobese women with very low weight gain during pregnancy also had a higher risk of infant death. The subset with weight information from medical records had similar results for recorded prepregnancy BMI and weight gain. Maternal obesity was associated with neonatal death from pregnancy complications or disorders relating to short gestation and unspecified low birth weight. CONCLUSIONS: Maternal obesity is associated with increased overall risk of infant death, mainly neonatal death.     

北京某社区40岁以上女性原发性骨质疏松症流行现状调查

目的了解西城区德胜社区中老年女性骨质疏松症(OP)的患病现状,并分析其危险因素,为该区域骨质疏松症防治工作提供理论上的依据。方法选取2013年4月~12月社区健康教育的中老年妇女,按照随机数字表选取380例纳入本研究,采取问卷调查及现场测量方式获得研究人群的年龄、身高、体重、以及饮食、运动、慢性疾病及家族史等资料。同时使用美国HOLOGIC公司骨密度仪进行骨密度测量。结果原发性骨质疏松症的发生率为28.1%,其中40~49、50~59、60~69、≥70岁人群的患病率分别为7.7%,17.9%、41.5%、49.4%。多因素Logistic回归分析显示年龄、文化程度、体重指数、绝经、子宫切除术、骨折家族史对Logistic回归模型的贡献有统计学意义(P<0.05);模型正确预测百分率为65.9%;而牛奶摄入、吸烟、喝咖啡、饮酒、怀孕次数、卵巢切除术、骨折史、活动量等变量对模型的贡献无统计学意义(P>0.05)。二分类Logistic回归分析显示增龄、绝经、子宫切除为OP可能危险因素;高文化、高体质量指数(BMI)值为OP的可能保护因素。结论北京市西城区德胜社区中40岁以上女性骨质疏松症与多种因素有关,其中包括年龄、绝经、文化程度、子宫切除史、体重指数等。     

Obesity in relation to smoking: A population study of women in Göteborg,Sweden

A population sample of 1,462 middle-aged women (participation rate 90.1%) was studied in 1968–1969, 1,302 of whom (participation rate 80.3%) were reexamined in 1974–1975. Cigarette smoking was more frequent among younger women. Current smokers were leaner than nonsmokers. A U-shaped relationship was found between obesity index and cigarette consumption. This relationship was not explained by differences in energy intake, physical activity, or social class. Cessation of smoking was correlated with weight gain, and commencement of smoking with weight loss. Of those who quit 13% gained weight ?10.0 kg and 22% gained between 5.0 and 9.9 kg compared with 4 and 14%, respectively, among those who did not change smoking habits. The average weight change was +3.5 and ?0.7 kg among those who quit smoking and started smoking, respectively, compared with +1.4 kg among those who did not change smoking habits. A greater weight gain with the amount smoked was found both in those who stopped smoking and in those who continued smoking. Increased physical activity and reduced energy intake need consideration at cessation of smoking, especially among heavy smokers. The quantitative aspects of the relationship between smoking and obesity, and between cessation of smoking and weight gain, are considered to be of special interest for health personnel engaged in antismoking campaigns.     

Vitamin D decreases risk of breast cancer in premenopausal women of normal weight in subtropical taiwan

Background

Evidence for an association between vitamin D status and breast cancer is now more convincing, but is uncertain in subtropical areas like Taiwan. This hospital-based case-control study examined the relationship of breast cancer with vitamin D intake and sunlight exposure.

Methods

A total of 200 incident breast cancer cases in a Taipei hospital were matched with 200 controls by date of interview and menopausal status. Information on risk factors for breast cancer was collected in face-to-face interviews and assessed with reference to vitamin D intake (foods and nutrients) and sunlight exposure. Vitamin D intake was divided into quartiles, and threshold effect was evaluated by comparing Q2–Q4 with Q1.

Results

After controlling for age, education, parity, hormone replacement therapy, body mass index (BMI), energy intake, menopausal status, and daily sunlight exposure, the risk of breast cancer in participants with a dietary vitamin D intake greater than 5 µg per day was significantly lower (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.24–0.97) than that of participants with an intake less than 2 µg per day. In analysis stratified by menopausal status and BMI, both dietary vitamin D and total vitamin D intakes were associated with a protective effect among premenopausal women. There was a significant linear trend for breast cancer risk and dietary vitamin D intake in premenopausal women (P = 0.02). In participants with a BMI lower than 24 kg/m² (ie, normal weight), dietary vitamin D intake was inversely related to breast cancer risk (P for trend = 0.002), and a threshold effect was apparent (Q2–Q4 vs Q1: OR, 0.46; 95% CI, 0.23–0.90).

Conclusions

Vitamin D had a protective effect against breast cancer in premenopausal women of normal weight in subtropical Taiwan, especially an intake greater than 5 µg per day.Key words: vitamin D, menopause, BMI, sunlight exposure, subtropical     

Faster self-reported speed of eating is related to higher body mass index in a nationwide survey of middle-aged women

This study is the first nationwide population survey to explore the association between speed of eating and degree of obesity. The objective was to cross-sectionally examine the relationship between self-reported speed of eating and body mass index (BMI; calculated as kg/m²) in a nationally representative sample of New Zealand women. In May 2009, a sample of 2,500 New Zealand women aged 40 to 50 years was randomly selected from the nationwide electoral rolls. A 66% participation rate was achieved. Potential participants were mailed a self-administered questionnaire containing questions on self-reported speed of eating, demographics, health conditions, menopause status, physical activity, height, and weight. Univariate models were used to examine the associations between demographic, health and behavioral variables, and BMI, while a multivariate model was developed to investigate the relationship between self-reported speed of eating and BMI. After adjusting for age, smoking status, menopause status, thyroid condition, ethnicity, socioeconomic status, and physical activity, BMI statistically significantly increased by 2.8% (95% confidence interval: 1.5% to 4.1%; P<0.001) for each category increase in self-reported speed of eating. Although the direction of causality requires confirmation in longitudinal and randomized intervention studies, the results suggest that faster eating is associated with higher BMI in middle-aged women.     

足月产小于胎龄儿孕妇危险因素病例-对照研究

目的　探索影响胎儿出生体重的危险因素。方法　采用 1∶1匹配的病例对照研究方法 ,收集了足月产小于胎龄儿 (SGA)及其对照共 1 5 5对。应用条件Logistic回归分析方法和相加模型对危险因素及其交互作用进行分析。结果　产妇孕前体重低 (≤ 5 2kg)、孕期体重增加少 (≤ 1 6kg)、被动吸烟和喝茶、孕期及怀孕之前 3个月内进行过染发、烫发或油、配偶身高低 (≤ 1 73cm)以及产妇体重指数大 (≥ 1 9)等与SGA的发生有显著性关联 (P <0 0 5 ) ,在调整了其他危险因素后 ,OR分别为 2 0 8、2 83、3 4 2、2 72、5 6 7、2 92和 0 4 1 ,其中产妇孕前体重低与孕期体重增加少、孕期及怀孕之前 3个月内进行过染发、烫发或油、配偶身高低和孕期被动吸烟之间存在正交互作用。结论　产妇孕前体重低 ,孕期体重增加少、被动吸烟和喝茶、孕期及怀孕之前 3个月内进行染发烫发或油以及配偶身高低等是SGA的危险因素 ,产妇体重指数大是SGA的保护因素     

Carbohydrate Intake and Overweight and Obesity among Healthy Adults

Background

Little is known about the dietary habits of people with optimal body weight in communities with high overweight and obesity prevalence.

Objective

To evaluate carbohydrate intake in relation to overweight and obesity in healthy, free-living adults.

Design

We used a cross-sectional analysis.

Subjects/setting

The Canadian Community Health Survey Cycle 2.2 is a cross-sectional survey of Canadians conducted in 2004-2005. There were 4,451 participants aged 18 years and older with anthropometric and dietary data and no comorbid conditions in this analysis.

Main outcome measures

Outcome variables were body mass index (BMI; calculated as kg/m²) and overweight or obesity status (dichotomous) defined as BMI ≥25 compared with BMI <25 based on measured height and weight. Diet was evaluated by 24-hour dietary recall based on the Automated Multi-Pass Method.

Statistical analyses performed

Weighted regression models with bootstrapping and cubic splines were used. Outcome variables were BMI and overweight or obesity, and predictors were daily nutrient intake. Adjustment for total energy intake, age, leisure time energy expenditure, sex, smoking, education, and income adequacy was performed.

Results

Risk of overweight and obesity was decreased in all quartiles of carbohydrate intake compared to the lowest intake category (multivariate odds ratio quartile 2=0.63; 95% confidence interval: 0.49 to 0.90; odds ratio quartile 3=0.58; 95% confidence interval: 0.41 to 0.82; odds ratio quartile 4=0.60; 95% confidence interval: 0.42 to 0.85). Spline analyses revealed lowest risk among those consuming 290 to 310 g/day carbohydrates.

Conclusions

Consuming a low-carbohydrate (approximately <47% energy) diet is associated with greater likelihood of being overweight or obese among healthy, free-living adults. Lowest risk may be obtained by consuming 47% to 64% energy from carbohydrates.