Adverse associations of car time with markers of cardio-metabolic risk

ObjectiveTo examine associations of time spent sitting in cars with markers of cardio-metabolic risk in Australian adults.MethodData were from 2800 participants (age range: 34–65) in the 2011–12 Australian Diabetes, Obesity and Lifestyle Study. Self-reported time spent in cars was categorized into four groups: ≤ 15 min/day; > 15 to ≤ 30 min/day; > 30 to ≤ 60 min/day; and > 60 min/day. Markers of cardio-metabolic risk were body mass index (BMI), waist circumference, systolic and diastolic blood pressure, triglycerides, HDL (high-density lipoprotein)-cholesterol, fasting plasma glucose, 2-h plasma glucose, a clustered cardio-metabolic risk score, and having the metabolic syndrome or not. Multilevel linear and logistic regression analyses examined associations of car time with each cardio-metabolic risk outcome, adjusting for socio-demographic and behavioral variables and medication use for blood pressure and cholesterol/triglycerides.ResultsCompared to spending 15 min/day or less in cars, spending more than 1 h/day in cars was significantly associated with higher BMI, waist circumference, fasting plasma glucose, and clustered cardio-metabolic risk, after adjusting for socio-demographic attributes and potentially relevant behaviors including leisure-time physical activity and dietary intake. Gender interactions showed car time to be associated with higher BMI in men only.ConclusionsProlonged time spent sitting in cars, in particular over 1 h/day, was associated with higher total and central adiposity and a more-adverse cardio-metabolic risk profile. Further studies, ideally using objective measures of sitting time in cars and prospective designs, are needed to confirm the impact of car use on cardio-metabolic disease risk.     

Neighborhood-level socioeconomic deprivation predicts weight gain in a multi-ethnic population: Longitudinal data from the Dallas Heart Study

ObjectiveThe aim of this study is to examine a relationship between neighborhood-level socioeconomic deprivation and weight change in a multi-ethnic cohort from Dallas County, Texas and whether behavioral/psychosocial factors attenuate the relationship.MethodsNon-movers (those in the same neighborhood throughout the study period) aged 18–65 (N = 939) in Dallas Heart Study (DHS) underwent weight measurements between 2000 and 2009 (median 7-year follow-up). Geocoded home addresses defined block groups; a neighborhood deprivation index (NDI) was created (higher NDI = greater deprivation). Multi-level modeling determined weight change relative to NDI. Model fit improvement was examined with adding physical activity and neighborhood environment perceptions (higher score = more unfavorable perceptions) as covariates. A significant interaction between residence length and NDI was found (p-interaction = 0.04); results were stratified by median residence length (11 years).ResultsAdjusting for age, sex, race/ethnicity, smoking, and education/income, those who lived in neighborhood > 11 years gained 1.0 kg per one-unit increment of NDI (p = 0.03), or 6 kg for those in highest NDI tertile compared with those in the lowest tertile. Physical activity improved model fit; NDI remained associated with weight gain after adjustment for physical activity and neighborhood environment perceptions. There was no significant relationship between NDI and weight change for those in their neighborhood ≤ 11 years.ConclusionsLiving in more socioeconomically deprived neighborhoods over a longer time period was associated with weight gain in DHS.     

Nine year changes in sitting time in young and mid-aged Australian women: Findings from the Australian Longitudinal Study for Women's Health

ObjectiveTo examine changes in sitting time (ST) in women over nine years and to identify associations between life events and these changes.MethodsYoung (born 1973–78, n = 5215) and mid-aged (born 1946–51, n = 6973) women reported life events and ST in four surveys of the Australian Longitudinal Study on Women's Health between 2000 and 2010. Associations between life events and changes in ST between surveys (decreasers ≥ 2 h/day less, increasers ≥ 2 h/day more) were estimated using generalized estimating equations.ResultsAgainst a background of complex changes there was an overall decrease in ST in young women (median change − 0.48 h/day, interquartile range [IQR] = − 2.54, 1.50) and an increase in ST in mid-aged women (median change 0.43 h/day; IQR = − 1.29, 2.0) over nine years. In young women, returning to study and job loss were associated with increased ST, while having a baby, beginning work and decreased income were associated with decreased ST. In mid-aged women, changes at work were associated with increased ST, while retiring and decreased income were associated with decreased ST.ConclusionsST changed over nine years in young and mid-aged Australian women. The life events they experienced, particularly events related to work and family, were associated with these changes.     

Prolonged sitting in cars: Prevalence,socio-demographic variations,and trends

BackgroundProlonged sitting is detrimentally associated with health outcomes. However, the prevalence and characteristics of those who sit in cars for long periods are not well understood. This study examined the population prevalence, socio-demographic variations, and trends for prolonged sitting in cars among adults.MethodsUsing the Sydney Greater Metropolitan Area Household Travel Survey, the prevalence of prolonged sitting time in cars (≥ 2 h/day) was calculated for four 3-year periods (1997–99, 2000–02, 2003–05, and 2006–08) for each population subgroup. Trends were calculated as the mean change in prevalence between adjacent survey periods.ResultsCars were used for 66% of the total trips recorded (n = 336,505). The prevalence of prolonged sitting time in cars was 16–18% in men, and 10–12% in women. Relatively higher prevalence rates were found among middle-age groups (men: 20–22%, women: 12–15%), full-time workers (men: 21–24%, women: 14–15%), those with higher income (men: 21–25%, women: 14–16%), couples with children (men: 20–21%, women: 12–14%), and those living in outer suburbs (men: 20–23%, women: 12–13%). Trends were stable in men, but increasing in women. Several subgroups (older age; living in regional suburbs) also showed increasing trends.ConclusionsThese findings provide evidence to inform integrated approaches to measurement and policy development on prolonged car use among the public health, urban planning, and transport sectors.     

The factors associated with toddlers’ screen time change in the STEPS Study: A two-year follow-up

Background and ObjectivesEarly childhood screen time seems to persist into later childhood. This study examined the factors affecting the screen time change during the first two years of toddler’s lives in Finland. We hypothesized that parents’ sedentary behaviour and physical activity habits correlate significantly with children’s screen time change.MethodsThe data consists of 1797 mothers, 1658 fathers and their 1827 children from the STEPS Study (Steps to the healthy development) in Southwest Finland. Screen time change during the two-year follow-up was calculated for those (n = 634) who had both 13 and 36 months screen time measures (13 months, n = 940; 36 months, n = 845). Demographic correlates and parental behavioural correlates were measured with questionnaires, and anthropometric measurements in study visits.ResultsThe mean change in the children’s screen time was a 55 min increase from 13 to 36 months. A linear mixed model analysis showed that the father’s longer duration of sitting time was statistically significantly associated with a smaller increase in screen time of the child. Parents’ physical activity was not associated with children’s screen time change. The mother’s advanced education, a younger age, and a lower screen time, the child attending day care and the child’s lower body mass index were associated with children’s smaller increase in screen time.ConclusionThe mother’s advanced education as well as the father’s sitting time, including sitting at the office, implied that children of higher educated parents have a smaller increase in screen time. Future studies should focus on studying why parental education has a greater influence on children’s screen time change than parents’ behaviour.     

Influence of socioeconomic status on the association between body mass index and cause-specific mortality among older Japanese adults: The AGES Cohort Study

ObjectiveMany studies have suggested a U-shaped curve for the association between body size and mortality risks, i.e., mortality risks increase in those who are both overweight and underweight. The strength of the associations may vary according to socioeconomic statuses (SES), as they determine levels of access to healthcare and psychosocial stresses. We investigated the modifying effects of SES on the relationship between body mass index (BMI) and mortality.MethodWe used prospective cohort data of participants in the Aichi Gerontological Evaluation Study in 2003 (n = 14,931), who were 65 years or older and physically and cognitively independent at baseline, and residing in eight municipalities in Japan. Data on all-causes mortality and mortality from cancer, cardiovascular disease, and respiratory disease was obtained from municipal government registries.ResultsProportional hazard regression analyses showed that, among men, the associations between overweight (BMI ≥ 25 kg/m²) and higher mortality risks by any cause were stronger among lower income groups. Even adjusting for multiple confounding factors, hazard ratios (95% confidence intervals) for mortality by all causes among low income group (household income < 1.5 million yen) were 1.96 (1.02–3.73) for overweight compared with BMIs between 23.0 and 24.9, whereas they were 0.94 (0.57–1.38) among men in high income group (income > 3 million yen). The modifying effects of income were not marked among women.ConclusionHousehold income, which may directly reflect accessibility to healthcare and psychosocial stress among older Japanese men, may be an important modifying factor in the health risks attributable to overweight.     

Vegetable protein intake is associated with lower gallbladder disease risk: Findings from the Women's Health Initiative prospective cohort

ObjectiveThis study aimed to measure associations between gallbladder disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women.MethodsAnalyses were based on 130,859 postmenopausal women enrolled from 1993 to 1998 at 40 U.S. clinical centers in the Women's Health Initiative clinical trials and observational study. Women were excluded if they reported a history of gallbladder disease prior to baseline. Cox proportional hazards regression models, adjusted for gallbladder disease risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between energy-adjusted protein intake and gallbladder disease.ResultsIn this study sample, 8.1% of postmenopausal women self-reported incident gallbladder disease. In multivariate analysis, women in the highest quintile of energy-adjusted vegetable protein intake (> 24.0 g/d) had a lower risk of gallbladder disease (HR, 0.87; 95% CI, 0.81–0.93) as compared to women in the lowest quintile (< 16.3 g/d) (P_trend < 0.001). Total protein intake was modestly protective against gallbladder disease (P_trend < 0.021). Animal protein intake was not associated with gallbladder disease risk. The protective effect of vegetable protein held stable only for women without history of diabetes (HR, 0.86; 95% CI, 0.80–0.92) and without recent weight loss (HR, 0.88; 95% CI, 0.80–0.97).ConclusionsVegetable protein intake is inversely associated with gallbladder disease risk in our sample of postmenopausal women. In addition to weight management, healthcare providers could emphasize vegetable protein as an additional dietary modality to promote lower risk for gallbladder disease.     

Longitudinal associations of active commuting with body mass index

ObjectiveTo investigate the longitudinal associations between active commuting (walking and cycling to work) and body mass index (BMI).MethodWe used self-reported data on height, weight and active commuting from the Commuting and Health in Cambridge study (2009 to 2012; n = 809). We used linear regression to test the associations between: a) maintenance of active commuting over one year and BMI at the end of that year; and b) change in weekly time spent in active commuting and change in BMI over one year.ResultsAfter adjusting for sociodemographic variables, other physical activity, physical wellbeing and maintenance of walking, those who maintained cycle commuting reported a lower BMI on average at one year follow-up (1.14 kg/m², 95% CI: 0.30 to 1.98, n = 579) than those who never cycled to work. No significant association remained after adjustment for baseline BMI. No significant associations were observed for maintenance of walking. An increase in walking was associated with a reduction in BMI (0.32 kg/m², 95% CI: 0.03 to 0.62, n = 651, after adjustment for co-variates and baseline BMI) only when restricting the analysis to those who did not move. No other significant associations between changes in weekly time spent walking or cycling on the commute and changes in BMI were observed.ConclusionsThis work provides further evidence of the contribution of active commuting, particularly cycling, to preventing weight gain or facilitating weight loss. The findings may be valuable for employees choosing how to commute and engaging employers in the promotion of active travel.     

Weight control success and depression by gender with respect to weight control behaviors

Background/ObjectiveThere are many methods for weight loss and they vary among people. Some are yet to be proven as appropriate regarding its physical or mental side effect. The aim of this study was to investigate the relationship between weight control success and depression by weight control behaviors (WCB) dividing them into appropriate and inappropriate.Subjects/MethodsWe used data from the 2016 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 4506 people were included in the study. The depression was measured by the 9-item Patient Health Questionnaire as a dependent variable. Using multiple regression analysis to determine the association between weight control success and depression with appropriate and inappropriate WCB, in men and women, separately.ResultsWe found that appropriate WCB was associated with decreased depression in women who had both success and fail (success: β = −0.16, S.E = 0.50, p < .001; fail: β = −0.09, S.E = 0.04, p = 0.04), whereas inappropriate WCB increased depression in men regardless of success or failure at weight control (success: β = 0.41, p = 0.02; fail: β = 0.22, p = 0.02). Thus, women who are successful at weight control and use appropriate WCB are more likely to have a decrease in depressive symptoms. However, men are most affected by using inappropriate WCB and can have an increase in depressive symptoms as a result.ConclusionThe findings have implications for encouraging the use of appropriate WCB for those attempting to control weight, especially in women.     

Sex differences in the association between dietary restraint,insulin resistance and obesity

Background & aimsRestrained food consumption may alter metabolic function and contribute to eventual weight gain; however, sex differences in these relationships have not been assessed. The objective of this study was to examine the relationship between restrained eating and insulin resistance and the influence of body mass index and sex on this relationship in a large community sample of both men and women. We hypothesized that restrained eating would be related to insulin resistance and this relationship would be influenced by sex and body mass index.MethodsIn this cross-sectional, observational study, we studied 487 individuals from the community (men N = 222, women N = 265), who ranged from lean (body mass index 18.5–24.9 kg/m², N = 173), overweight (body mass index 25–29.9 kg/m², N = 159) to obese (body mass index > 30 kg/m², N = 155) weight categories. We assessed restrained eating using the Dutch Eating Behavior Questionnaire and obtained fasting morning plasma insulin and glucose on all subjects.ResultsIn men, but not in women, restrained eating was related to homeostatic model assessment of insulin resistance (HOMA-IR) (p < 0.0001). Furthermore, HOMA-IR was significantly higher in men who were high- versus low-restrained eaters (p = 0.0006).ConclusionsThis study is the first to report sex differences with regard to the relationship between restrained eating and insulin resistance. Our results suggest that high restrained eating is associated with insulin resistance in men but not in women.     

Monitoring sedentary patterns in office employees: validity of an m-health tool (Walk@Work-App) for occupational health

ObjectiveThis study validated the Walk@Work-Application (W@W-App) for measuring occupational sitting and stepping.MethodsThe W@W-App was installed on the smartphones of office-based employees (n = 17; 10 women; 26 ± 3 years). A prescribed 1-hour laboratory protocol plus two continuous hours of occupational free-living activities were performed. Intra-class correlation coefficients (ICC) compared mean differences of sitting time and step count measurements between the W@W-App and criterion measures (ActivPAL3TM and SW200Yamax Digi-Walker).ResultsDuring the protocol, agreement between self-paced walking (ICC = 0.85) and active working tasks step counts (ICC = 0.80) was good. The smallest median difference was for sitting time (1.5 seconds). During free-living conditions, sitting time (ICC = 0.99) and stepping (ICC = 0.92) showed excellent agreement, with a difference of 0.5 minutes and 18 steps respectively.ConclusionsThe W@W-App provided valid measures for monitoring occupational sedentary patterns in real life conditions; a key issue for increasing awareness and changing occupational sedentariness.     

Neighborhood environmental attributes and adults' sedentary behaviors: Review and research agenda

ObjectivePhysical activity recommendations are beginning to address sedentary behaviors – time spent sitting. Environmental and policy initiatives for physical activity might assist in addressing sedentary behaviors, but sedentary-specific innovations may be required. This review synthesizes current evidence on associations of neighborhood environmental attributes with adults' sedentary behaviors.MethodsA search was conducted using three electronic databases (PubMed, Web of Science, and Transport Research Information Services). Relevant articles were assessed for their eligibility for inclusion (English-language articles with a quantitative examination of associations of neighborhood environmental attributes with adults' sedentary behaviors).ResultsWithin 17 studies meeting inclusion criteria, associations of environmental attributes with sedentary behaviors were examined in 89 instances. Significant associations were found in 28% (n = 25) of them; however, non-significant associations were found in 56% (n = 50) of these instances. The most consistent association was for lower levels of sedentary behavior among residents of urban compared to regional areas.ConclusionsThere is a modest but mixed initial evidence in associations of neighborhood environmental attributes with adults' sedentary behaviors. A research agenda required for this emerging field should include the development of more relevant conceptual models, measuring domain-specific sedentary behavior objectively, examining environments in close vicinity of and a larger area around home, and the use of prospective designs.     

Disparités géographiques d’évolution d’incidence des cancers de la thyroïde par taille entre 1983 et 2000 en France

BackgroundThe aim of this investigation was to study geographic time trends of thyroid cancer incidence according to tumor size in France, 1983 to 2000.MethodsIncidence data were provided from six French registries over the period 1983–2000 covering seven administrative districts. Five tumor size groups were distinguished: < 10 mm, 10–20 mm, 20–40 mm, > 40 mm and unknown size. Papillary cancers diagnosed in women were analyzed according to tumor size in each geographic area. World age standardized rates were calculated and annual percent change rates were estimated for each tumor size group in each geographic area. Loglinear Poisson regression models were used to study geographic discrepancies in time trends incidences.ResultsThe six French registries included 2222 papillary thyroid cancers in women between 1983 et 2000. Thyroid cancer incidence was increasing in the six geographic areas. Geographical variations in time trends incidence between registries reflected geographical variations in time trends incidence of small sized tumors (less than 10 mm).ConclusionWide geographic variations in thyroid cancer incidence were noticed for small size tumors, which may be correlated with geographic variations in medical practices.     

Weight and health-related quality of life: The moderating role of weight discrimination and internalized weight bias

ObjectivesObesity is an increasingly prevalent public health concern, with associated medical comorbidities and impairment in health-related quality of life (HRQoL). Obese women are frequently victims of weight-related discrimination. The HRQoL impairments among obese people could be related to this discrimination and to internalized weight bias.DesignWe examined the potential moderating role of discrimination (from others) and self-directed (internalized) weight-based discrimination in the association between body mass index (BMI) and HRQoL.MethodsEighty-one women (mean age = 41.1 years; mean BMI = 43.40 kg/m², 97% Caucasian) completed valid and reliable measures of weight bias internalization (weight bias internalization scale), perceived discrimination by others (everyday discrimination scale) and both physical and mental HRQoL (SF-36 Health Survey). Multiple regression analysis was used to test whether internalized weight bias or discrimination moderated the association between BMI and the summary scores for physical and mental HRQoL, controlling for age.ResultsSignificant associations were found between BMI and discrimination (r = .36, p = .002), between internalized weight bias and both mental (r = .61, p < .001) and physical HRQoL (r = .45, p < .001), and between discrimination and physical HRQoL (r = .29, p = .014). A statistically significant interaction was found between BMI and internalized weight bias (b = − .21, SE = .10, p < 0.05) in accounting for the variance in physical HRQoL.ConclusionsThe association between higher BMI and poorer physical HRQoL was found only in individuals reporting high levels of internalized weight bias. Self-discrimination among overweight individuals may be a critical factor in their physical health impairment.     

Food diversity and nutrient intake during pregnancy in relation to maternal weight gain

BackgroundInadequate gestational weight gain has become a major problem for Algerian women and this is due to inadequate maternal nutrient intake and lack of food diversity. Our objective was to assess the caloric and nutrient intake, the nutritional adequacy of the diet of women during pregnancy and to appreciate their effects on gestational weight gain.MethodsA prospective cohort study of 300 pregnant women aged 19 to 43 years was conducted, from December 2013 to July 2016. Maternal age, parity, educational level, household income and pre-pregnancy body mass index were collected. Gestational weight gain was calculated and classified according to the IOM recommendations. Participants were asked to report the frequency of consumption of foods and beverages in the last trimester of gestation. Also, the estimation of energy and nutrient intakes was made by a three-day dietary record. Statistics were performed using StatviewTM and SPSS software.ResultsIntakes of energy, vitamines and minerals of women with insufficient weight gain were less than that of women with normal and excessive gain (P < 0.0001). Milk and dairy products (P = 0.0009), fruits and vegetables (P = 0.03), meats, fish and eggs (P = 0.0049) were significantly less consumed by women with insufficient gain. The lowest food diversification was more observed in women with insufficient gestational weight gain.ConclusionMost of the pregnant women had a poorly diversified diet and especially women with insufficient weight gain. Also, the intakes of energy, vitamins and minerals of women with insufficient gain were the lowest.     

Melanocortin-3 receptor gene variants: Association with childhood obesity and eating behavior in Chilean families

ObjectiveTo evaluate the association between melanocortin-3 receptor common genetic polymorphisms with childhood obesity and eating behavior in Chilean families.MethodsTwo hundred twenty-nine obese children (6–12 y old, body mass index >95th percentile of Centers for Disease Control and Prevention/National Center for Health Statistics, 2000) and 270 parents were selected. Genotypes for MC3R genetic markers ?239A > G, 17C > A (Thr6Lys), 241 G > A (Val81Ile), +2138InsCAGACC, and microsatellite D20s32e were determined. Eating behavior scores were computed using the Child Eating Behavior Questionnaire and a shorter version of the Three Factor Eating Questionnaire adapted for evaluating eating inclinations in children. Genotype-obesity associations were assessed by the Transmission Disequilibrium Test. Non-parametric tests were used to compare eating behavior scores across study groups.ResultsAllelic frequencies of ?239 G, 17A, 241A, and +2138InsCAGACC were estimated as 4.5%, 5.9%, 5.6%, and 17.6%, respectively, in obese children. The Transmission Disequilibrium Test in case–parent trios revealed no significant associations between childhood obesity and genetic markers, including the microsatellite D20s32e. In girls, we found significantly higher scores of the emotional eating subscale in carriers of the +2138InsCAGACC compared with non-carriers (P = 0.04). In boys, carriers of 17A and 241A showed lower scores for the emotional eating subscale (P = 0.01), whereas carriers of +2138InsCAGACC showed significantly lower scores for the enjoyment of food subscale compared with non-carriers (P = 0.04).ConclusionsThere is not sufficient evidence to support the contribution for common melanocortin-3 receptor variants in childhood obesity. However, our results are concordant for a role of melanocortin-3 receptor variants in some dimensions of eating behavior such as emotional eating and enjoyment of food.     

Trends in prolonged sitting time among European adults: 27 country analysis

ObjectiveTo examine trends in adult sitting time across 27 European countries.MethodData were from the Eurobarometer surveys collected in 2002, 2005, and 2013. Sitting time data were used to categorise respondents into ‘low’ (0 to 4h30min), ‘middle’ (4h31min to 7h30min), and ‘high’ levels of sitting (>7h30min). We modelled the likelihood of being in the high sitting group within a given country and overall across the three time points, controlling for age, gender, education, employment status, and physical activity.ResultsIn total 17 countries had sitting data at all three time points; among these countries the prevalence of ‘high sitting’ decreased steadily from 23.1% (95% CI = 22.2–24.1) in 2002 to 21.8% (95% CI = 20.8–22.8) in 2005, and 17.8% (95% CI = 16.9–18.7) in 2013. A further 10 countries had data only over the latter two time points; among these countries the prevalence of high sitting decreased from 27.7% (95% CI = 26.0–29.4) in 2005 to 19.0% (95% CI = 17.6–20.5) in 2013.ConclusionTime spent in sedentary behaviour may not be increasing in the European region, and prolonged sitting may, in fact, be decreasing. This finding has important implications for the sedentary behaviour debate and the policy response.     

Relationships between depression,gender, and unhealthy weight loss practices among overweight or obese college students

IntroductionUnhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices among overweight or obese college students.MethodsStudents (body mass index between 25.0 and 34.9 kg/m²) from three Southern California universities (M_age = 22 years, SD = 4; 70% women) were recruited from May 2011 to May 2012 for participation in a weight loss clinical trial (N = 404). Logistic regressions were performed with baseline data to assess the cross-sectional relationship between self-reported unhealthy weight loss practices and gender and depression as measured by the Center for Epidemiologic Studies Depression short form.ResultsTwenty-nine percent of participants reported engaging in at least one unhealthy weight loss behavior (e.g., fasting, purging) over the last 30 days, with no differences by gender. Self-report of at least one unhealthy weight loss behavior was associated with report of symptoms of depression (e^B = 1.14 [confidence interval, CI: 1.08–1.20]), adjusting for potential confounders. Interactions between gender and depression were not significant (e^B = 1.04 [CI: 0.93–1.16]).ConclusionAmong an overweight or obese sample of college students, unhealthy weight loss practices were equally common in both genders, and students with depressive symptomatology were at greatest risk. Obesity interventions targeting overweight or obese college students should educate both men and women about the dangers of unhealthy weight loss practices. In addition, screening for depression can help identify students who would benefit from additional supportive and coping strategies and resources.     

Pain intensity and imaging at the initial phase of acute pyelonephritis

ObjectiveTo identify predictive factors of urological complication on imaging findings in women with pyelonephritis aged 18 to 65 years.MethodsWe performed an observational, retrospective, single-center study. The medical charts of women diagnosed with pyelonephritis at the emergency department from 2010 to 2015 were reviewed. Only patients who underwent an imaging study at the emergency department and with microbiologically confirmed pyelonephritis were included for analysis. The primary endpoint was the presence of urological complications on imaging findings. The secondary endpoint was treatment changes after imaging diagnosis.ResultsOf the 193 women enrolled, 88 (45.6%) had urological complication(s) on imaging findings. The multivariate analysis revealed that history of urolithiasis (OR = 2.41; P = 0.01) and pain requiring morphine use (OR = 5.29; P = 0.009) were predictive of urological complications on imaging findings. Of the 120 women with uncomplicated pyelonephritis who underwent imaging studies, 45% had urological complication, resulting in a treatment change in 36.7% of patients. The multivariate analysis revealed that age > 40 years (OR = 4.58; P = 0.02) and pain requiring morphine use (OR = 3.78; P = 0.02) were predictive of urological complication(s) on imaging findings and of treatment change based on imaging findings (OR = 6.76; P = 0.005 and OR = 4.19; P = 0.01 respectively) in this subgroup.ConclusionsPain requiring morphine use, age, and history of urolithiasis are independent predictors of urological complications on imaging findings in patients with acute pyelonephritis.     

The association between discrepant weight perceptions and objectively measured physical activity

BackgroundSome individuals perceive themselves as being normal weight, despite having an excess body fat percentage (e.g., underestimate weight). Conversely, other individuals perceive themselves as being overweight, despite having a normal body fat percentage (e.g., overestimate weight). When perceived and actual weight statuses are incongruent, individuals possess a discrepant weight perception. The association between discrepant weight perceptions and engagement in moderate-to-vigorous physical activity (MVPA) has not been thoroughly investigated, which was this study's purpose.MethodsFor this cross-sectional study, data from the 2003–2006 National Health and Nutrition Examination Survey were utilized (N = 5462 adults). MVPA was assessed via accelerometry. Based on measured body mass index and whether participants considered themselves as overweight, underweight, or about the right weight, we classified individuals as accurate perception, overestimate weight (discrepant), or underestimate weight (discrepant). A negative binomial logistical regression was used to assess the association between discrepant weight perception (independent variable) and engagement in MVPA (outcome variable).ResultsFemales who said that they are normal weight, but were in fact overweight based on body mass index, engaged in 13% less MVPA (rate ratio = .87, 95% confidence interval: .769–.999, P = .05). Also, older adults (> 60 yrs) who said that they are normal weight, but were overweight based on body mass index, engaged in 23% less MVPA (rate ratio = .77, 95% confidence interval: .616–.965, P = .025).ConclusionDiscrepant weight perceptions were associated with less objectively measured MVPA. Interventions should take weight perceptions into consideration when designing and evaluating intervention impact.