Who discusses reaching a healthy weight with a general practitioner? Findings from the 2014–15 Australian National Health Survey

ObjectiveGeneral practitioners (GPs) can positively impact upon patient intentions to lose weight and weight management, and are important in the referral pathway to specialist weight-loss programs and surgical interventions. The aim of this study was to investigate the characteristics and proportions of Australians who report talking to a GP about weight management.MethodsCross-sectional data from 15,329 participants aged 15 years and over in the 2014–15 Australian National Health Survey were used. Proportions (with 95% confidence intervals (95%CI)) of respondents who reported discussing reaching a healthy weight with a GP in the previous 12 months were estimated, categorised by demographic, social and health characteristics.ResultsWe found that 10.8% (95%CI:9.8–11.8) of overweight participants, 24.4% (95%CI:22.7–26.4) with Class 1 obesity (30 ≤ BMI < 35 kg/m²) and 41.8% (95%CI:38.3–45.3) with Classes II/III obesity (BMI ≥ 35 kg/m²) reported discussing weight with a GP. Higher proportions of respondents with Class II/Class III obesity and poor/fair self-reported health (50.2%, 95%CI:43.3–57.0), or high/very high levels of psychological distress (53.3%, 95%CI:43.7–61.4), or diabetes (64.8%, 95%CI:51.9–77.3) reported discussing weight. As age, number of GP visits, or comorbid conditions increased, the proportions of people who discussed their weight with a GP also increased, across all weight classes.ConclusionsWhile discussions are more likely with increasing BMI and comorbidities, most Australians with overweight and obesity appear to be missing opportunities to discuss reaching a healthy weight with their GP. Policies, training and education programs to encourage this dialogue could lead to earlier and more beneficial weight-related interventions.     

Impact of diagnosis of overweight and obesity on weight management among hospitalized patients

BackgroundObesity is a growing epidemic associated with a 30% increase in general mortality. Despite this, diagnosis and treatment is still deficient. A large number of patients with overweight and obesity enter hospitals daily; therefore, the hospital setting could be used as a scenario for intervention in this population.ObjectivesTo determine the frequency of diagnosis and treatment of overweight/obesity in hospitalized patients and to identify the factors involved in the probability of offering a diagnosis and treatment.MethodsCross-sectional data from 316 patients aged 18 years and over admitted in the Department of Internal Medicine during 2016–2017 period. Logistic regression was used to estimate the relationship between the possible predictors and the diagnosis of overweight and/or obesity and the development of a treatment.ResultsOnly 10.8% of the population was diagnosed (overweight 2.6%, obesity 18.8%). Patients with a BMI >40 kg/m² had a greater probability of being diagnosed (OR = 1.87; 95% CI, 2.2–19.4; p = 0.001). Only 4.4% of the population received treatment (overweight 3.2%, obesity 5.6%) and the only factor that increased the probability of receiving treatment was having been diagnosed with overweight/obesity in the medical record (OR = 2.28; 95% CI, 2.31–41.94; p = 0.002).DiscussionDespite the high prevalence of overweight and obesity among hospitalized patients, there is no adequate diagnosis and treatment. Future research should be directed at strategies that increase medical recognition of overweight/obesity as well as identifying the long-term benefits of diagnosing overweight/obesity for the reduction and control of body weight.     

Urinary triclosan concentrations are inversely associated with body mass index and waist circumference in the US general population: Experience in NHANES 2003–2010

BackgroundHumans are extensively exposed to triclosan, an antibacterial and antifungal agent. Triclosan's effects on human health, however, have not been carefully investigated.ObjectiveTo examine whether triclosan exposure is associated with obesity traits.MethodsThis study included 2898 children (6–19 years old) and 5066 adults (20 years or older) who participated in the National Health and Nutrition Examination Surveys (NHANES) 2003–2010 and had a detectable level of urinary triclosan. Multiple linear regression models were used to examine the association between urinary triclosan and both body mass index (BMI) and waist circumference.ResultsEach standard deviation increase in urinary triclosan was associated with a 0.34 (95% confidence interval, CI: 0.05, 0.64) kg/m² lower level of BMI (P = 0.02) and 0.92 (95% CI: 0.09, 1.74) cm smaller waist circumference (P = 0.03) in boys, and a 0.62 (95% CI: 0.31, 0.94) kg/m² lower level of BMI (P = 0.0002) and 1.32 (95% CI: 0.54, 2.09) cm smaller waist circumference in girls (P = 0.001); a 0.42 (95% CI: 0.06, 0.77) kg/m² lower level of BMI (P = 0.02) and 1.35 (95% CI: 0.48, 2.22) cm smaller waist circumference (P = 0.003) in men, and a 0.71 (95% CI: 0.34, 1.07) kg/m² lower level of BMI (P = 0.0002) and 1.68 (95% CI: 0.86, 2.50) cm smaller waist circumference (P = 0.0001) in women. In both children and adults, there was a consistent trend for lower levels of BMI and smaller waist circumference with increasing levels of urinary triclosan, from the lowest to the highest quartile of urinary triclosan (P ≤ 0.001 in all cases).ConclusionTriclosan exposure is inversely associated with BMI and waist circumference. The biological mechanisms linking triclosan exposure to obesity await further investigation.     

Joint association of body mass index and central obesity with cardiovascular events and all-cause mortality in prediabetic population: A prospective cohort study

ObjectiveTo assess the joint association of body mass index (BMI) and central obesity with cardiovascular events and all-cause mortality in prediabetic population.MethodsAltogether 18,703 participants with prediabetes completed follow-up between June 2006 and December 2015 were included in the analyses. Prediabetes was defined as fasting plasma glucose level 5.6–6.9 mmol/L, and without history of diabetes or currently use of hypoglycemic agents. Participants were classified according to the baseline status of BMI as well as the absence/presence of central obesity. We examined these associations in men and women separately.ResultsThe mean age was 51.5 ± 11.1 years, and 85.6% (N = 16,002) were male. During a median follow up of 9.0 (interquartile range 8.7–9.2) years, 848 and 88 major CV events occurred in men and women, respectively. Besides, 1111 men and 89 women died. Compared with men of BMI 22–23.9 kg/m² and without central obesity, the risk of CV events was increased among men with higher BMI and central obesity (HR 1.32 (95% CI: 1.05–1.67) for BMI 24–27.9 kg/m² and 1.31 (1.03–1.66) for BMI ≥ 28 kg/m², respectively); and the risk of all-cause mortality was the lowest among men of BMI 24–27.9 kg/m² but without central obesity (0.75, 0.61–0.92). We found no such association in women.ConclusionAmong men with prediabetes, both BMI and waist circumference should be included when evaluating the risks of major CV events and mortality. Measurement of adiposity constitutes a simple and cost-effective strategy to identify those at high-risk population in prediabetes.     

Joint effects of age and body mass index on the incidence of hypertension subtypes in the China Health and Nutrition Survey: A cohort study over 22 years

ObjectivesWe seek to investigate the joint effects of age and body mass index (BMI) on the incident hypertension subtypes among Chinese adults during 1989–2011.MethodsWe investigated the Incidence rates (IRs, per 100 person-years) of hypertension subtypes, adjusted relative risks (RRs) and population attributable risk percent (PAR%) of BMI for hypertension, and clarified the age-specific effect of BMI on incident hypertension utilizing a dynamic cohort study from the China Health and Nutrition Survey (CHNS) 1989–2011.ResultsNormotensive participants (n = 53,028) at baseline were included, with mean age was 41.7 (95% CI, 41.6–41.7) years old. During a total of 118,694 person years (average was 6.38 years) of follow-up, a total of 5208 incident cases of hypertension were documented. The IRs of hypertension were 4.4 (95% CI, 4.3–4.5), which increased gradually by age and BMI (P_trend < 0.001). Compared with those with BMI < 22 kg/m², the RR of hypertension was 3.13 (95% CI, 2.84–3.45) in the group with BMI ≥ 28 kg/m². The PAR% (BMI > 22 vs. BMI < 22) for hypertension in Chinese population was 32% (95% CI, 29–34%). Similar trends were observed in all age and BMI groups for both isolated systolic hypertension and systolic–diastolic hypertension, which were mainly affected by age. In contrast, the peak IR of isolated diastolic hypertension was observed in participants aged 30–49 years with higher BMIs.ConclusionsThe PAR% (IR of BP ≥ 140/90 or treatment for BMI > 22 vs. IR for BMI < 22) of elevated body weight for hypertension was 32% in Chinese population.     

Medical costs attributable to overweight and obesity in Japanese individuals

ObjectiveWe aimed to reveal the association between body mass index (BMI) and medical costs in the current Japanese population, and to estimate the population attributable fraction (PAF) of medical costs due to overweight and obesity.MethodsA generalized linear mixed model with log link function and gamma distribution was used to evaluate the association between BMI and medical costs in 34,537 beneficiaries of the National Health Insurance aged 40–69 years in Chiba City. Medical cost data were obtained from insurance claims submitted between April 2012 and March 2016. PAFs due to overweight (BMI ≥25.0 and <30.0 kg/m²) and obesity (BMI ≥30.0 kg/m²) were calculated.ResultsOverweight and obesity were significant predictors of excessive medical costs in all age and sex groups. PAF due to overweight and obesity was estimated to be 9.62% (95% confidence interval, 8.52–10.73%). Additionally, PAFs in 40–59-year-old individuals (12.76% in men and 11.63% in women) were greater than those in 60–69-year-old subjects (6.55% in men and 7.80% in women) for both sexes.ConclusionsIn the Japanese population, overweight and obesity are an excessive financial burden with an estimated PAF of 9.62% of total medical costs.     

Body weight dissatisfaction: A comparison of women with and without eating disorders

ObjectiveBody dissatisfaction is present in a majority of women without eating disorders (EDs), and almost all women with EDs. We compared body dissatisfaction in women with and without EDs to determine at which BMI women are content with their weight, and to determine if body dissatisfaction is affected by the presence of purging behaviours.MethodsWe assessed women, age 18 to 55 with an ED (N = 431) and without an ED (N = 719) using the discrepancy between their current and desired BMI. This measure of body weight dissatisfaction (BWD) has been validated as being representative of overall body dissatisfaction. We also measured perceptions of (i) Body Appearance and (ii) Body Image to confirm our results.ResultsWomen with and without EDs wished to lose weight until very low weights were achieved (BMI 15–16 kg/m² and BMI 18–19 kg/m² respectively). BWD is higher in women with EDs (median 1.77, IQR 0–4.61) than women without EDs (median 0.85, IQR 0–1.80, p < 0.001). Purging behaviours in women with EDs were associated with lower BMIs to achieve body satisfaction (BMI 15–16 kg/m²) than women who did not purge (16–17 kg/m²).ConclusionsBody weight dissatisfaction is highly prevalent amongst women with and without EDs. Understanding body weight dissatisfaction in women with EDs and its association with purging may assist in the prevention, detection and treatment of these disorders. Women with EDs should be informed that body weight dissatisfaction will not resolve with the cessation of their disorder, as it is prevalent within the general population.     

Eight-year change in body mass index and subsequent risk of cardiovascular disease among healthy non-smoking men

Objective.To determine how change in BMI over 8 years is associated with risk of subsequent cardiovascular disease (CVD) among middle aged men.Methods.Prospective cohort study among 13,230 healthy men (aged 51.6 ± 8.7 years) in the Physicians' Health Study. BMI was collected at baseline in 1982 and after 8 years, at which time follow-up began. Subsequent CVD events were collected and confirmed through March 31, 2005. Cox proportional hazards models evaluated BMI at 8 years and risk of CVD, 8-year change in BMI and risk of CVD, and whether change in BMI added prognostic information after the consideration of BMI at 8 years.Results.1308 major CVD events occurred over 13.5 years. A higher BMI at year 8 was associated with an increased risk of CVD. Compared to a stable BMI (± 0.5 kg/m²), a 0.5–2.0 kg/m² increase had a multivariable-adjusted RR of 1.00 (0.86–1.16). A ≥ 2.0 kg/m² increase had a multivariable-adjusted RR of 1.39 (1.16–1.68), however further adjustment for BMI reduced the RR to 1.00 (0.81–1.23). A decrease in BMI had a multivariable RR of 1.23 (1.07–1.42) which was unaffected by adjustment for BMI at 8 years.Conclusion.A higher BMI and a rising BMI were both associated with an increased risk of CVD, however an increasing BMI did not add prognostic information once current BMI was considered. In contrast, a declining BMI was associated with an increased risk of CVD independent of current BMI.     

Social anxiety and disordered overeating: An association among overweight and obese individuals

ObjectiveThe study objectives were to evaluate the relationship between social anxiety, binge eating, and emotional eating in overweight and obese individuals and to evaluate the relationship between weight and social anxiety.MethodsUsing an internet based survey, overweight and obese men and women (n = 231; mean age = 36.0 ± 12.8; mean BMI = 33.7 kg/m² ± 6.7) completed several self-report measures including: social anxiety, social physique anxiety, binge eating, and emotional eating. The relationships among variables were evaluated using Spearman's correlations, ANOVAs, and linear and logistic regression equations.ResultsClinically significant levels of social anxiety were reported in 59% of participants, and binge eating disorder criteria were met by 13%. Social anxiety was significantly associated with binge eating (r = .36; OR = 1.06, CI = 1.02–1.10) and emotional eating (r = .46; β = 0.36), but was not associated with restrained eating. The association between social physique anxiety and emotional and binge eating did not remain significant in regression equations. BMI was associated with binge eating (r = .19) but not emotional eating. Level of social anxiety was not significantly higher among extremely obese participants, compared to overweight and obese participants.ConclusionsIn this study, social anxiety was associated with binge eating and emotional eating in overweight and obese men and women. When appropriate, interventions could address social anxiety as a barrier to normative eating patterns and weight loss.     

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.     

Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis

ObjectiveIn recent years, many original studies have shown that skipping breakfast has been associated with overweight and obesity; however, the results of different studies are inconsistent. Therefore, we conducted a systematic review and meta-analysis of observational studies to synthesize the associations between skipping breakfast and the risk of overweight/ obesity.MethodsWe did a systematic search using Pubmed, and Ovid searched up to August 2019. Observational studies (cohort studies and cross-sectional studies) reporting adjusted Odds Ratio or Risk Ratio estimates for the association between breakfast skipping and overweight/obesity (including abdominal obesity). Summary odds ratio (or Risk Ratio) and 95% confidence intervals calculated with a random-effects model.Results45 observational studies (36 cross-sectional studies and 9 cohort studies) were included in this meta-analysis. In cross-sectional studies, The ORs of low frequency breakfast intake per week versus high frequency were 1.48 (95% CI 1.40–1.57; I² = 54.0%; P = 0.002) for overweight/obesity, 1.31 (95% CI 1.17–1.47; I² = 43.0%; P = 0.15) for abdominal obesity. In cohort studies, The RR of low-frequency breakfast intake per week versus high frequency was 1.44 (95% CI 1.25–1.66; I² = 61%; P = 0.009) for overweight/obesity.ConclusionsThis meta-analysis confirmed that skipping breakfast is associated with overweight/obesity, and skipping breakfast increases the risk of overweight/obesity. The results of cohort studies and cross-sectional studies are consistent. There is no significant difference in these results among different ages, gender, regions, and economic conditions.     

Use of levonorgestrel as emergency contraception in overweight women

ObjectiveLevonorgestrel (LNG) emergency contraception (EC) may have decreased efficacy for women with body mass indices (BMI) ≥ 26 kg/m². This study aims to evaluate the prevalence of LNG EC use and EC counseling among overweight women.MethodsThe 2013–2015 dataset from the National Survey of Family Growth was analyzed to determine the proportion of women with BMI ≥ 26 kg/m² who report recent use of LNG EC and EC counseling.ResultsOverall, 2.4% of respondents reported recent use of LNG EC. Among women using oral LNG for EC, 29.8% of survey participants reported BMI ≥ 26 kg/m². Additionally, 40.2% of women with BMI ≥ 26 kg/m² using oral LNG EC reported having a doctor or medical provider talk to them about emergency contraception within the last 12 months, compared to 18.3% of LNG EC users with BMI < 26 kg/m² (p < 0.001).ConclusionsDespite recent counseling from clinicians and concerns for decreased efficacy, a significant number of overweight women continue to use LNG for EC. Clinicians should counsel women with BMI ≥ 26 kg/m² on the potential limitations of oral LNG for EC and offer more effective EC methods, including the copper intrauterine device and oral ulipristal acetate.     

Proximity to supermarkets associated with higher body mass index among overweight and obese preschool-age children

ObjectiveThe objective of this study is to examine associations of proximity to food establishments with body mass index (BMI) among preschool-age children.MethodsWe used baseline data from 438 children ages 2–6.9 years with a BMI ≥ 85th percentile participating in a RCT in Massachusetts from 2006 to 2009. We used a geographic information system to determine proximity to six types of food establishments: 1) convenience stores, 2) bakeries, coffee shops, candy stores, 3) full service restaurants, 4) large supermarkets, 5) small supermarkets, and 6) fast-food restaurants. The main outcome was child's BMI.ResultsChildren's mean (SD) BMI was 19.2 (2.4) kg/m²; 35% lived ≤ 1 mile from a large supermarket, 42% lived > 1 to 2 miles, and 22% lived > 2 miles. Compared to children living > 2 miles from a large supermarket, those who lived within 1 mile had a BMI 1.06 kg/m² higher. Adjustment for socioeconomic characteristics and distance to fast-food restaurants attenuated this estimate to 0.77 kg/m². Living in any other distance category from a large supermarket and proximity to other food establishments were not associated with child BMI.ConclusionsLiving closer to a large supermarket was associated with higher BMI among preschool-age children who were overweight or obese.     

The MTHFR C677T mutation is not a risk factor recognized for HBV-related HCC in a population with a high prevalence of this genetic marker

BackgroundPolymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene can affect disease progression in HBV infection. However, the results from different reports are inconsistent. The aim of this study was to investigate the association between the MTHFR C677T polymorphism and the outcome of HBV infection in a Tianjin Han population.MethodsTaqMan SNP genotyping was employed to determine the alleles and genotypes of MTHFR C677T in 2511 subjects from various stages of HBV infection and 549 healthy controls.ResultsOf the 3060 subjects, the genotypic frequencies were CT 48.9%, TT 29.3% and CC 21.8%; the allelic frequencies were T 53.8% and C 46.2%. There was no significant difference in genotypic or allelic distribution among the different disease groups. When either healthy subjects or self-limited subjects were used as controls, the TT genotype and the T allele conferred protective effects against hepatocellular carcinoma (HCC) (HCC vs healthy subjects: OR = 0.588, 95% CI = 0.413–0.836, P = 0.003; OR = 0.768, 95% CI = 0.645–0.915, P = 0.003, respectively. HCC vs self-limited subjects: OR = 0.598, 95% CI = 0.404–0.886, P = 0.010; OR = 0.772, 95% CI = 0.635–0.940, P = 0.010, respectively). After sub-stratification by gender, the prevalence of the TT genotype or T allele was the lowest in the male HCC group (TT 23.5%, T 49.8%). The protective effects of the TT genotype and the T allele were observed in male HCC and cirrhotic subjects (HCC vs self-limited subjects: OR = 0.470, 95% CI = 0.288–0.766, P = 0.002; OR = 0.681, 95% CI = 0.535–0.866, P = 0.002, respectively. Liver cirrhosis vs self-limited subjects: OR = 0.624, 95% CI = 0.392–0.992, P = 0.046; OR = 0.791, 95% CI = 0.627–0.998, P = 0.048, respectively), but not in female. When the subjects were stratified according to the clinical features, no statistically significant difference in the genotypic distribution was observed (P > 0.05).ConclusionsThe TT genotype and T allele of MTHFR C677T may confer a protective effect on disease progression to HCC in HBV-infected individuals, especially among male patients, in a population with a high prevalence of this genetic marker.     

Impact of obesity and diabetes mellitus in critically ill patients with SARS-CoV-2

PurposeEvaluate the associations of obesity and diabetes with the risk of mortality in critically ill patients infected with SARS-CoV-2.Materials and methodsThis cohort study included 115 adult patients admitted to the ICU with SARS-CoV-2 pneumonia. Anthropometric variables and biochemical (C-reactive protein, ferritin, leukocyte, neutrophils, and fibrinogen) were measured. Multivariate logistic regression analyses were used to investigate the associations.ResultsMean age was 50.6 ± 11.2 years, 68.7% were male. Median BMI was 30.9 kg/m². All patients had invasive mechanical ventilation. Patients with diabetes had increased risk of mortality with OR of 2.86 (CI 95% 1.1–7.4, p = 0.026); among those patients who, in addition to diabetes had obesity, the risk was de 3.17 (CI 95% 1.9–10.2, p = 0.038). Patients with obesity had 1.25 times greater risk of developing a severe SARS-CoV-2 infection (95% CI 1.09–1.46, p = 0.025). Negative correlation was observed between BMI and the PaO2/FiO2 ratio (r = ?0.023, p < 0.05). Obese patients required more days of mechanical ventilation and longer hospital stay compared to non-obese patients.ConclusionsDiabetes and obesity are risk factors for increasing severity of SARS-CoV-2 infection, and they are both associated with an increase in mortality.     

Levels of physical activity and relationship with markers of diabetes and cardiovascular disease risk in 5474 white European and South Asian adults screened for type 2 diabetes

ObjectiveInvestigate levels of physical activity and their association with health in a white European (WE) and South Asian (SA) population.MethodsThis study reports data from a diabetes screening programme, 2004–2007, Leicester, UK. Physical activity was measured using the International Physical Activity Questionnaire; additional outcomes included fasting and 2-h post-challenge glucose, lipid profile, body mass index (BMI) and waist circumference.Results1164 SA (female = 48%) and 4310 WE (female = 53%) were included. SAs were more likely fall below the minimum physical activity recommendations for health compared to WEs (age-adjusted OR for SA men = 2.35; 95% CI = 1.89–2.93, age adjusted OR for SA women = 2.25; 95% CI = 1.81–2.80). There were significant associations between levels of physical activity and BMI (men and women), waist circumference (men and women), 2-h glucose (women), HDL-cholesterol (men) and triglycerides (men) in WEs and waist circumference (women) and HDL-cholesterol (men) in SAs. Significant interactions between ethnicity and physical activity existed in the relationship with BMI and waist circumference in men.ConclusionsSAs are substantially less physically active than WEs. There may also be differences between SAs and WEs in the health benefits associated with higher physical activity that warrant further investigation.     

Healthy excessive weight in Portuguese women 4 years after delivery of a liveborn

ObjectiveTo quantify the prevalence of healthy excessive weight and determinants of metabolic profile, considering women's reproductive life.MethodsWe evaluated 1847 mothers of a birth cohort assembled after delivery and reevaluated 4 years later. A healthy profile was defined as the absence of hypertension, diabetes, dyslipidemia, C-reactive protein < 3 mg/l and being below the second tertile of HOMA-IR. Adjusted odds ratios (OR) and confidence intervals (95% CI) were computed using multinomial logistic regression, taking women with normal BMI as the reference category of the outcome.ResultsFour years after delivery, 47% of women had normal BMI, 33% were overweight and 20% obese. In each BMI class, 61%, 33% and 12% presented a healthy metabolic profile, respectively. Family history of CVD/cardiometabolic risk factors was associated with a higher probability of obesity with a not healthy metabolic profile (OR = 1.39 95% CI: 0.98–1.98). Women who breastfed the enrolled child for > 26 weeks and practiced physical exercise were less likely to be obese and metabolically unhealthy (OR = 0.39 95% CI: 0.23–0.68; OR = 0.48 95% CI: 0.33–0.70, respectively), with no effect on healthy excessive weight.ConclusionsThese results support the existence of a healthy excessive weight phenotype in women after motherhood, influenced by anthropometrics, genetic and lifestyles characteristics.     

Évolution du statut nutritionnel d’une cohorte d’enfants tunisiens au cours de l’hospitalisation : facteurs de risque de la dénutrition hospitalière

ObjectivesStudy the evolution of the nutritional status of a cohort of hospitalized children and identify the risk factors of hospital malnutrition.MethodsProspective, cross-sectional study carried out in a pediatric department over a period of six months, including all children aged ≥ 30 days, hospitalized for a period ≥ six days. Anthropometric data were assessed on admission and discharge. Food consumption was assessed using the flower tool. We identified the risk factors for hospital undernutrition (HUN) by multivariate analysis.ResultsWe included 120 patients with a mean age 46.3 months. The prevalence of acute undernutrition at admission was 21.7% and that of chronic undernutrition was 10%. The prevalence of acute undernutrition at discharge rose to 34%. Weight loss during hospitalization was noted in 68.3% of cases. The prevalence of HUN was 55% considering a decrease in BMI or P/PAT z-score ≥ 25%. The risk factors for HUN were: age ≤ 24 months (P = 0.039; OR 95% CI = 2.67 [1.05–6.82]), the presence of undernutrition on admission (P = 0.002; OR 95% CI = 2.32 [0.93–6.51]) and average food consumption < 50% during hospitalization (P < 10^?3; OR 95% CI = 6.69 [2.57–17.40]).ConclusionScreening for undernutrition on admission to hospital as well as assessment of the nutritional risk in hospitalized children is essential so that preventive or curative nutritional care can be taken.     

Risk factors for tuberculosis among health care workers in South India: a nested case–control study

ObjectiveThe epidemiology of tuberculosis (TB) among health care workers (HCWs) in India remains under-researched. This study is a nested case–control design assessing the risk factors for acquiring TB among HCWs in India.Study Design and SettingsIt is a nested case–control study conducted at a tertiary teaching hospital in India. Cases (n = 101) were HCWs with active TB. Controls (n = 101) were HCWs who did not have TB, randomly selected from the 6,003 subjects employed at the facility. Cases and controls were compared with respect to clinical and demographic variables.ResultsThe cases and controls were of similar age. Logistic regression analysis showed that body mass index (BMI) <19 kg/m² (odds ratio [OR]: 2.96, 95% confidence interval [CI]: 1.49–5.87), having frequent contact with patients (OR: 2.83, 95% CI: 1.47–5.45) and being employed in medical wards (OR: 12.37, 95% CI: 1.38–110.17) or microbiology laboratories (OR: 5.65, 95% CI: 1.74–18.36) were independently associated with increased risk of acquiring TB.ConclusionHCWs with frequent patient contact and those with BMI <19 kg/m² were at high risk of acquiring active TB. Nosocomial transmission of TB was pronounced in locations, such as medical wards and microbiology laboratories. Surveillance of high-risk HCWs and appropriate infrastructure modifications may be important to prevent interpersonal TB transmission in health care facilities.     

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.