Preschool Enrollment is Associated with Lower Odds of Childhood Obesity Among WIC Participants in LA County

The prevalence of obesity among children in the United States has increased rapidly during the past few decades. Research into social and behavioral determinants of obesity could lead to innovative strategies for prevention. The objective of the present study was to examine the association between childhood obesity and preschool enrollment and number of hours in child care among low-income preschool-aged children who were participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). We conducted a case–control study including 556 3- to 4-year-old children who were either obese (BMI > 95th percentile of reference standard) or normal-weight (BMI 25–75th percentile). The population was largely (96%) Hispanic, an ethnic group that has one of the highest rates of overweight and obesity in adults and children in the US. In multiple logistic regression analysis, controlling for a variety of psychosocial and cognitive home environment variables, key demographics and maternal variables, the odds ratio of being obese was 0.61 for children who attended preschool more than 4 days a week (95% CI: 0.41–0.90). Watching television or videos for an hour or more on a typical day (odds ratio 1.71 (95% CI 1.07–2.75)), and higher maternal BMI (odds ratio 1.08 (95% CI 1.05–1.11)) were independently related to odds of obesity. The impact of preschool attendance and TV viewing are potentially instructive in terms of preventive interventions for children at this age.     

Racial differences in gestational weight gain and pregnancy-related hypertension

PurposeThe aim of the study was to examine racial differences in gestational weight gain (GWG) and pregnancy-related hypertension.MethodsLogistic regression models tested racial differences in adequacy of GWG and pregnancy-induced hypertension in all singleton live births from the South Carolina 2004–2006 birth certificates.ResultsCompared with white women, black and Hispanic women had 16%–46% lower odds of gaining weight above the recommendations. However, the odds of inadequate GWG was ∼50% higher in black and Hispanic women with a pregnancy body mass index (BMI) less than 25 kg/m². Furthermore, compared with women with adequate GWG, women with excessive GWG had higher odds of pregnancy-related hypertension (underweight: 2.35, 95% confidence interval [CI; 1.66, 3.32]; normal: 2.05, 95% CI [1.84, 2.27]; overweight: 1.93, 95% CI [1.64, 2.27]; obese: 1.46, 95% CI [1.30, 1.63]). Among women with a BMI less than 25 kg/m², black women had higher odds of pregnancy-related hypertension than white women (underweight: 1.64, 95% CI [1.14, 2.36]; normal weight: 1.28, 95% CI [1.15, 1.42]), whereas among women with a BMI less than 25 kg/m², Hispanic women had 40% lower odds.ConclusionsPrograms are needed to curb excessive GWG in all racial groups and to help some sub-groups ensure adequate GWG. Maternal obesity and GWG are two factors that should be used in combination to reduce racial differences in pregnancy-related hypertension.     

Impact of Body Mass Index on the Incidence of Cardiometabolic Risk Factors in Ambulatory Care Settings over 5 Years or More

ObjectiveThis study was performed to evaluate the association of body mass index (BMI) with the incidence of cardiometabolic risk factors in ambulatory care electronic medical records (EMRs) over 5 years or more.DesignA retrospective cohort of normal versus obese patients.SubjectsSubjects ≥18 years were identified between 1996 and 2005.MeasurementsPatients were categorized as either normal weight (18 kg/m² < BMI ≤ 27 kg/m²) or obese (BMI > 27 kg/m²) based on baseline BMI (measured 395 days or more after first EMR activity). Outcomes included development, at least 180 days after the first BMI reading date, of four cardiometabolic risk factors (elevated triglycerides, low high-density lipoprotein cholesterol [HDL-C], hypertension, or type 2 diabetes) determined from ICD-9 code, prescribed drug, or biometric reading. Logistic regression estimated the odds of developing cardiometabolic risk factors, alone and combined for normal versus obese patients forward for at least 5 years.ResultsSeventy-one percent were female, mean age was 43.5 years, and 37.6% had a baseline BMI > 27 kg/m². Comparing obese versus normal weight patients, adjusted odds ratios for the incidence of elevated triglycerides, hypertension, diabetes, and low HDL-C were 2.1 (95% confidence interval [95% CI] 1.9–2.3), 2.2 (95% CI 2.1–2.4), 2.3 (95% CI 2.0–2.7), and 2.2 (95% CI 2.0–2.4), respectively. Adjusted odds ratios of developing one and all four new risk factors were 1.9 (95% CI 1.8–2.1) and 7.9 (95% CI 5.9–10.5), respectively.ConclusionObese patients are approximately twice as likely to develop cardiometabolic risk factors compared with those having normal weight over 5 or more years.     

Beta(2)-adrenergic receptor mutation and abdominal obesity risk: effect modification by gender and HDL-cholesterol

Summary Objective and design A case-control study was conducted to examine the association between the 27Glu polymorphism of the β₂-adrenergic receptor gene (ADRB2) and the risk of abdominal obesity (defined by a waist/hip ratio: WHR higher than 0.85). Methods The case series encompassed 112 obese subjects with body mass index (BMI) > 30 kg/m² and WHR > 0.85 and no other major disease except for type 2 diabetes, while the controls were 127 healthy subjects, BMI < 25 kg/m² and WHR < 0.85. Results The association between the risk of abdominal obesity and the 27Glu polymorphism was estimated using multivariate logistic regression. A higher crude odds ratio (OR) of 4.08 (95 % confidence interval: 0.98–16.3) for the 27Glu allele was found among men, while no increased risk was apparent among female participants. Moreover, when the model was adjusted for age, male subjects carriers of the 27Glu allele had a significant ten-fold higher risk of abdominal obesity (OR = 10.31; 95 % CI: 1.4–76.8) and the product-term for the interaction (effect modification) between gender and the ADRB2 mutation was near to the limits of statistical significance (Likelihood ratio test p = 0.056). Interestingly, we also found an effect modification with higher OR among individuals with low HDL-cholesterol (< 1.5 mmol/l) after adjustment for age and gender (OR = 2.87 95 % CI 1.09–7.50) and the product-term for interaction between the 27Glu allele and HDL-cholesterol was statistically significant (Likelihood ratio test p = 0.003). Conclusions. Our results showed that the 27Glu allele of the ADRB2 gene appears to be a risk factor for abdominal obesity among male subjects, specially among those with lower HDL-cholesterol levels. Received: 26 November 2001, Accepted: 2 March 2002     

Prevalence of Overweight and Obesity Among Women of Childbearing Age: Results from the 2002 National Survey of Family Growth

Objective To estimate the prevalence of overweight and obesity among U.S. women of childbearing age. Methods Our study population was drawn from the 2002 National Survey of Family Growth (NSFG) and consisted of non-pregnant female respondents aged 20–44 years with a valid body mass index (BMI) (N = 5,958). Univariate and bivariate analyses were conducted to document variations in the prevalence of overweight and obesity by age, race and Hispanic origin, and socioeconomic status. Results Overall, 24.5% of women 20–44 years of age were overweight (BMI 25.0–29.9 kg/m²) and 23.0% were obese (BMI ≥ 30.0 kg/m²). Among those who were obese, 10.3% met the criteria for class II or III obesity (BMI ≥ 35.0 kg/m²). Non-Hispanic black and women were 2.25 times more likely to be overweight or obese compared to non-Hispanic white women (95% CI: 1.87–2.69). This disparity in risk between non-Hispanic black and non-Hispanic white women declined and no longer achieved statistical significance after adjustment for education, household income, and health insurance coverage. Conclusions Nearly one in two U.S. women of childbearing age are either overweight or obese. The racial/ethnic disparity in prevalence rates may be due in part to variability in educational attainment, household income, and stability of health insurance coverage.     

Natural histories of metabolite BMI phenotypes and their impacts on cardiovascular disease risk over a decade-long follow-up

PurposeThe prognostic significance of obesity phenotypes is under debate, and few studies have characterized their transition trajectories. This study examined the natural courses of different phenotypes and their associations with cardiovascular disease risks.MethodsA total of 1827 participants were followed for 14 years and re-evaluated every 4–5 years. Four metabolite BMI phenotypes were determined according to overweight or obesity (BMI ≥ 24 kg/m²) and metabolic health status (≤1 Adult Treatment Panel III criteria, excluding waist circumference). Cardiovascular risks were assessed by evaluating baPWV and hypertension, diabetes and chronic kidney disease (CKD) development.ResultsMore than 20% of participants changed their initial phenotypes within 5 years. One-third of healthy overweight/obese (MHO) individuals became unhealthy, and only 10.6% regressed to a healthy normal weight (MHN) at the end of follow-up. Compared with MHN participants, MHO participants had higher odds of increased baPWV (OR: 1.18, 95% CI, 0.42–3.33) and increased risks of incident hypertension (HR: 1.87, 95% CI, 1.18–2.98) and diabetes (HR: 2.61, 95% CI, 1.35–5.03). Metabolic deterioration during follow-up resulted in an increased risk of baPWV and clinical diseases.ConclusionsThe natural trajectory of metabolite BMI phenotypes is time-varying, and interventions for both healthy and unhealthy overweight/obese individuals should be widely recommended.     

Total and abdominal obesity among rural Chinese women and the association with hypertension

Objective

Obesity increases the risk of hypertension and other chronic diseases, which are little known in rural China. This study aimed to investigate the epidemiologic features and the association with hypertension of obesity in rural Chinese women.

Methods

A cross-sectional survey was conducted during 2004 through 2006, which used a multistage cluster sampling method to select a representative sample in Liaoning Province, China. In total 23 178 rural participants at least 35 y of age were examined (the percentage of subjects >64 y old was 14.5%). Data on demographic variables (age, sex, and race), smoking status, use of alcohol, physical activity, and education level were obtained by interview. Overweight and obesity were defined according to the World Health Organization classification. Hypertension was defined according to the criteria established by the Seventh Report of the Joint National Committee, and untreated hypertensive subjects were further classified into three subtypes: isolated systolic hypertension, isolated diastolic hypertension, and systolic and diastolic hypertension. Multivariable models and performed Poisson logistic regression analysis were used to determine associations among body mass index (BMI), waist circumference, and variables.

Results

Overall, the prevalences of overweight and obesity were 24.4% and 2.7%, respectively, as defined by BMI, whereas the prevalences were 48.6% and 4.9% as defined by waist circumference. Poisson regression revealed that high levels of physical activity (defined by BMI, moderate: prevalence ratio [PR] 0.976, 95% confidence interval [CI] 0.965-0.988, high: PR 0.985, 95% CI 0.971-0.999; defined by waist circumference, moderate: PR 0.955, 95% CI 0.944-0.965, high: PR 0.973, 95% CI 0.960-0.985) and current smoking status (defined by BMI, PR 0.950, 95% CI 0.938-0.962; defined by waist circumference, PR 0.966, 95% CI 0.954-0.978) were protective factors and ethnicity was a risk factor (defined by BMI, Mongolian nationality: PR 1.042, 95% CI 1.030-1.054; defined by waist circumference, PR 1.043, 95% CI 1.033-1.054) for overweight or obese participants. There were other risk factors for overweight or obese participants such as high levels of education defined by BMI (PR 1.033, 95% CI 1.010-1.058) and diet score defined by waist circumference (PR 1.004, 95% CI 1.000-1.008). After adjustment, BMI and waist circumference were associated with the greatest likelihood of systolic and diastolic hypertension (for BMI ≥30 kg/m², PR 2.455, 95% CI 1.786-3.374; for waist circumference ≥88 cm, PR 1.517, 95% CI 1.133-2.031). BMI was more related to isolated diastolic hypertension than to isolated systolic hypertension, whereas waist circumference was more related to isolated systolic hypertension than to isolated diastolic hypertension.

Conclusion

Although the prevalence of overweight and obesity as defined by BMI was low, it was relatively high as defined by waist circumference in rural Chinese women. High levels of physical activity and current smoking status had negative relations to overweight or obesity, whereas ethnicity, high levels of education, and diet score showed positive relations. Obese women defined by BMI or waist circumference had an increased risk of hypertension.     

Dietary patterns interact with chromosome 9p21 rs1333048 polymorphism on the risk of obesity and cardiovascular risk factors in apparently healthy Tehrani adults

Gene-dietary patterns may contribute to determining body composition and related biochemical indices. The aim of this study was to evaluate interactions between rs1333048 polymorphism and major dietary patterns on body fat percentage, general and central obesity, and related biochemical measurements. This cross-sectional study was conducted on 265 healthy Tehrani adults with mean age of 35 years (47.5% men, 52.5% women). Dietary patterns (DPs) were extracted by factor analysis. Bioelectrical impedance analysis was used for body analysis and rs1333048 was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. Three DPs were extracted: restricted refined grains DP, legumes DP and healthy DP. AA genotype compared to CC genotype had greater odds for general obesity before (OR 3.14; 95% CI 1.008–9.60, P = 0.045) and after (OR 3.11; 95% CI 1.008–9.60, P = 0.048) adjusting for potential confounders. Individuals with AA genotype were more likely to be centrally obese before (OR 2.09; 95% CI 1.006–4.35, P = 0.048) and after (OR 2.63; 95% CI 1.12–6.17, P = 0.026) controlling for potential confounders. Significant interactions were observed between Legumes DP and rs1333048 SNP on waist circumference (P = 0.047), body fat % (BFP) (P = 0.048), hs-Crp (P = 0.042), BMI (P = 0.073), WHtR (P = 0.063) and odds for general obesity (P = 0.051). Following this DP reduced all these items for individuals with CC genotype, whereas increased them for people who carry CA or AA genotypes. The findings indicate that there are significant associations between AA genotype of rs1333048 SNP and general and central obesity, and significant interaction between alleles of this SNP and major dietary patterns on the odds of general obesity, BFP, waist circumference, BMI, WHtR and hs-Crp.     

The obesity paradox in acute coronary syndrome: a meta-analysis

In the general population, the lowest mortality risk is considered to be for the body mass index (BMI) range of 20–24.9 kg/m². In chronic diseases (chronic kidney disease, chronic heart failure or chronic obstructive pulmonary disease) the best survival is observed in overweight or obese patients. Recently above-mentioned phenomenon, called obesity paradox, has been described in patients with coronary artery disease. Our aim was to analyze the relationship between BMI and total mortality in patients after acute coronary syndrome (ACS) in the context of obesity paradox. We searched scientific databases for studies describing relation in body mass index with mortality in patients with ACS. The study selection process was performed according to PRISMA statement. Crude mortality rates, odds ratio or risk ratio for all-cause mortality were extracted from articles and included into meta-analysis. 26 studies and 218,532 patients with ACS were included into meta-analysis. The highest risk of mortality was found in Low BMI patients—RR 1.47 (95 % CI 1.24–1.74). Overweight, obese and severely obese patients had lower mortality compared with those with normal BMI–RR 0.70 (95 % CI 0.64–0.76), RR 0.60, (95 % CI 0.53–0.68) and RR 0.70 (95 % CI 0.58–0.86), respectively. The obesity paradox in patients with ACS has been confirmed. Although it seems to be clear and quite obvious, outcomes should be interpreted with caution. It is remarkable that obese patients had more often diabetes mellitus and/or hypertension, but they were younger and had less bleeding complications, which could have influence on their survival.     

Association of hypertension with changes in the body mass index of university students

Background  There are few longitudinal studies on the associations of obesity with hypertension in young adults. Objectives  To analyze longitudinally to what extent weight gain associates with hypertension in young adults. Methods  The subjects of this study consisted of 6,178 university students (male 4,098; female 2,080). The associations of hypertension with body type change were longitudinally examined by using the records of health examinations while at university. The prevalence ratios (PRs) for hypertension in their senior year were calculated on groups that changed toward obese against those that changed toward underweight. The logistic regression analyses were used to estimate odds ratios (ORs) for hypertension in their senior year of each factor. The analyses were conducted on (i) all subjects, (ii) non-hypertensive subjects in their freshman year, and (iii) by schools, in order to take into account physical activities. Results  The PRs of hypertension in subjects changed toward obese from their freshmen to seniors against ones toward underweight were 1.47 (95% CI; 1.00–2.15) for males and 3.50 (0.93–13.22) for females. In analyses limited to non-hypertensive subjects in their freshman year, results were similar to those of all subjects. The analyses by school also showed similar results to those including all subjects. In logistic regression analyses, although the factor most strongly associated with hypertension was body type in their senior year, the body type in their freshman still showed significant association with hypertension after the adjustment of senior year body type and hypertension in freshman year. The ORs for hypertension in obese subjects to normal weight ones in their senior year were 9.13 (95% CI; 5.77–14.45) for males and 22.59 (5.69–89.67) for females after adjusted by hypertension in freshman, body type in freshman and school. Conclusions  These data suggest that the increase of BMI is linked to hypertension in university students.     

Consumption of Ultra-Processed Foods Increases the Likelihood of Having Obesity in Korean Women

This study aimed to determine the association between consumption of ultra-processed foods and obesity among Korean adults. We used the data of 7364 participants (men 3219, women 4145) aged 19–64 years from the Korea National Health and Nutrition Examination Survey (KNHANES), 2016–2018. Food items were classified using the NOVA food classification system, depending on the extent and purpose of food processing: (1) unprocessed or minimally processed foods, (2) processed culinary ingredients, (3) processed foods, and (4) ultra-processed foods. Consumption of ultra-processed foods accounted for 26.8% of the total energy intake. After adjusting for potential confounders including sociodemographic and lifestyle characteristics, subjects with the highest consumption of ultra-processed foods (fourth quartile of % energy intake from ultra-processed foods) had 0.61 kg/m² higher body mass index (BMI; 95% confidence interval [CI] 0.23–0.99, p-trend 0.0047), 1.34 cm higher waist circumference (WC; 95% CI 0.35–2.34, p-trend 0.0146), 51% higher odds of being obese (BMI > 25 kg/m²; odds ratio [OR] 1.51, 95% CI 1.14–1.99, p-trend 0.0037), and 64% higher odds of abdominal obesity (men: WC ≥ 90 cm, women: WC ≥ 85 cm; OR 1.64, 95% CI 1.24–2.16, p-trend 0.0004) than those with the lowest consumption (first quartile) among women. However, no association was found in men. These findings provide evidence that high consumption of ultra-processed foods is positively associated with obesity in Korean women. Further studies with a large-scale cohort or intervention trial are needed to identify the mechanism of associations between consumption of ultra-processed foods and health-related outcomes including obesity in Korea.     

Disability, arthritis, and body weight among adults 45 years and older

OBJECTIVE: To examine the association between body weight and disability among persons with and without self-reported arthritis. RESEARCH METHODS AND PROCEDURES: Data were analyzed for noninstitutionalized adults, 45 years or older, in states that participated in the Behavioral Risk Factor Surveillance System. Self-reported BMI (kilograms per meter squared) was used to categorize participants into six BMI-defined groups: underweight (<18.5), normal weight (18.5 to < 25), overweight (25 to < 30), obese, class 1 (30 to < 35), obese, class 2 (35 to < 40), and obese, class 3 (> or = 40). RESULTS: Class 3 obesity (BMI > or = 40) was significantly associated with disability among participants both with and without self-reported arthritis. The adjusted odds ratio (AOR) for disability in participants with class 3 obesity was 2.75 [95% confidence interval (CI) = 2.22 to 3.40] among those with self-reported arthritis and 1.77 (95% CI = 1.20 to 2.62) among those without self-reported arthritis compared with those of normal weight (BMI 18.5 to < 25). Persons with self-reported arthritis who were obese, class 2 (BMI 35 to < 40) and obese, class 1 (BMI 30 to <35) and women with self-reported arthritis who were overweight (BMI 25 to < 30) also had higher odds of disability compared with those of normal weight [AOR = 1.72 (95% CI = 1.47 to 2.00), AOR = 1.30 (95% CI = 1.17 to 1.44), and AOR = 1.18 (95% CI = 1.06 to 1.32), respectively]. DISCUSSION: Our findings reveal that obesity is associated with disability. Preventing and controlling obesity may improve the quality of life for persons with and without self-reported arthritis.     

Population-Based Assessment of the Risk of Primary Cesarean Delivery Due to Excess Prepregnancy Weight Among Nulliparous Women Delivering Term Infants

Objective: To estimate the risk of cesarean delivery due to excess prepregnancy body mass index (BMI) in a multistate, US population-based sample. Methods: We analyzed data from the population-based Pregnancy Risk Assessment Monitoring System (PRAMS) on 24,423 nulliparous women with single, term infants delivered between 1998 and 2000 in 19 states. We calculated BMI from self-reported weight and height. We assessed interactions between prepregnancy BMI and other risk factors. We estimated weighted relative risks and 95% confidence intervals for the association between prepregnancy BMI and cesarean section from multiple logistic regression models adjusting for demographic and medical risk factors from the PRAMS questionnaire or birth certificates. Results: The incidence of cesarean delivery increased with increased prepregnancy BMI, from 14.3% (0.8 standard error (SE)) for lean women (BMI < 19.8) to 42.6% (2.0 SE) for very obese women (BMI ≥ 35). The risk of cesarean section differed by presence of any medical, labor and/or delivery complication. Among women with any complication, the estimated adjusted RR for cesarean delivery was 1.1 (95% confidence interval (CI) 1.0–1.2) among overweight women, 1.3 (95% CI 1.1–1.4) among obese women, and 1.4 (95% CI 1.2–1.6) among very obese women compared with normal weight women. Among women without any complications, the estimated adjusted RR was 1.4 (95% CI 1.0–1.8) among overweight women, 1.5 (95% CI 1.1–2.1) among obese women, and 3.1 (95% CI 2.3–4.8) among very obese women. Conclusion: Excess prepregnancy weight increases the risk of cesarean delivery among nulliparous women giving birth to single, term infants, especially among very obese women without any complications.     

The impact of obesity on cardiovascular disease mortality in the District Sumperk,Czech Republic

Summary Objective: The impact of obesity on cardiovascular mortality in the District Sumperk (C2) is assessed. Methods: A case-control design was selected to study the impact of obesity on cardiovascular mortality among the population of the District Sumperk, Czech Republic. Exposure to obesity was defined as body-mass index (BMI) higher or equal 30. Men and women with BMI lower than 30 were considered nonexposed. Odds ratios were calculated, comparing the probability of exposure among cases and controls. Cases were defined as persons from the studied population who died between 1987–2004, the cause of death being circulatory system diseases. Controls were persons from the studied population who had not died as to December 31, 2004. Results: Cases were more likely to be obese than controls (OR = 1.68; 95 % CI 1.56–1.80). In men OR was 1.56 (95 % CI 1.40–1.74), in women OR was 1.89 (95 % CI 1.72–2.06). The impact of obesity was decreasing with increasing age. Conclusions: An increased risk of cardiovascular mortality following exposure to obesity was observed. Younger age groups seem to be the important target population for preventive programmes focusing on treatment of obesity. Submitted: 6 June 2006; Revised: 9 March 2007; Accepted: 29 March 2007     

Pre-Pregnancy Weight Status Is Associated with Diet Quality and Nutritional Biomarkers during Pregnancy

Although the positive association between pre-pregnancy overweight and obesity with excessive gestational weight gain is well known, it is not clear how pre-pregnancy weight status is associated with gestational weight gain through maternal diet during pregnancy. This study aimed to examine the relationship between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Our study included 795 U.S. pregnant women from the National Health and Nutrition Examination Survey, 2003–2012. Pre-pregnancy body mass index (BMI) was calculated based on self-reported pre-pregnancy weight and height. The cutoff points of <18.5 (underweight), 18.5–24.9 (normal), 25.0–29.9 (overweight), and 30 kg/m² (obese) were used to categorize pregnant women’s weight status. Diet quality during pregnancy was assessed by the Healthy Eating Index (HEI)-2010 based on a 24-h recall. Multivariable logistic regressions were used to estimate the odds ratios (OR) and 95% confidence intervals (CI). For all pregnant women included in this study, the mean HEI-2010 (±standard error of the mean (SEM)) was 50.7 (±0.9). Women with obese pre-pregnancy BMI demonstrated significantly lower HEI-2010 compared to those with underweight and normal pre-pregnancy BMI, respectively. In an unadjusted model, women with pre-pregnancy obesity BMI had increased odds for being in the lowest tertile of HEI-2010 (33.4 ± 0.5) compared to those with underweight pre-pregnancy BMI (OR 5.0; 95% CI 2.2–11.4). The inverse association between pre-pregnancy overweight and obesity status and diet quality during pregnancy persisted even after we controlled for physical activity levels (adjusted OR (AOR) 3.8; 95% CI 1.2–11.7, AOR 5.4; 95% CI 2.0–14.5, respectively). Serum folate concentration (ng/mL) was significantly higher in underweight women compared to overweight women (23.4 ± 1.7 vs. 17.0 ± 0.8, p < 0.05). Serum iron concentration (ng/dL) was significantly higher in normal weight women compared to overweight women (86.2 ± 5.0 vs. 68.9 ± 3.0, p < 0.05). An inverse association was found between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Poor diet quality as measured by HEI-2010 was shown among overweight and obese women. Nutrition education and interventions need to be targeted to those women entering pregnancy as overweight and obese.     

Obesity and Immigration Among Latina Women

Several studies have shown a positive association between acculturation and obesity in Hispanics. We sought to examine the association in a sample of urban Hispanic women. Using data collected in the Chicago Breast Health Project, we used logistic regression to examine the association of obesity (BMI ≥ 30 kg/m²) with language acculturation and years in the US in a sample of 388 Hispanic women. Women self-reported the number of years they had lived in the US (mean 17.6) as well as their preferred language across several domains, which was used to calculate a language acculturation score. Nearly all the women (98%) were born outside the US with the majority (65%) born in Mexico and the majority of women (69%) had low language acculturation, i.e., answered “only Spanish” in every domain. Over half of the women were obese (56%). In multivariable analysis, odds of obesity was twice as high among women living in the US for greater than 20 years compared to those in the US for 10 years or less (OR/year = 2.07, 95% CI 1.25–3.42). In contrast, low language acculturation was not associated with odds of obesity (OR = 1.14, 95% CI 0.70–1.86). While greater years in the US increased odds of obesity among Hispanic women, no association of obesity with language acculturation was found. These results suggest that mechanisms other than language contribute to the immigration effect.     

Peer Reviewed: The Association Between Body Mass Index and Arthritis Among US Adults: CDC’s Surveillance Case Definition

Introduction

The Centers for Disease Control and Prevention modified the surveillance case definition of arthritis to a more stringent form in 2002. To date, the association between arthritis and obesity (an established risk factor for arthritis) has not been examined with the new definition. We describe the association between body mass index (BMI) (kg/m²) and arthritis using the new arthritis case definition to provide a more accurate assessment of the relationship between weight and arthritis among US adults.

Methods

We used data from the 2005 Behavioral Risk Factor Surveillance System (N = 356,112) and univariate and multivariate analyses to assess the relationship between BMI and arthritis among US adults.

Results

Overall, 26% of US adults had self-reported arthritis. Obese respondents (BMI ≥30.0 kg/m²) were 1.9 times more likely to report arthritis compared with normal-weight respondents (BMI <25.0 kg/m²), and distinguishing between obese levels revealed an even greater association between BMI and arthritis (class III obesity [BMI ≥40.0], odds ratio [OR] = 3.3, 95% confidence interval [CI] = 3.1-3.6; class II obesity [BMI 35.0-39.9 kg/m²], OR = 2.5, 95% CI = 2.3-2.7; class I obesity [BMI 30.0-34.9], OR = 1.9, 95% CI = 1.8-2.0).

Conclusion

BMI is an independent risk factor for self-reported arthritis. Maintaining a healthy weight may delay the onset of arthritis. More research is needed to determine the effect of weight loss on the progression of arthritis in overweight individuals.     

Demographic and Behavioral Factors Associated with Daily Sugar-sweetened Soda Consumption in New York City Adults

The objective of the study was to assess the relations of socioeconomic and behavioral factors to frequent consumption of sugar-sweetened soda among New York City (NYC) adults and the relation of frequent consumption to body mass index (BMI; kg/m²). Data from the 2005 NYC Community Health Survey, a population-based telephone survey, were analyzed. Frequent consumption was defined as drinking one or more 12-oz servings of sugar-sweetened soda on an average day; 9,865 adults, aged 18 years and older, provided valid responses. Logistic regression was used to identify factors associated with frequent consumption, and linear regression models were used to assess the relation of frequent consumption to BMI. An estimated 27.5% of NYC adults are frequent sugar-sweetened soda consumers. Frequent consumption is independently associated with low household income (odds ratio [OR] = 1.7, 95% confidence interval [CI] 1.4–2.1 for <200% vs. ≥600% federal poverty level) and with ethnic group and nativity (e.g., OR = 3.1, 95% CI 2.6–3.7 for U.S.-born blacks vs. whites). Men report more consumption then women, but an association of less education with frequent consumption is stronger among women. Adjusting for demographics, frequent consumption is associated with more television viewing and with less physical activity. Adjusting for demographics and behaviors, frequent consumption was associated with higher BMI among women (0.7 BMI units, 95% CI 0.1–1.2) but not among men. Disparities in sugar-sweetened soda consumption mirror obesity disparities. Improved surveillance and interventions are needed to better quantify and reduce consumption of sugar-sweetened beverages, especially in groups most impacted by obesity.     

Association between diabetes mellitus and hypertension with anthropometric indicators in older adults: Results of the Mexican Health Survey, 2000

Objective: To determine the association between anthropometric indicators of adiposity with type 2 diabetes mellitus (T2DM) and hypertension (HTN) in older adults.Design: Cross-sectional study of participants of the Mexican Health Survey 2000 (MHS).Setting: Mexico, subjects recruited from the general community.Participants: The analytic sample included 7,322 adults who were ≥60 years of age at the time of the survey. T2DM data were available on 6,994 individuals, who represent 95.5% of the original sample; data on HTN was available on 6,268 subjects, which accounted for 86.5% of the original sample.Measurements: Type 2 diabetes mellitus and hypertension, as well as anthropometric indicators including body mass index (BMI), waist circumference (WC), and conicity index (CI).Results: The prevalence of T2DM and HTN in this age group was 34.3% and 73.9%, respectively. After adjusting for other variables, the association between high WC and T2DM (OR=1.59 95%CI=1.26-2.01, P < 0.001) was stronger than the association with overweight (OR=1.26, 95%CI= 1.01–1.58, P=0.04) and obesity (OR=1.38, 95%CI= 1.08–1.79, P< 0.01) using BMI, and slightly higher than tertile 2 of the CI (OR=1.49, 95%CI=1.20–1.88, P< 0.01), while tertile 3 showed a stronger association with T2DM (OR=1.60, 95%CI=1.22–2.08, P< 0.001). However, the association between obesity and HTN measured by BMI (OR=1.98, 95%CI=1.48–2.65, P< 0.001) was stronger than what was observed with overweight (OR=1.42, 95%CI 1.13–1.77, P< 0.01), with high WC (OR=1.62, 95%CI=1.25–2.10, P< 0.001) and tertiles 2 and 3 of the CI (OR=1.23, 95%CI=0.99–1.55, P= 0.09); (OR=1.53, 95%CI= 1.16–2.03, P< 0.01) respectively.Conclusions: BMI and abdominal obesity are significantly and independently associated with an increase in the prevalence of T2DM and HTN among older Mexican adults.     

Means of transportation to work and overweight and obesity: a population-based study in southern Sweden

OBJECTIVES: To investigate the association between means of transportation to work and overweight+obesity and obesity. METHODS: The 2004 public health survey in Sk?ne is a cross-sectional postal questionnaire study of the population aged 18-80 with a 59% response rate including 16,705 employed participants. RESULTS: Forty-six percent of men and 26.6% of women were overweight (BMI 25.0-29.9); 11.6% of men and 10.3% of women were obese (BMI 30.0-); 18.2% of men and 25.9% of women bicycled and/or walked to work and 10.4% and 16.2% used public transportation, respectively. In contrast, 68.3% of men and 55.8% of women went to work by car. The odds ratios of overweight+obesity among persons who walked or bicycled were significantly lower and remained 0.62 (95% CI 0.51-0.76) among men and 0.79 (95% CI 0.67-0.94) among women in the models including all confounders compared to the car driving reference category. The odds ratios of obesity were initially significantly lower among both men and women who walked or bicycled, but in the final models only among women. The odds ratios of overweight+obesity as well as obesity were also lower among men using public transportation. CONCLUSIONS: Walking and bicycling to work are significantly negatively associated with overweight+obesity and, to some extent, obesity. Public transportation is significantly negatively associated with overweight+obesity and obesity among men.