Blink duration as an indicator of driver sleepiness in professional bus drivers.

This study focused on eyeblink duration as a measure of sleepiness in on-road driving and on the driving performance of professional bus drivers with polysomnographically confirmed mild obstructive Sleep Apnea Syndrome (OSAS). Ten bus drivers with OSAS and their matched controls participated in the study. The Maintenance of Wakefulness Test (MWT) and a monotonous on-road driving task were completed. Eyeblink duration and frequency and speed control were measured while driving. Lane-keeping was evaluated by the supervisor in the car. Subsequent to these tasks, drivers with OSAS received continuous positive airway pressure treatment (nasal CPAP). After nine weeks of treatment, the tasks were repeated. Prior to treatment the average blink duration in the driving task was significantly longer and sleep latency in the MWT was significantly shorter for bus drivers with OSAS than for controls (mean blink duration 82.3 ms; 51.9 ms and mean sleep latency 23.2 min; 35.4 min), indicating increased daytime sleepiness. Subsequent to treatment both measures in drivers with OSAS decreased to the level of the controls. Treatment effects in MWT and blink duration in on-road driving also correlated significantly. No significant differences between the groups appeared in average blink frequency or driving performance in terms of maintenance of speed. No significant lane drifting appeared either. These results support earlier findings on blink duration as an indicator of increased sleepiness and have important implications for those involved in the transport technological industry. The findings also suggest that nasal CPAP treatment is effective in reducing excessive daytime sleepiness.     

Job hassles and cardiovascular reaction patterns among urban bus drivers

Forty-six bus drivers took part in a longitudinal field study of cardiovascular reactions 10 urban driving. “Job hassles” were recorded by observers using a standardized list of stress-related events in traffic and on the bus. Measures of blood pressure, heart rate, and ratings of perceived mental strain were obtained after each route segment. Intraindividual correlations between psychophysiological recordings and job hassles were calculated and submitted 10 cluster analysis. Two reaction patterns were identified. I characterized by consistently, although modeslly, positive associations between the frequency of job hassles and psychophysiological reactions, the other characterized by a low association between the frequency of hassles and indicators of psychophysiological arousal. The former group displayed significantly higher blood pressure and mental strain ratings in the unwinding phase after work than did the latter group of workers. The results are discussed in terms of rate of “unwinding” after exposure to stressful conditions.     

Thinness,overweight, and obesity in indigenous school children and youth in Mexico

Abstract

Background: The prevalence of overweight (OWT) and obesity (OB), defined by the body mass index (BMI, kg/m²) among children and youth has increased worldwide in the last 30–40 years.

Aim: To evaluate the weight status, defined by the BMI, of indigenous school children and youth resident in different regions of Mexico

Subjects and methods: Students 6–18 years (31,448 boys, 27,306 girls) were enrolled in bilingual schools for indigenous children and youth in Mexico in 2012. Height and weight were measured; the BMI was calculated. The BMI of each student was classified relative to International Obesity Task Force (IOTF) age- and sex-specific criteria as thin (three grades), normal, overweight (OWT) or obese (OB). The sample was divided into five geographic regions for analysis: North, Central, South-Gulf, South-Pacific, and South-Southeast. Age- and sex-specific prevalence, 95% confidence intervals, and Chi-square tests were calculated.

Results: Prevalence of OWT?+?OB was highest in the South-Gulf, South-Pacific and South-Southeast regions and lowest in the North and Central regions, while thinness was most prevalent in the North and Central regions.

Conclusion: Prevalence of severe and moderate thinness was relatively low, while the combined prevalence of OWT?+?OB was generally more prevalent in indigenous boys than girls. However, the prevalence of thinness, OWT?+?OB among indigenous children and youth was lower than in the general population of children and youth in Mexico.     

Comparative study of subjective fatigue between automatic transmission bus drivers and manual transmission bus drivers

The difference in the physiological condition of drivers of manual transmission buses (MTB) and automatic transmission buses (ATB) was examined from the viewpoint of occupational health. This study was based on a self-administered questionnaire which involved items concerning subjective fatigue complaints. No differences in the mental fatigue and stress between MTB drivers and ATB drivers were observed. Although ATB drivers tended to feel less physical fatigue than MTB drivers, the difference was not statistically significant. From these results, it was suggested that there was little difference in the subjective fatigue between ATB drivers and MTB drivers.     

Anthropometric indices in relation to overweight and obesity among Turkish medical students

Introduction

The aim of this study was to present the reference anthropometric data associated with obesity for cardiovascular risk and metabolic diseases for healthy young adults in a Turkish population.

Material and methods

The study group consisted of 1163 second-year medical students (650 women, 513 men) aged 20-25 years from Çukurova University in Adana and the measurements were made using a flexible standard measuring tape. The data were collected during the period 2007-2011.

Results

From 1163 medical students, the mean values of body mass index, circumferences of waist, hip, neck, mid-arm, thigh and calf were 20.89 ±1.6 kg/m², 73.15 ±5.1 cm, 95.35 ±4.8 cm, 30.32 ±1.37 cm, 24.12 ±1.75 cm, 47.23 ±3.26 cm and 34.36 ±2.19 cm respectively in women, while the same measurements were 21.98 ±1.67 kg/m², 77.73 ±5.81 cm, 95.64 ±4.81 cm, 35.61 ±1.43 cm, 25.60 ±1.84 cm, 44.10 ±3.26 cm and 34.92 ±2.08 cm respectively in men. Moreover, waist to hip ratio, waist to height ratio and neck to height ratio were respectively 0.76, 0.44 and 0.18 in women and 0.81, 0.43 and 0.19 in men.

Conclusions

The precise knowledge of anthropometric data could be used as reference values for evaluating the body composition and fat distribution of Turkish young people.     

High prevalence of overweight and obesity among inner city Chinese children in Shanghai, 2011

Background: In China, the prevalence of overweight and obesity appears to be increasing at unacceptable levels among young people living in major cities undergoing rapid economic growth.

Objective: To report the prevalence of overweight and obesity among Shanghai inner city youth using the recently published International Obesity Task Force (IOTF) Asian definition.

Methods: Secondary analysis of children aged 8–15 years who participated in the Shanghai Schools’ Physical Fitness Examinations, a representative school-based survey. Height and weight were measured and body mass index (kg/m²) was calculated. The prevalence of overweight and obesity was determined using the IOTF children’s BMI cut-points for Asian populations, equivalent to an adult BMI of 23?kg/m² (overweight) and 27?kg/m² (obese).

Results: The prevalence of combined overweight and obesity was 49.1% for boys and 30.8% for girls aged 8–15-years. Almost one-in-five boys were obese, compared with 8.4% of girls. In boys the prevalence of overweight appeared to increase from age 10 years.

Conclusion: The high prevalence of combined overweight and obesity among urban Chinese youth, especially among boys, requires immediate health promotion intervention.     

Knowledge of the health consequences of obesity among overweight/obese Black and Hispanic adults

Objective

To measure knowledge of the health consequences of obesity among overweight/obese Black and Hispanic adults and examine the relationship to prior weight loss.

Methods

Knowledge of the health consequences of obesity was assessed among 410 Black and Hispanic adults with BMI ≥ 25 kg/m² enrolled in a behavior change weight loss study. The relationship between obesity risk knowledge and previous weight loss was also examined.

Results

The majority of participants were knowledgeable of the risk of hypertension (94%), diabetes (96%), high cholesterol (91%), joint pains/arthritis (89%) and sleep apnea (89%) associated with obesity. Among post-menopausal age women, 53% were aware of the increased risk of breast cancer. There was no significant relationship between obesity risk knowledge and previous weight loss of 10 pounds or more (OR = 1.075, 95% CI: [0.808, 1.430]).

Conclusions

We found that knowledge of the health consequences of obesity was high, except for knowledge of the risk of breast cancer. Obesity risk knowledge was not associated with past weight loss.

Practice implications

Further health education is needed regarding the increased risk of breast cancer associated with obesity. Our data suggest that knowledge of the health consequences of obesity is not associated with weight loss success.     

Prevalence of overweight and obesity among Guaraní-Mbyá from Misiones, Argentina.

The aim of this study was to evaluate the prevalence of overweight and obesity and the fat distribution pattern in Mbyá-Guaraní children and adults from Misiones, Argentina. Height, weight, and triceps and subscapular skinfolds were measured in 197 individuals aged 2-60 years. Body mass index (BMI), fat and muscle areas, and subscapular/tricipital index were calculated. All data were transformed to z-scores using US references (NHANES I and II). Overweight and obesity were defined as BMIs between the 85th-95th or above the 95th percentile, respectively. Compared to NHANES references, the Mbyá were shorter and lighter, although their BMI was slightly higher. There were no substantial differences in body composition (fat and muscle) between the Mbyá and the reference. Prevalences of overweight and obesity reached (on average) 16.2 and 14.7%, respectively, and were similar in both sexes. Stunting was higher in females than in males (49.6 vs. 33.3%). Sixty percent of overweight and obese subjects showed a centralized adiposity pattern, and 49% had a high risk for abdominal adiposity. The present results provide new evidence of a striking increase in obesity rates in Amerindians as a part of the process of nutritional transition. The contribution of each component of energy balance, physical activity, and lifestyle could play an important role in this observed tendency, justifying further research in these transitional populations.     

Socioeconomic costs of overweight and obesity in Korean adults

This study was conducted to estimate the socioeconomic costs of overweight and obesity in a sample of Korean adults aged 20 yr and older in 2005. The socioeconomic costs of overweight and obesity include direct costs (inpatient care, outpatient care and medication) and indirect costs (loss of productivity due to premature deaths and inpatient care, time costs, traffic costs and nursing fees). Hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease, stroke, colon cancer and osteoarthritis were selected as obesity-related diseases. The population attributable fraction (PAF) of obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation (NHIC) cohort data and the 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Direct costs of overweight and obesity were estimated at approximately U$1,081 million equivalent (men: U$497 million, women: U$584 million) and indirect costs were estimated at approximately U$706 million (men: U$527 million, women: U$178 million). The estimated total socioeconomic costs of overweight and obesity were approximately U$1,787 million (men: U$1,081 million, women: U$706 million). These total costs represented about 0.22% of the gross domestic product (GDP) and 3.7% of the national health care expenditures in 2005. We found the socioeconomic costs of overweight and obesity in Korean adults aged 20 yr and older are substantial. In order to control the socioeconomic burden attributable to overweight and obesity, effective national strategies for prevention and management of obesity should be established and implemented.     

Prevalence of overweight and obesity in young adults in Uganda

Background:

Obesity in young adults is rising and predicts diabetes and cardiovascular diseases later in life. Data on prevalence and determinants of obesity in developing countries are needed for primary prevention.

Objectives

To determine the prevalence of overweight and obesity in young adults in urban (Kampala city) and rural areas (Kamuli District) of Uganda.

Methods

Cross-sectional survey of 683 randomly selected young adults aged 18–30 years. Obesity was defined as body mass index (BMI) > 30 kg/m² and overweight as BMI > 25 kg/m². Distribution of BMI by socio-demographic characteristics was determined.

Results

Of the 683 participants, 50.5% were female and 53.2% were from Kampala. The overall prevalence of obesity and overweight was 2.3% and 10.4%, respectively. The prevalence of obesity was 4.4% in Kampala and 0% in Kamuli while the prevalence of overweight was 10.2% and 10.6% in Kampala and Kamuli, respectively. Compared to males, females were more likely to be obese (2.9% vs. 1.8%) or overweight (17.4% vs. 3.3%). Residing in the city, alcohol consumption, smoking, non-engagement in sports activities, commuting to school by taxi or private vehicle and being from a rich family were the main factors significantly associated (P<0.05) with obesity. Being female (p = 0.0001) and not engaging in any sports activities (P = 0.002) were two factors significantly associated with being overweight.

Conclusion

We observed significant gender differences in the prevalence of obesity among young adults in Uganda. Contrary to expectation, we did not observe significant rural-urban differences in the prevalence of overweight.     

Trend in the prevalence of overweight and obesity among urban African American hospital employees and public housing residents

INTRODUCTION: To help understand the impact of socioeconomic status, we examined the current prevalence and age-specific trend in overweight and obesity among two socioeconomically diverse groups of African Americans in the Washington, DC, area. MATERIALS AND METHODS: Data on height and weight were collected between March 1995 and December 1996 as a part of nutrition survey to develop a food frequency questionnaire. Gender-stratified multiple logistic regression analyses were used to examine factors related to the current prevalence of overweight and obesity. RESULTS: Three hundred nine African American public housing residents and 293 African American hospital employees participated in this survey. Overall, hospital workers and public housing residents differed significantly in the distribution of BMI (p = 0.003). Among men, the prevalence of overweight and obesity were 34.9% and 29.4% for hospital workers and 27.0% and 18.2% for public housing residents, respectively. For females these rates were 31.3% and 46.3% for hospital employees and 26.1% and 42.9% for public housing residents, respectively. CONCLUSION: Overweight and obesity were highly prevalent among all age and socioeconomic groups. Future research should focus on a more in-depth study of the relationship between socioeconomic status and the correlates of obesity among African-Americans, particularly women.     

Prevalence of overweight and obesity for urban adults in Cameroon

Background: The emergence of a nutrition transition in developing countries might lead to higher prevalence of obesity and related adverse health effects. In Cameroon, urbanization growth rate is one of the highest in sub-Saharan Africa. Such dramatic demographic change favours important modifications, notably in nutritional patterns. Aim: In this paper we examine the current prevalence of overweight and obesity in Yaoundé, the capital city of Cameroon and search for possible causal factors. Detrimental consequences of overweight are also discussed. Material and methods: Samples of adults (519 women, 252 men) of all ages in all districts of Yaoundé were subjected to anthropometric and body composition measurements, blood pressure and resting heart rate determination, and interviewer-administered questionnaires on socio-demography, smoking habits, physical activity, self-perception of body weight and health status. Results: In both sexes body mass index (BMI) increases with age and peaks in the years of maturity. These changes are related to changes in adiposity. Prevalence rates of overweight (BMI ≥ 25) and obesity (BMI ≥ 30) increase from 20 to 29 years and peak at 40-49 years in men and at 50-59 years in women before starting to decline. One woman in two is overweight and one woman in five is obese, whereas one-third of men are overweight and only 5% are obese. Obese subjects have a larger age-adjusted waist to hip ratio (WHR) than their non-overweight counterparts, attesting that fat gain is oriented towards a more abdominal fat mass distribution. The length of residence in Yaoundé, increasing education level, occupation, ethnicity, physical inactivity and smoking practices appear to influence early overweight and/or obesity. No parity effect is observed in women. From the present study, it appears that obesity, and especially obesity in women, could be less benign than that described in other studies in Africa. Conclusion: Research is needed in Cameroon, including aetiological and cohort studies aimed at the quantification of morbidity and mortality risks associated with overweight and obesity.     

Prevalence of overweight and obesity for urban adults in Cameroon

BACKGROUND: The emergence of a nutrition transition in developing countries might lead to higher prevalence of obesity and related adverse health effects. In Cameroon,urbanization growth rate is one of the highest in sub-Saharan Africa. Such dramatic demographic change favours important modifications, notably in nutritional patterns. AIM: In this paper we examine the current prevalence of overweight and obesity in Yaounde,the capital city of Cameroon and search for possible causal factors. Detrimental consequences of overweight are also discussed. MATERIAL AND METHODS: Samples of adults (519 women, 252 men) of all ages in all districts of Yaounde were subjected to anthropometric and body composition measurements, blood pressure and resting heart rate determination, and interviewer-administered questionnaires on socio-demography, smoking habits, physical activity, self-perception of body weight and health status. RESULTS: In both sexes body mass index (BMI) increases with age and peaks in the years of maturity. These changes are related to changes in adiposity. Prevalence rates of overweight(BMI >or= 25) and obesity (BMI > or = 30) increase from 20 to 29 years and peak at 40-49 years in men and at 50-59 years in women before starting to decline. One woman in two is overweight and one woman in five is obese, whereas one-third of men are overweight and only 5% are obese. Obese subjects have a larger age-adjusted waist to hip ratio(WHR) than their non-overweight counterparts, attesting that fat gain is oriented towards a more abdominal fat mass distribution. The length of residence in Yaounde, increasing education level, occupation, ethnicity, physical inactivity and smoking practices appear to influence early overweight and/or obesity. No parity effect is observed in women. From the present study, it appears that obesity, and especially obesity in women, could be less benign than that described in other studies in Africa. CONCLUSION: Research is needed in Cameroon, including aetiological and cohort studies aimed at the quantification of morbidity and mortality risks associated with overweight and obesity.     

Epidemiologic aspects of overweight and obesity in the United States

National survey data from the U.S. show that the prevalence of overweight and obesity among adults remained relatively constant over the 20-year period from 1960 to 1980, began to increase around the mid-1980s and has continued to increase. Data for children and adolescents, based on different definitions, show the same pattern. It can sometimes be more useful to look at the whole distribution of body mass index, rather than on prevalence estimates based on pre-defined cutoffs. Data from several countries suggest that for both adults and children, the distribution of BMI has become more skewed over time. Although many hypotheses have been put forward about the causes of the increases, data to address these issues are sparse. Obesity is a well-known risk factor for numerous health conditions. Nonetheless, the health consequences of the increases in obesity have not been fully delineated. Increases in diabetes have been noted in conjunction with the rise in obesity. On the other hand, declines in some other cardiovascular risk factors have been seen at all BMI levels. Rising life expectancy and decreasing heart disease mortality rates seem to confound some of the expectations about the effects of increasing obesity on mortality. The effects of obesity on morbidity may be greater than its effects on mortality. The increasing prevalence of obesity poses challenges for researchers and for policy makers.     

High prevalence of overweight and obesity in females with phenylketonuria

The primary treatment for phenylketonuria (PKU) is a low phenylalanine diet together with an amino acid-based, phenylalanine-free formula. Thus, PKU patients tend to consume a diet enriched in carbohydrates which could predispose to obesity. Studies in the 1980s and 1990s demonstrated that school-age phenylketonuria (PKU) patients have a higher mean body weight compared to a control population. However, no recent studies in the United States PKU population have examined whether this trend has persisted or whether adolescents are also affected. To investigate whether pediatric PKU populations (ages 2-20years) in two major metropolitan areas of the United States (Cleveland, OH and Houston, TX) have a higher than expected percentage of overweight (BMI≥85th percentile) relative to the general population in the United States (NHANES), a retrospective chart review of PKU patients born between 1990 and 2008 and followed in Cleveland, OH (Rainbow Babies and Children's Hospital/University Hospitals Case Medical Center) and in Houston, TX (Texas Children's Hospital) was performed. Based on data from the U.S., 40% of pediatric PKU patients were overweight or obese. However, the percentage of overweight females (55%) and obese females (33%) is 1.8× and 2.1× higher respectively than expected based on comparison data from U.S. children. Further studies are necessary to identify potential strategies for prevention of excessive weight gain in children with PKU, especially in females.     

Stress prevention in bus drivers: evaluation of 13 natural experiments

The research aim was to select, compare, and analyze interventions and preventive actions from international bus companies to decrease bus drivers' occupational stress and sickness absenteeism. Through networking, international surveys, and literature study, 13 "natural experiments" were identified with an acceptable research design rating. Interventions were both work and person directed. Principles of worker participation were often followed. The variety in intervention programs, outcome measures, case evaluations, and methodological flaws makes it difficult to present a general picture of program effectiveness. However, analyses on more objective and more subjective outcomes do point at positive effects. This study suggests that stress prevention that combines adequate interventions and proper implementation may be beneficial to both the employee and the company.     

Residential segregation, health behavior and overweight/obesity among a national sample of African American adults

We examined the role of residential segregation in 5+ daily fruit/vegetable consumption, exercise, and overweight/obesity among African Americans by linking data on the 11,142 African American adults in the 2000 Behavioral Risk Factor Surveillance System to 2000 census data on the segregation of metropolitan statistical areas (MSAs). Multi-level modeling revealed that after controlling for individual-level variables, MSA Segregation and Poverty contributed to fruit/vegetable consumption, MSA Poverty alone contributed to exercise, and MSA Segregation alone contributed to overweight/obesity. These findings highlight the need for research on the built-environments of the segregated neighborhoods in which most African Americans reside, and suggest that neighborhood disparities may contribute to health disparities.