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1.
L.B. Strober 《Disability and health journal》2018,11(4):555-561
Background
Reductions in quality of life (QOL) exist among individuals with multiple sclerosis (MS).Objective
The present investigation aimed to adopt a biopsychosocial model in examining QOL in the early stages of MS.Methods
Individuals with MS (34 with average to low QOL and 35 with high QOL) were compared on measures of disease symptoms, psychological functioning, personality, self-efficacy, locus of control (LOC), social support, and coping to determine the most salient predictors of QOL.Results
Individuals were matched on disease course and duration. Individuals with lower QOL reported more fatigue, sleep problems, pain, depression, and anxiety (d?=?0.83–1.49, p's?<?0.001). They also reported lower levels of self-efficacy, LOC, and social support (d?=?0.75–1.50 p's?<?0.01). They indicated higher levels of neuroticism (d?=?1.31, p?<?.001) and lower levels of extraversion (d?=?1.21, p?<?.001) and reported greater levels of disengagement as a means of coping (d?=?0.75, p?=?.002). Those with high QOL endorsed more use of adaptive coping (d?=?0.52 - 0.86, p's?<?0.05). When taken together, LOC and anxiety were the most significant predictors, accounting for 40% of the variance.Conclusion
Even early on in the illness, there exists differing levels of QOL. Identifying the psychological and social variables as well as the disease related factors is important, and in this case, may make a much greater contribution. Efforts to assure routine assessment and effective intervention aimed at these factors are warranted, particularly as an early intervention to assure maintenance/improvement in QOL among individuals with MS. 相似文献2.
Background
Evidence suggests there is an association between depressive symptoms and disability.Objective/Hypothesis
The objective of this study was to examine whether people with disabilities in the United Kingdom and Greece face more depressive symptoms than people without disabilities. The hypothesis was that people with disabilities in both countries are more likely to experience depressive symptoms.Methods
We used data from the 2014 European Health Interview Survey (wave 2). After performing principal-component factor analysis, we carried out logistic regressions, in order to investigate differences in depressive symptoms between people with and without disabilities, and examine the factors affecting depressive symptoms for people with disabilities.Results
People with disabilities in the UK were 2.8 times more likely to experience depressive symptoms compared to people without disabilities (95% C.I.: 2.51–3.05, p?<?.001), while in Greece, they were 2.2 times more likely to do so (95% C.I.: 1.90–2.64, p?<?.001). Our findings regarding people with disabilities showed that women, older people (in Greece), unemployed and inactive people (in Greece), and better-educated people (in the UK) were more likely to experience depressive symptoms. Married people, older people (in the UK), people living in densely-populated areas (in Greece), people who assessed their health as ‘average’ or ‘good’, and people who enjoyed social support (in Greece) were less likely to face depressive symptoms.Conclusions
Due to population-ageing and higher incidence of depressive symptoms in disabled people, it is important that policies are put in place to address the mental health needs of this population. 相似文献3.
Background
Persons with disabilities experience health disparities while having usual providers more frequently than persons without disabilities. Provider discontinuity may help to explain these paradoxical findings, but research on the topic is nascent.Objective
To provide initial insight into whether persons with disabilities more frequently experience provider discontinuity than persons without disabilities.Methods
Pooled 2-year data from panels 14–16 (2009–2012) of the Medical Expenditure Panel Survey were examined. Working-age adults (18–64) were categorized as having no disability, basic disabilities, or complex disabilities. Persons were categorized having provider continuity (provider throughout the period) or discontinuity (gaining or losing providers during the period). χ2 and multinomial logistic regressions were used to examine outcomes by disability status.Results
Persons with complex disabilities more frequently experienced continuity (83.7%) than persons without disabilities and those with basic disabilities (60.7% and 65.6%, respectively, p?<?0.001). Seldom or never being sick was the most frequently reported reason for not having a usual provider; more persons without disabilities (64%) reported this reason than persons with disabilities (basic: 41.9%, p?<?0.001; complex: 26.6%, p?=?0.001). Persons with disabilities more frequently reported visiting different providers for different needs and not having a usual provider due to the costs of medical care than persons without disabilities.Conclusions
Future research needs to examine the influence of continuity on healthcare disparities among persons with complex disabilities. Policies and practice must be attentive to how proposed changes to the healthcare system potentially reduce access to care among persons with disabilities. 相似文献4.
Background
High fruit and vegetable (F/V) intake may be beneficial for hypertension prevention. However, a prospective association has not been investigated in a Korean population, and differences exist between typical diets in Korea and those of Western populations.Objective
The aim of this prospective study was to investigate the association between F/V intake and risk of incident hypertension in middle-aged and older Korean adults using the data from the Korean Genome and Epidemiology Study (KoGES).Design
The KoGES is a large community-based cohort study of Korean adults aged 40 to 69 years, which began in May 2001. Questionnaires on demographic information and lifestyle factors were completed at baseline. Anthropometrics and biochemical measurements were conducted biennially. Fruit and vegetable consumption was assessed with a semiquantitative food frequency questionnaire. Hypertension was defined as a systolic blood pressure≥140 mm Hg or diastolic blood pressure ≥90 mm Hg.Participants and setting
A total of 4,257 participants (2,085 men, 2,172 women) without hypertension at baseline were evaluated.Main outcome measures
The primary outcome was incident hypertension.Statistical analysis performed
Multivariate Cox proportional hazard models were used to examine hazard ratios (HRs) and 95% CIs for incident hypertension according to F/V consumption.Results
During the 8-year follow-up, 1,158 participants (606 men and 552 women) developed hypertension. Among men, frequent fruit consumers (≥4 servings/day) had a 56% lower risk of incident hypertension than did infrequent consumers (<1 serving/day) (HR=0.44, 95% CI=0.32 to 0.60, P for trend <0.0001). Among women, frequent fruit consumers had a 67% lower risk of incident hypertension than did infrequent consumers (HR=0.33, 95% CI=0.24 to 0.45, P for trend <0.0001), after adjustment for potential confounders. However, there was no association between vegetable consumption and risk of incident hypertension in either men or women.Conclusion
A higher intake of fruit was prospectively associated with a lower risk of incident hypertension in middle-aged and older Korean adults, regardless of sex. 相似文献5.
Vincenzo Carnevale Valeria Castriotta Pamela Angela Piscitelli Luciano Nieddu Maria Mattera Giuseppe Guglielmi Alfredo Scillitani 《Journal of the American Medical Directors Association》2018,19(9):793-796
Objectives
Sarcopenia is a common geriatric syndrome, whose diagnosis implies the assessment of muscle mass. Dual-energy x-ray absorptiometry (DXA) is the reference method for clinical practice, but it is not universally available. We compared DXA with 2 anthropometry-based methods to assess muscle mass in older adults.Design
Cross-sectional.Setting
Ambulatory patients.Participants
148 (87 female and 61 male) white older adults.Measurements
Mid-arm muscle circumference (MAMC), whole skeletal muscle mass estimated by the Lee's formula (eTSMM), and relative skeletal muscle index (RSMI).Results
Men and women did not differ for MAMC and RSMI, whereas eTSMM was higher (P < .001) in men. MAMC and eTSMM correlated with RSMI, in the whole sample as in men and women separately (P < .001). According to the McNemar test, the frequencies of older men and women with low muscle mass identified by eTSMM did not differ from those detected by RSMI (P = .066) at variance with MAMC. Using EWGSOP (European Working Group on Sarcopenia in Older People) criteria for RSMI as standard reference, the receiver operating characteristic (ROC) curves provided redefined cut-offs of reduced muscle mass: 18.6 cm in women and 22.3 cm in men for MAMC, and 17.7 kg in women and 28.3 kg in men for eTSMM. The areas under the ROC curves (AUCs) for MAMC were 0.882 in women (sensitivity 89%, specificity 84%) and 0.826 in men (sensitivity 94%, specificity 67%). The AUCs for eTSMM were 0.8913 in women (sensitivity 95%, specificity 81%) and 0.878 in men (sensitivity 97%, specificity 67%). No significant difference was found between the ROC curves of MAMC and eTSMM in both sexes.Conclusion
Two simple anthropometric methods, possibly used in every clinical setting, could be valuable screening tools for low muscle mass in older subjects. 相似文献6.
Sunha Choi 《Disability and health journal》2018,11(3):374-381
Background
Arthritis is the most common cause of disability among U.S. adults.Objective
This study examined how the onset of arthritis-attributable disability affects midlife individuals.Methods
Using the 2014–2015 National Health Interview Survey, this study compared three groups of midlife adults (ages 50–64): individuals without any physical limitations (n?=?13,779); individuals with early-onset arthritis that has limited their functioning for more than 20 years (n?=?330); and individuals suffering from late-onset arthritis-attributable disability for less than five years (n?=?299), in relation to five domains in the International Classification of Functioning, Disability and Health (ICF) framework. Stata's SVY procedures were used for bivariate and multivariate comparisons.Results
Compared with the two groups with arthritis-attributable disability, midlife adults without disability were more likely to be married, college educated, high income, and employed. They also reported considerably lower levels of financial worries, barriers to healthcare access, and psychological distress (p?<?.05). However, although midlife adults with arthritis-attributable disability in both groups displayed similar vulnerability in all domains, the two groups were different in significant ways. For example, compared with those with early-onset disability, midlife adults with late-onset arthritis-related disability were more likely to worry about their finances in general, while they experienced lower levels of social participation restrictions and activity limitations in some functioning areas (p?<?.05).Conclusions
This study clearly indicates how experiencing arthritis-attributable disability on top of aging is challenging for midlife adults and how considering the onset of disability is important for practitioners and researchers. 相似文献7.
Background
Previous literature suggests that individuals with disabilities have increased rates of obesity and decreased participation in physical activity contributing to overall higher incidence of secondary health conditions compared to the general population without disabilities.Objective/hypothesis
The purpose of this research study was to examine the differences in physical activity rates for college students with Attention Deficit Hyperactivity Disorder (ADHD) and Learning Disabilities (LD).Methods
A secondary analysis was utilized to examine differences in physical activity rates based on disability, gender, and factors influencing participation in physical activity. The 2011 Fall National College Health Assessment was used as the reference group with a sample of 27,774 students. Multiple independent samples t-tests were utilized in this research.Results
The results of this study indicated that physical activity for college students with disabilities does not have significant variations compared to those without disabilities. However, gender influences participation in physical activity for this population.Conclusions
This research helps in narrowing the research gap in this topic through analysis of the college population with ADHD and LD. This paper concludes with implications that could benefit the health status of this population. 相似文献8.
Min Wook So Sunggun Lee Seong-Ho Kim 《Journal of the Academy of Nutrition and Dietetics》2018,118(9):1673-1686.e2
Background
Obesity and metabolic abnormalities are important risk factors for knee osteoarthritis (KOA). Recent epidemiologic studies have found that a high glycemic index (GI) and glycemic load (GL) diet are associated with a higher risk for metabolic complications and cardiovascular mortality.Objective
We aimed to examine the association between dietary GI, dietary GL, and KOA among Korean adults.Design
This was a cross-sectional study that analyzed data obtained from the Korean National Health and Nutrition Examination Survey 2010-2012.Participants/setting
A total of 9,203 participants (5,275 women) aged ≥50 years were included.Main outcome measures
KOA was defined as the presence of radiographic features of Kellgren-Lawrence grade ≥2. Chronic knee pain was defined as the presence of knee pain for more than 30 days during the past 3 months. Dietary information was collected using a single 24-hour recall method.Statistical analyses performed
The association between the quintiles of dietary GI and dietary GL and knee conditions was analyzed using a multinomial logistic regression analysis adjusting for age, physical activity, obesity, hypertension and diabetes, serum low-density lipoprotein, and total energy intake.Results
Among the women, the association between dietary GI and symptomatic KOA was: quintile 1: 1.00 (reference); quintile 2: 1.29 (95% CI 0.87 to 1.92); quintile 3: 1.59 (95% CI 1.11 to 2.28); quintile 4: 1.74 (95% CI 1.21 to 2.51); and quintile 5: 1.77 (95% CI 1.20 to 2.60) (P=0.001). Chronic knee pain without KOA was associated with dietary GI; however, this association was not linear across quintiles. There was no significant association between dietary GI and asymptomatic KOA. Among the men, no significant association was found between dietary GI and any knee conditions. There was no significant association between dietary GL and KOA in both men and women.Conclusions
There was a significant positive association between dietary GI and symptomatic KOA in women. 相似文献9.
Ilanit Hasson-Ohayon Meiran Hason-Shaked Tamar Silberg Carmit-Noa Shpigelman David Roe 《Disability and health journal》2018,11(4):612-617
Background
Women with disabilities may face social negative attitudes with regard to their being mothers. In addition, attitudes toward different disabilities form a hierarchy, with more positive attitudes being displayed toward persons with physical disabilities than toward persons with psychiatric disabilities.Objective
Current observational study examined whether the relationship between a woman's type of disability (psychiatric vs. physical) and the social attitude towards her would be moderated by her being presented as a mother.Method
University students (N?=?100) filled out the Multidimensional Attitudes Scale Toward Persons With Disabilities and the Social Distance Scale, after reading one of six randomly assigned fictitious vignettes. The vignettes consisted of a woman with a physical disability/a woman with a psychiatric disability/a woman without a disability, who either was or was not a mother.Results
Type of disability was found to have a main effect in some attitude domains, suggesting that attitudes toward women with physical disabilities were better than attitudes towards women with psychiatric disabilities. An interaction between type of disability and motherhood was found for the interpersonal distress subscale of the attitudes scale. It was found that when women had physical disabilities, there was no change in attitude towards them regardless of whether they were presented as mothers or not; However, when the target woman had a psychiatric disability, and she was presented as a mother, negative attitudes were generated towards her.Conclusions
The study demonstrates the existence of a hierarchy of stigmatization and the effect of being a mother on stigmatization. 相似文献10.
Luis Alfonso Ortíz-Reyes Lilia Castillo-Martínez Arianne Itzel Lupián-Angulo Daniel Dante Yeh Héctor Isaac Rocha-González Aurora Elizabeth Serralde-Zúñiga 《Journal of the Academy of Nutrition and Dietetics》2018,118(1):52-61
Background
Unintentional underfeeding is common in patients receiving enteral nutrition (EN), and is associated with increased risk of malnutrition complications. Protocols for EN in critically ill patients have been shown to enhance adequacy, resulting in better clinical outcomes; however, outside of intensive care unit (ICU) settings, the influence of a protocol for EN is unknown.Objective
To evaluate the efficacy and safety of implementing an EN protocol in a noncritical setting.Design
Randomized controlled clinical trial.Participants and settings
This trial was conducted from 2014 to 2016 in 90 adult hospitalized patients (non-ICU) receiving exclusively EN. Patients with carcinomatosis, ICU admission, or <72 hours of EN were excluded.Intervention
The intervention group received EN according to a protocol, whereas the control group was fed according to standard practice.Main outcome measures
The proportion of patients receiving ≥80% of their caloric target at Day 4 after EN initiation.Statistical analyses performed
Student t test or Wilcoxon rank-sum test were used for continuous variables and the difference between the groups in the time to receipt of the optimal amount of nutrition was analyzed using Kaplan-Meier curves.Results
Forty-five patients were randomized to each group. At Day 4 after EN initiation, 61% of patients in the intervention arm had achieved the primary end point compared with 23% in the control group (P=0.001). In malnourished patients, 63% achieved the primary end point in the intervention group compared with 16% in the control group (P=0.003). The cumulative deficit on Day 4 was lower in the intervention arm compared with the control arm: 2,507 kcal (interquartile range [IQR]=1,262 to 2,908 kcal) vs 3,844 kcal (IQR=2,620 to 4,808 kcal) (P<0.001) and 116 g (IQR=69 to 151 g) vs 191 g (IQR=147 to 244 g) protein (P<0.001), respectively. The rates of gastrointestinal complications were not significantly different between groups.Conclusions
Implementation of an EN protocol outside the ICU significantly improved the delivery of calories and protein when compared with current standard practice without increasing gastrointestinal complications. 相似文献11.
Background
According to prior studies, it is possible to consider the emergency care utilization due to ambulatory care sensitive conditions (ACSCs) as a proxy measure of access to primary care but there was no confirmed study among people with disabilities.Objective/Hypothesis
We examined overall emergency department (ED) utilization patterns among people with disabilities compared with the general population and estimated factors affecting ED utilization. Additionally, we examined whether there were any differences in ED visits due to ACSCs according to type and severity of disability.Methods
The nationally representative Korean Health Panel Survey was used. Data from 14,616 individuals who participated in the survey from 2008 to 2012 were analyzed. The frequency and causes of emergency visits were examined between individuals with and without disabilities. A generalized regression model with Poisson distribution was applied to identify factors that affect ED visits.Results
In 2012, people with disabilities were about two times as likely to visit the ED compared to people without disabilities, and people with external disability represented the largest proportion of people with disabilities. According to generalized linear model, disability was a strong predictor of ED visits, along with lower education level, being elderly, having a chronic disease, and being less healthy. Overall, ED visits due to ACSCs were about three times higher in the disabled group than in the non-disabled group.Conclusions
Public health authorities should consider strengthening the primary care system to avoid unnecessary and preventable ED utilization among all Korean people, including people with disabilities. 相似文献12.
Teresa T. Fung Haakon E. Meyer Walter C. Willett Diane Feskanich 《Journal of the Academy of Nutrition and Dietetics》2018,118(12):2269-2279.e4
Background
Although a number of studies showed a lower risk of hip fractures with high-quality diets, few of them were conducted in the United States.Objective
This prospective analysis examined the association between several diet quality indexes and risk of hip fractures in US men and women.Design
This is a prospective cohort study.Participants/setting
The participants were 74,446 postmenopausal women from the Nurses’ Health Study and 36,602 men aged 50 years and older from the Health Professionals Follow-Up Study in the United States.Main outcome measure
Hip fractures were self-reported on biennial questionnaires between 1980-2012 in women, and between 1986-2012 in men.Statistical analysis
Diet was assessed every 4 years with a validated food frequency questionnaire. Relative risks were computed for hip fracture by quintiles of the Alternate Mediterranean Diet score (aMed), the Alternate Healthy Eating Index-2010 (AHEI-2010), and the Dietary Approaches to Stop Hypertension score using Cox proportional hazards models, adjusting for potential confounders.Results
Two thousand one hundred forty-three incident hip fractures in women and 603 in men were reported during follow-up. A significant inverse trend was observed with the cumulative AHEI-2010 score in women (relative risk comparing extreme quintiles 0.87, 95% CI 0.75 to 1.00; P for trend=0.02). There was also a suggestion of an inverse association with the Dietary Approaches to Stop Hypertension score (P for trend=0.03). In addition, significant inverse trends were observed between all three diet quality scores and hip fractures in women younger than age 75 years but not older women. There was no clear association between diet quality indexes and hip fracture in men.Conclusions
Higher AHEI-2010 scores were associated with a lower risk of hip fractures in US women. The inverse associations with diet quality may be more apparent among those younger than age 75 years. 相似文献13.
Minji Kang Song-Yi Park Carol J. Boushey Lynne R. Wilkens Kristine R. Monroe Loïc Le Marchand Laurence N. Kolonel Suzanne P. Murphy Hee-Young Paik 《Journal of the Academy of Nutrition and Dietetics》2018,118(9):1711-1718
Background
Accounting for sex differences in food portions may improve dietary measurement; however, this factor has not been well examined.Objective
The aim of this study was to examine sex differences in reported food portions from 24-hour dietary recalls (24HDRs) among those who selected the same portion size category on a quantitative food frequency questionnaire (QFFQ).Design
This study was conducted with a cross-sectional design.Participants/setting
Participants (n=319) were members of the Hawaii–Los Angeles Multiethnic Cohort who completed three 24HDRs and a QFFQ in a calibration study conducted in 2010 and 2011.Main outcome measures
Portions of individual foods reported from 24HDRs served as the outcome measures.Statistical analyses performed
Mean food portions from 24HDRs were compared between men and women who reported the same portion size on the QFFQ, after adjustment for race/ethnicity using a linear regression model. Actual amount and the assigned amount of the selected portion size in the QFFQ were compared using one-sample t test for men and women separately.Results
Of 163 food items with portion size options listed in the QFFQ, 32 were reported in 24HDRs by ≥20 men and ≥20 women who selected the same portion size in the QFFQ. Although they chose the same portion size on the QFFQ, mean intake amounts from 24HDRs were significantly higher for men than for women for “beef/lamb/veal,” “white rice,” “brown/wild rice,” “lettuce/tossed salad,” “eggs cooked/raw,” “whole wheat/rye bread,” “buns/rolls,” and “mayonnaise in sandwiches.” For men, mean portions of 14 items from the 24HDRs were significantly different from the assigned amounts for QFFQ items (seven higher and seven lower), whereas for women, mean portions of 14 items were significantly lower from the assigned amounts (with five significantly higher).Conclusions
These sex differences in reported 24HDR food portions—even among participants who selected the same portion size on the QFFQ—suggest that the use of methods that account for differences in the portions consumed by men and women when QFFQs are quantified may provide more accurate absolute dietary intakes. 相似文献14.
Mónica Pinilla-Roncancio 《Disability and health journal》2018,11(3):398-404
Background
Disability and poverty are interconnected and although this relationship has been recognised, there is a lack of empirical evidence to support any possible causal relationship in this topic, particularly in the context of Latin America (LA).Hypothesis
This study tests the hypothesis “Disability increases the risk of multidimensional poverty of people living with disabilities and their families”.Methods
Using national census data from Brazil, Chile, Colombia, Costa Rica and Mexico, the Global Multidimensional Poverty Index (Global MPI) was calculated with the aim of measuring and comparing the levels of multidimensional poverty of people living in households with and without disabled members in the five countries.Results
We found that in the five countries people with disabilities and their families had higher incidence, intensity and levels of multidimensional poverty compared with people living in other households. Their levels of deprivation were also higher for all the indicators included in the Global MPI and the contribution of this group to the national MPI was higher than their share of the population, thus people with disabilities and their families are overrepresented in those living in multidimensional poverty.Conclusions
People with disabilities and their families are in worse conditions than poor households without disabled members and social policies should aim to reduce their high levels of multidimensional poverty and deprivation. 相似文献15.
Kristen Arnold Kellie R. Weinhold Rebecca Andridge Kylie Johnson Tonya S. Orchard 《Journal of the Academy of Nutrition and Dietetics》2018,118(11):2135-2143
Background
Chronic inflammation is associated with obesity, morbidity, and mortality in postmenopausal women.Objective
The objective of this pilot study was to determine preliminary feasibility and efficacy of a dietary intervention to improve diet quality and lower inflammation.Design
The study had a single-arm, pre- and posttest design.Participants/setting
Fourteen postmenopausal women (body mass index >30 [calculated as kg/m2]) from the greater Columbus, OH, area participated between August 2015 and April 2016.Intervention
This was a 12-week individualized dietary intervention targeting lower consumption of added sugars and increased fiber and fatty fish.Main outcome measures
Primary outcomes of this analysis were serum tumor necrosis factor α receptor-2 (TNFαR-2), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP); other outcomes included intake of targeted food components and Healthy Eating Index-2010 (HEI-2010) scores calculated from food frequency questionnaires at baseline, end of intervention (week 12 [WK12]), and 24-week (WK24) follow-up.Statistical analyses performed
Repeated measures analysis of variance and partial Pearson correlations, respectively, were used to assess changes in outcomes and associations between dietary variables and inflammatory markers, controlling for percent weight change.Results
Mean levels of TNFαR-2 decreased pre- to postintervention (P<0.01) and remained reduced at WK24 (P<0.001). Mean intake of added sugars and n-3-rich fish improved from baseline to WK12 and remained better at WK24 (all P<0.001); mean fiber intake did not change significantly (P=0.66; baseline to WK24). Mean HEI-2010 score increased (P<0.001; baseline to WK12). Change in HEI-2010 score inversely correlated with change in TNFαR-2 (P<0.05; baseline to WK24). Change in added sugars directly correlated with change in TNFαR-2 (P<0.05; baseline to WK24), but inversely correlated with change in hsCRP (P<0.05; baseline to WK12, and WK12 to WK24). All participants lost weight by WK12 (P<0.001).Conclusions
These pilot intervention findings suggest that improving diet quality is associated with decreases in TNFαR-2. 相似文献16.
Lauren Butler Barry M. Popkin Jennifer M. Poti 《Journal of the Academy of Nutrition and Dietetics》2018,118(3):409-420.e3
Background
Findings from studies of alcohol and obesity measures (eg, waist circumference [WC] and body mass index [BMI; calculated as kg/m2]) are conflicting. Residual confounding by dietary intake, inconsistent definitions of alcohol consumption across studies, and the inclusion of former drinkers in the nondrinking comparison group can contribute to the mixed literature.Objective
This study examines associations of alcoholic beverage consumption with dietary intake, WC, and BMI.Design
Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Survey were analyzed.Participants/setting
Adults 20 to 79 years of age (n=7,436 men; n=6,939 women) were studied.Main outcome measures
Associations of alcoholic beverage consumption with energy (kcal), macronutrient and sugar intakes (% kcal), WC, and BMI were determined.Statistical analyses performed
Multivariable linear regression models were used to determine associations of average daily volume and drinking quantity (ie, drinks per drinking day) with dietary intake and obesity measures. Former and never drinkers were analyzed as distinct categories; associations of drinking with WC and BMI were examined with and without adjustment for dietary intake variables.Results
Heavier-drinking men (≥3 drinks/day) and women (≥2 drinks/day) consumed less nonalcoholic energy (β ?252 kcal/day, 95% CI ?346 to ?159 kcal/day and β ?159 kcal/day, 95% CI ?245 to ?73 kcal/day, respectively) than moderate drinkers (1 to 2 drinks/day in men and 1 drink/day in women). By average daily drinking volume, differences in WC and BMI between former and moderate drinkers were +1.78 cm (95% CI 0.51 to 3.05 cm) and +0.65 (95% CI 0.12 to 1.18) in men and +4.67 cm (95% CI 2.95 to 6.39 cm) and +2.49 (95% CI 1.64 to 3.34) in women. Compared with moderate drinking, heavier drinking volume was not associated with WC or BMI among men or women. In men, drinking ≥5 drinks/drinking day was associated with higher WC (β 3.48 cm, 95% CI 1.97 to 5.00 cm) and BMI (β 1.39, 95% CI 0.79 to 2.00) compared with men who consumed 1 to 2 drinks/drinking day. In women, WC and BMI were not significantly different for women drinking ≥4 drinks/drinking day compared with 1 drink/drinking day.Conclusions
Differences in dietary intake across drinking subgroups and separation of former drinkers from nondrinkers should be considered in studies of alcohol intake in relation to WC and BMI. 相似文献17.
Davide L. Vetrano Maria S. Pisciotta Alice Laudisio Maria R. Lo Monaco Graziano Onder Vincenzo Brandi Domenico Fusco Beatrice Di Capua Diego Ricciardi Roberto Bernabei Giuseppe Zuccalà 《Journal of the American Medical Directors Association》2018,19(6):523-527
Objectives
In Parkinson disease (PD), sarcopenia may represent the common downstream pathway that from motor and nonmotor symptoms leads to the progressive loss of resilience, frailty, and disability. Here we (1) assessed the prevalence of sarcopenia in older adults with PD using 3 different criteria, testing their agreement, and (2) evaluated the association between PD severity and sarcopenia.Design
Cross-sectional, observation study.Setting
Geriatric day hospital.Participants
Older adults with idiopathic PD.Measurements
Body composition was evaluated through dual energy x-ray absorptiometry. Handgrip strength and walking speed were measured. Sarcopenia was operationalized according to the Foundation for the National Institutes of Health, the European Working Group on Sarcopenia in Older Persons, and the International Working Group. Cohen k statistics was used to test the agreement among criteria.Results
Among the 210 participants (mean age 73 years; 38% women), the prevalence of sarcopenia was 28.5%–40.7% in men and 17.5%–32.5% in women. The prevalence of severe sarcopenia was 16.8%–20.0% in men and 11.3%–18.8% in women. The agreement among criteria was poor. The highest agreement was obtained between the European Working Group on Sarcopenia in Older Persons (severe sarcopenia) and International Working Group criteria (k = 0.52 in men; k = 0.65 in women; P < .01 for both). Finally, severe sarcopenia was associated with PD severity (odds ratio 2.30; 95% confidence interval 1.15–4.58).Conclusions
Sarcopenia is common in PD, with severe sarcopenia being diagnosed in 1 in every 5 patients with PD. We found a significant disagreement among the 3 criteria evaluated, in detecting sarcopenia more than in ruling it out. Finally, sarcopenia is associated with PD severity. Considering its massive prevalence, further studies should address the prognosis of sarcopenia in PD. 相似文献18.
19.
Lisa Jahns Zach Conrad LuAnn K. Johnson Susan K. Raatz Sibylle Kranz 《Journal of the Academy of Nutrition and Dietetics》2018,118(11):2120-2127
Background
Although the purpose of federal dietary guidance is to improve eating habits, few studies have described awareness of guidance and concurrent diet quality.Objective
The objective of the current study was to examine the prevalence of individuals who reported hearing of dietary guidance icons and to describe the association between having heard of the icons and diet quality.Design
This study was a cross-sectional survey.Participants/setting
Participants (n=23,343) were from the National Health and Nutrition Examination—What We Eat in America survey 2005–2014 cycles.Main outcome measures
Awareness of the Food Guide Pyramid, MyPyramid, or MyPlate icons by sociodemographic characteristics and diet quality were measured using Healthy Eating Index (HEI) scores derived from 24-hour recall data.Statistical analyses performed
Global Wald tests were used to test for differences in awareness of the icons within sociodemographic groups. Total HEI scores were calculated using the population-ratio method. Z-scores were used to test differences in HEI total scores between those with knowledge of the icons and those who responded negatively.Results
In all cycles, those with less than a high school diploma were the least likely to report having heard of the icons (P<0.001). In every wave except 2011 to 2012, participants with low or marginal food security status were less likely to report affirmatively (P<0.001), and Supplemental Nutrition Assistance Program (SNAP) participants and SNAP-eligible nonparticipants were least likely to report having heard of the icons (P<0.001) except for 2005 to 2006. HEI scores were higher among those who had heard of MyPyramid in 2007-2012 (P<0.05) and MyPlate in 2013-2014 (P<0.001) compared with those who had not heard of the icon.Conclusions
Recognition of federal dietary guidance icons was associated with higher diet quality recently, but the cross-sectional nature of the data precludes conclusions of causality. Further research is needed to identify barriers and promoters for translating awareness of the federal dietary guidance icons into healthful food purchasing and food consumption decisions. 相似文献20.
David D. Dore Andrew R. Zullo Vincent Mor Yoojin Lee Sarah D. Berry 《Journal of the American Medical Directors Association》2018,19(4):328-332.e2