Prevalence and correlates of body image dissatisfaction in postmenopausal women

ABSTRACT

Dissatisfaction with one’s body image is widespread and can have serious health consequences; however, research about its prevalence and correlates in older women is limited. We analyzed data from 75,256 women participating in the Women’s Health Initiative Observational Study, a longitudinal study of postmenopausal women’s health. Measures used in the study were collected at baseline and/or the third year of follow-up between 1993 and 2002. The majority of participants (83%) in this study were dissatisfied with their bodies because they perceived themselves as heavier than their ideal. Overall, the multiple and significant correlates of body image dissatisfaction explained 36.2% of the variance in the body image dissatisfaction score, with body mass index (BMI) and change in BMI being the two most important contributors to explaining the variance. The results of this study suggest future research should focus on the utility of interventions to reduce dissatisfaction with body image in postmenopausal women that target either maintenance of a lower BMI through diet and exercise, and/or body acceptance. Further, future research should aim to identify factors in addition to body size that drive body image dissatisfaction.     

Breakfast size is related to body mass index for men,but not women

The objective of this study was to examine the effect of self-reported breakfast size, daily eating, and other health habits on body mass index (BMI). We hypothesized that a consumption of a substantial breakfast compared with skipping or small breakfasts would be associated with lower BMI. Three independent, cross-sectional, screening surveys were conducted by Sydney Adventist Hospital in 1976, 1986, and 2005 in the surrounding community. The archived survey forms of 384 men and 338 women in 1976, 244 men and 229 women in 1986, and 270 men and 62 women in 2005 were randomly selected. Body mass index was determined from height and weight measured by hospital staff. The reported amount consumed at breakfast was one of several eating habits that predicted BMI for men but not women. It explained 5% to 6% of the variance in male BMI in all 3 years examined. As the reported breakfast amount increased, men's BMI decreased. Lifestyle confounders including vegetarianism and physical activity did not affect this relationship. However, the consumption of breakfast was significantly positively associated with consumption of cereals, bread, fruit, and spreads, while coffee consumption was significantly associated with smaller breakfasts or breakfast skipping. The consumption of relatively large breakfasts may influence BMI in men, and its promotion may help reduce the prevalence of obesity in Australia and elsewhere.     

Calcium and magnesium status is not impaired in pregnant women

Deficiencies in calcium (Ca) and magnesium (Mg) are associated with various complications during pregnancy. To test the hypothesis that the status of these minerals is inadequate in pregnancy, a cross-sectional study was conducted of the dietary intake and status of Ca and Mg in pregnant women (n = 50) attending a general public university hospital in Brazil. Dietary intake was assessed from 4-day food records; levels of plasma Mg, erythrocyte Mg, and urinary Ca and Mg excretion were determined by flame atomic absorption spectroscopy; and type I collagen C-telopeptides were evaluated by enzyme-linked immunosorbent assay. Probabilities of inadequate Ca and Mg intake were exhibited by 58 and 98% of the study population, respectively. The mean levels of urinary Ca and Mg excretion were 8.55 and 3.77 mmol/L, respectively. Plasma C-telopeptides, plasma Mg, and erythrocyte Mg were within normal levels. Multiple linear regression analysis revealed positive relationships among urinary Ca excretion, Ca intake (P = .002) and urinary Mg excretion (P < .001) and between erythrocyte Mg and Mg intake (P = .023). It is concluded that the Ca and Mg status of participants was adequate even though the intake of Ca and Mg was lower than the recommended level.     

The soluble fiber NUTRIOSE induces a dose-dependent beneficial impact on satiety over time in humans

Strong evidence supports the ability of dietary fibers to improve satiety. However, large variations in the physical and chemical characteristics of dietary fiber modulate the physiologic responses. We hypothesized that a nonviscous soluble dietary fiber may influence satiety. This randomized, double-blind, placebo-controlled clinical study in 100 overweight healthy adults in China investigated the effect of different dosages of dietary supplementation with a dextrin, NUTRIOSE (ROQUETTE frères, Lestrem, France), on short-term satiety over time. Subjects were randomized by body mass index and energy intake and then assigned to receive either placebo or 8, 14, 18, or 24 g/d of NUTRIOSE mixed with orange juice (n = 20 volunteers per group). On days −2, 0, 2, 5, 7, 14, and 21, short-term satiety was evaluated with a visual analog scale, and hunger feeling status was assessed with Likert scale. NUTRIOSE exhibits a progressive and significant impact on short-term satiety, which is time and dosage correlated. Some statistical differences appear for the group 8 g/d from day 5, and from day 0 for the groups 14, 18, and 24 g/d. The hunger feeling status decreases significantly from day 5 to the end of the evaluation for the group 24 g and from day 7 for the groups 14 and 18 g. By day 5, the group 24 g showed significantly longer time to hunger between meals compared with placebo. These results suggest that dietary supplementation with a soluble fiber can decrease hunger feeling and increase short-term satiety over time when added to a beverage from 8 to 24 g/d with time- and dose-responses relationship.     

Caffeinated coffee, decaffeinated coffee and endometrial cancer risk: a prospective cohort study among US postmenopausal women

There is plausible biological evidence as well as epidemiologic evidence to suggest coffee consumption may lower endometrial cancer risk. We evaluated the associations between self-reported total coffee, caffeinated coffee and decaffeinated coffee, and endometrial cancer risk using the Women's Health Initiative Observational Study Research Materials obtained from the National Heart, Lung, and Blood Institute Biological Specimen and Data Repository Coordinating Center. Our primary analyses included 45,696 women and 427 incident endometrial cancer cases, diagnosed over a total of 342,927 person-years of follow-up. We used Cox-proportional hazard models to evaluate coffee consumption and endometrial cancer risk. Overall, we did not find an association between coffee consumption and endometrial cancer risk. Compared to non-daily drinkers (none or <1 cup/day), the multivariable adjusted hazard ratios for women who drank ≥4 cups/day were 0.86 (95% confidence interval (CI) 0.63, 1.18) for total coffee, 0.89 (95% CI 0.63, 1.27) for caffeinated coffee, and 0.51 (95% CI 0.25, 1.03) for decaf coffee. In subgroup analyses by body mass index (BMI) there were no associations among normal-weight and overweight women for total coffee and caffeinated coffee. However among obese women, compared to the referent group (none or <1 cup/day), the hazard ratios for women who drank ≥2 cups/day were: 0.72 (95% CI 0.50, 1.04) for total coffee and 0.66 (95% CI 0.45, 0.97) for caffeinated coffee. Hazard ratios for women who drank ≥2 cups/day for decaffeinated coffee drinkers were 0.67 (0.43-1.06), 0.93 (0.55-1.58) and 0.80 (0.49-1.30) for normal, overweight and obese women, respectively. Our study suggests that caffeinated coffee consumption may be associated with lower endometrial cancer risk among obese postmenopausal women, but the association with decaffeinated coffee remains unclear.     

Nutrient intake risk factors of osteoporosis in postmenopausal women

This study was conducted to assess the association between dietary nutrient intake and osteoporosis risk in post-menopausal women. Bone mineral density was measured at the lumbar spine by dual-energy X-ray absorptiometry and a structured questionnaire was administered by a trained interviewer, which included information on sociodemographics, medical and reproductive history, and dietary intake. The study sample included 134 osteoporotic and 137 non-osteoporotic subjects between the ages of 52 and 68. Nutrient variables were classified into tertiles. Odds ratios and 95% confidence intervals (CI) were calculated which compared the highest tertile with the lowest tertile as a reference group. Odds ratios for osteoporosis were 1.47 (95% CI: 1.03-2.05) for total protein, 1.62 (95% CI: 0.51-3.92) for animal protein, and 2.98 (95% CI: 1.42-4.23) for sodium. Odds ratios for osteoporosis in the highest tertile were: 0.42 (95% CI: 0.23-0.83) for vegetable protein, 0.72 (95% CI: 0.51-0.90) for Ca, and 0.65 (95% CI: 0.49-0.88) for Fe, relative to the respective lowest tertile. These findings suggest that adequate nutrient intake may be important for prevention of osteoporosis in postmenopausal women.     

不同性别高敏C-反应蛋白与代谢综合征关系

目的探讨江苏省男、女性中高敏C-反应蛋白（hs-CRP）度与代谢综合征（MS）的关系及其影响因素。方法采用横断面研究的方法。在江苏省多代谢异常和代谢综合征综合防治研究基线调查资料中选择1039名男性和1291名女性作为研究对象，测量研究对象的身高、体重、腰围、血压，计算体质指数（BMI）；检测血清中hs-CRP、血脂、血糖、高密度脂蛋白、低密度脂蛋白。采用Logistic回归分析影响男、女性hs-CRP浓度与MS的关系。结果女性随着hs-CRP浓度的增加患MS的危险增加（P〈0．01）。而男性hs-CRP浓度与MS的关系则不明显（P=0．08）。女性中这种联系在调整年龄、吸烟、饮酒、高血压家族、糖尿病家族史后仍存在，但在进一步调整体质指数后这种关系消失。结论BMI是影响hs-CRP浓度的主要因素。女性随着hs-CRP浓度的升高，患MS的危险也相应增加。而男性中hs-CRP浓度与MS的联系则不显著。     

Soy intake is related to a lower body mass index in adult women

BACKGROUND: Experimental and epidemiologic studies suggest that soy may promote weight loss. AIM OF THE STUDY: The goal of this study was to examine the relation of soy intake with body weight over the lifespan of women with Caucasian, Japanese, and Native Hawaiian ancestry. METHODS: We assessed the relation between lifetime soy consumption and body mass index (BMI) among 1,418 women in Hawaii. All subjects reported anthropometric measures, regular diet, and soy intake throughout life. The lifetime soy questionnaire was completed again by a subset of 356 women 5 years after study entry and the kappa values indicated moderate agreement. We regressed soy intake on BMI at study entry and at age 21 while controlling for confounding variables, computed least square means, and performed trend tests. RESULTS: Higher soy consumption in adulthood was related to a lower BMI (P=0.02). This association was only significant for Caucasian women and for postmenopausal subjects. The women in the highest category also experienced a smaller annual weight change since age 21 (by 0.05 kg/year) than the low soy intake group (P=0.02). We observed no association between early life soy intake and BMI. High vegetable consumption was significantly associated with a higher soy intake among Caucasian women. CONCLUSIONS: In this study, women consuming more soy during adulthood had a lower BMI, but the relation was primarily observed for Caucasian and postmenopausal subjects. This indicates that the association may be due to other nutritional factors and behaviors common in women with high soy intake.     

饮食、运动指导对孕妇 BMI与分娩方式的影响研究

目的：探讨饮食、运动指导对孕妇分娩方式及体质量指数（ BMI）的影响作用。方法选取2013年3月至2015年3月建卡后一直在东南大学附属江阴市人民医院产检及分娩的600例孕妇作为研究对象,其中300例接受饮食、运动指导及常规医嘱（指导组）,另外300例仅接受常规医嘱指导（对照组）,监测两组孕妇的BMI变化及分娩方式。结果孕第24周、36周、分娩时,指导组的BMI值均显著低于对照组（t值分别为2．598、3．729、4．041,均P＜0．05）。指导组的阴道顺产率为61．00％,显著的高于对照组的45．67％,差异具有统计学意义（χ2＝14．17,P＞0．05）,指导组的分娩孕周显著大于对照组,差异具有统计学意义（t＝12．231,P＜0．05）。指导组的巨大儿、宫内窘迫、胎膜早破发生率均显著低于对照组,差异具有统计学意义（χ2值分别为11．395、5．172、11．527,均P＜0．05）。结论加强孕期饮食、运动指导有利于合理控制孕妇的体重增值、提高阴道顺产率、提高生育质量。     

A milk and cereal dietary pattern is associated with a reduced likelihood of having a low bone mineral density of the lumbar spine in Korean adolescents

The traditional rice-based Korean diet has been changing toward a Western-style diet. This change has been especially rapid among adolescents. The purpose of this study was to investigate the association between dietary patterns and bone health among Korean adolescents. This cross-sectional study was conducted on 196 adolescents aged 12 to 15 years. Information on the general characteristics of the subjects was obtained through a questionnaire, and dietary intake was assessed with 6-day food records. Bone mineral densities (BMDs) of the lumbar spine and femur were measured by dual-energy x-ray absorptiometry. Dietary patterns were derived from 24 food groups using factor analysis. Four distinct dietary patterns—traditional Korean, fast food, milk and cereal, and snacks—were identified and accounted for 28.4% of the total variance. After adjusting for sex, age, body mass index percentiles, weight loss attempts, pubertal status, and regular exercise, the adolescents in the highest tertile of the “milk and cereal” dietary pattern score had significantly a reduced likelihood of having low BMD compared with those in the lowest tertile of this diet at the lumbar spine (odds ratio, 0.36; 95% confidence interval, 0.14-0.93; P = .0461). The other dietary patterns were not associated with the BMD of Korean adolescents. These results indicate that the intake of milk and cereal is important for the bone health of Korean adolescents, whose diets are composed mainly of grains and vegetables.     

朝鲜族学生超重肥胖现况及与汉族学生比较

目的 了解我国朝鲜族中小学生超重肥胖流行现况，为增进朝鲜族中小学生健康提供科学依据。方法 分析2000年全国学生体质调研资料中朝鲜族资料，并与同批吉林省汉族学生资料进行对比。结果 朝鲜族城市男生超重肥胖明显高于乡村男生，朝鲜族城乡女生比较无明显差异；朝鲜族女生超重、肥胖明显高于汉族女生，朝鲜族、汉族男生比较差异无统计学意义。结论 朝鲜族中小学生超重肥胖发生率较高，应尽快采取措施进行预预防控制。     

Short-term consumption of sucralose, a nonnutritive sweetener, is similar to water with regard to select markers of hunger signaling and short-term glucose homeostasis in women

Nonnutritive sweeteners have been used to lower the energy density of foods with the intention of affecting weight loss or weight maintenance. However, some epidemiological and animal evidence indicates an association between weight gain or insulin resistance and artificial sweetener consumption. In the present study, we hypothesized that the nonnutritive sweetener sucralose, a trichlorinated sucrose molecule, would elicit responses similar to water but different from sucrose and sucrose combined with sucralose on subjective and hormonal indications of hunger and short-term glucose homeostasis. Eight female volunteers (body mass index, 22.16 ± 1.71 kg/m²; age, 21.75 ± 2.25 years) consumed sucrose and/or sucralose in water in a factorial design. Blood samples were taken at fasting and 30 and 60 minutes after treatment followed by a standardized breakfast across treatments, and blood samples were taken 30, 60, 90, and 120 minutes after breakfast. Plasma was analyzed for glucose, insulin, glucagon, triacylglycerols (TAG), and acylated ghrelin. Perceptions of hunger and other subjective measurements were assessed before each blood sample. No differences were detected in subjective responses, circulating triacylglycerol, or glucagon concentrations among treatments over time. Significant differences were observed in insulin, glucose, and acylated ghrelin concentrations over time only between sucrose-containing treatments and non–sucrose-containing treatments regardless of sucralose consumption. Therefore, sucralose may be a relatively inert nonnutritive sweetener with regard to hunger signaling and short-term glucose homeostasis.     

Serum Folate Related to Five Measurements of Obesity and High-Sensitivity C-Reactive Protein in Korean Adults

This study investigated the effects of folic acid on obesity and high-sensitivity C-reactive protein (CRP) levels. Using data from the Korea National Health and Nutrition Examination Survey (KNHANES VII 2016–2018), 6394 adults (aged 19–80 years) who met the study criteria were identified and divided into young, middle-aged, and older adult groups. The analysis assessed associations using logistic regression for complex samples. Obesity was measured using body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI). The odds ratio (OR) of obesity based on BMI were statistically significant for young adults and older participants with low levels of folic acid compared to those with high levels (OR: 1.33 and 1.58, respectively). The OR of obesity based on BMI, WC, WHtR, ABSI, and BRI was significant with low levels of folic acid in middle-aged individuals (OR: 1.36, 1.32, 1.41, 1.29, and 1.47, respectively). Low folate levels were related to higher high-sensitivity CRP levels in middle-aged patients. In conclusion, folate level showed a significant inverse association with obesity and inflammatory biomarkers, especially in the middle-aged group. Further longitudinal or randomized controlled trials are needed to confirm and expand our results.     

The relationship between osteoporosis and body composition in pre- and postmenopausal women from different ethnic groups in China

Objective: To investigate the ethnic differences in osteoporosis (OP) and body composition (BC) and their relationship in the Maonan, Mulam, Hmong, and Yao minorities in China.

Design: A total of 860 Maonan, Mulam, Hmong, and Yao women were included in this cross-sectional study. Demographic, health history, and lifestyle information was collected using questionnaires. BC was measured through bioelectrical impedance analysis, and bone mineral density (BMD) was assessed via calcaneal quantitative ultrasound.

Results: Compared with premenopausal women, postmenopausal women exhibited a lower fat-free mass (FFM), muscle mass (MM), limb muscle mass, and T-score but a higher waist-to-hip ratio and prevalence of OP in each minority (p?T-scores and lowest prevalence of OP among the four minorities (p?p??1). In addition, our results revealed that FFM and MM exhibited exactly the same weak positive relationship with the T-score (r?=?0.081, p?T-score existed in the four minorities studied here.

Conclusions: BC and OP prevalence varied by menopausal status and ethnic group, and ethnic-specific relationships between BC and BMD were present in the four minorities. More research is needed to further investigate the ethnic differences in BC, OP, and risk factors for lower BMD to develop targeted prevention strategies to reduce the burden of OP across different ethnic groups in China.     

2019—2020年武汉某高校3369例医学研究生BMI和血红蛋白含量的分析

目的 通过研究分析某高校研究生BMI和血红蛋白含量状况,以期为制订有针对性的卫生保健措施提供参考依据。方法 收集武汉某高校2019年—2020年医学研究生新生入学体检资料,对BMI和血红蛋白含量等指标进行统计分析。结果 研究生新生中,不同性别在年龄、文化程度、婚姻状况、身高、体重、体重指数和血红蛋白含量差异均有统计学意义(P<0.05)。男生中体重超重和肥胖的检出率为31.93%(372/1 165),高于女生的6.94%(153/2 204)(χ2=361.794,P<0.001)。而新生中女生体重过低的检出率为21.46%(473/2 204),较男生的6.44%(75/1 165)高,差异具有统计学意义(χ2=126.293,P<0.001)。不同性别之间体重指数分型总体分布不全相同(Z=19.641,P<0.001)。新生中男生和女生血红蛋白含量偏低检出率分别是1.38%(16/1 163)和7.72%(260/2 204),女生中血红蛋白含量偏低检出率明显比男生中检出率高(χ2=109.81,P<0.001)。在BMI分型中,除肥胖组外(χ2=0.032,P=0.858),在体重过低、正常、超重的学生中,女生的血红蛋白含量偏低的发生率均高于男生,差异具有统计学意义(χ2=7.399,P=0.007、χ2=71.385,P<0.001、χ2=8.963,P=0.003)。此外,男、女生中血红蛋白偏低的检出率在不同BMI类型中的分布均无差异(H=1.569,P=0.666、H=5.005,P=0.171)。结论 2019—2020年入学医学研究生新生中,体重过低、血红蛋白含量偏低的女生比男生多,而在超重和肥胖的男生比女生多,因此,对研究生新生有针对性的进行早期干预和健康教育,提高学生的自我保健能力。     

体格测量对围绝经期糖尿病患病风险的预测

目的：探讨围绝经期女性人体测量参数对2型糖尿病( T2DM)患病风险的预测价值。方法以2011年1月至2014年12月在广州市妇女儿童医疗中心体检中心参与体检并符合纳入标准的637例围绝经期女性为研究对象,进行T2DM患病筛查,测量身高、体重、腰围( WC )、臀围,计算体质指数( BMI )、腰臀比( WHR )和腰围身高比( WHtR );采用Logistic回归和ROC曲线评估各指标对T2DM患病风险的预测价值。结果有20.3%的调查对象患T2DM;随着BMI(χ2=9.64,P=0.008)、WC(χ2=8.99,P=0.010)、WHR(χ2=18.78,P<0.001)和WHtR(χ2=10.97,P<0.001)反映肥胖程度的增加,T2DM患病率上升,差异均有统计学意义。在控制年龄差异之后的多因素Logistic回归分析结果显示,仅BMI≥28kg/m2( OR=2.61,95%CI：1.22~5.56)和WHR≥0.85(OR=2.35,95%CI：1.43~3.88)与T2DM的发生相关。 ROC测定结果显示,4项指标单独用于预测血糖异常状况的效果均不理想,WHR和WHtR相对较好,ROC曲线下面积(AUC)分别为0.67和0.64,BMI最差,为0.60。结论腹型肥胖指标WHR和WHtR对围绝经期女性T2DM的预测价值优于BMI和WC,其为该时期女性T2DM高危人群的筛查提供了合适的参数。     

新疆博尔塔拉州居民肥胖及其危险因素分析

目的了解新疆博尔塔拉州维吾尔、哈萨克、蒙古、汉等4个民族中30岁以上人群的超重肥胖流行状况及其与心血管危险因素的关系，为肥胖防治提供科学依据。方法采用随机整群抽样方法，对新疆博尔塔拉州4个民族30岁以上居民共3732人进行流行病学调查。结果居民超重和肥胖率分别为36．02％和27．39％；城市肥胖率高于农村；男、女性超重与肥胖总体上的差异无统计学意义，但超重率男性高于女性，肥胖率则女性高于男性。蒙古族居民超重和肥胖的危险最大，维吾尔族和汉族次之，哈萨克族最小；蒙古族男性和维吾尔族女性的肥胖问题较突出。影响各民族超重和肥胖率的因素主要是性别，民族，年龄，城乡，职业，文化程度，饮酒和肉食等，其中男性超重与肥胖者合并的危险因素多。结论新疆博尔塔拉州人群中超重和肥胖患病率较高，尤其是肥胖，已成为突出的公共卫生问题之一，其中男性肥胖者是心血管病的高危人群。     

北京市不同营养状况中学生血脂状况调查

目的 了解不同营养状况青少年血脂水平及其异常情况，为早期预防心脑血管疾病提供理论依据。方法 对北京市966名初中三年级学生进行体检和血脂检测，分体重正常组、超重组和肥胖组进行血清学各指标比较。结果 随体质指数（BMI）增高，血清总胆固醇（TC）、甘油三脂（TG）和低密度脂蛋白胆固醇（LDL—C）水平及其异常检出率呈增高趋势，不同组间差异有统计学意义（P〈0．05）；HDL—C在超重组和肥胖组差异无统计学意义（P〉0．05），其余2组比较差异有统计学意义（P〈0．05）。结论 肥胖青少年血脂水平及其血脂异常率较高，应积极预防和治疗青少年高脂血症。     

Self-efficacy improves weight loss in overweight/obese postmenopausal women during a 6-month weight loss intervention

The objective was to examine the relationship between self-efficacy and subsequent weight loss during a 6-month weight loss intervention in 90 white early postmenopausal healthy women. We hypothesized that participants with higher self-efficacy scores, either at baseline or follow-up, would lose more weight than those with lower scores. Each participant received a balanced meal plan with reduced energy intake. Nutritional and behavioral sessions were provided every 2 weeks during the first 3 months. Weight and height were measured at baseline, every 2 weeks in the first 3 months, and at month 6. Three-day dietary and physical activity records and Weight Efficacy Lifestyle Questionnaire were completed at the same intervals. At month 6, participants lost 3.6 ± 4.1 kg or 4.4% (mean ± SD) and decreased in weight from 82.2 ± 11.1 kg to 77.6 ± 11.4 kg (P < .001). When participants were divided into groups based on weight loss success (<5% or ≥5% of initial weight), logistic regression (controlling for age, energy intake, physical activity, attendance at group sessions, and previous weight loss attempts) demonstrated that higher self-efficacy for the Availability of Food subscale of Weight Efficacy Lifestyle Questionnaire (95% confidence interval, 1.03-1.17) and total self-efficacy (95% confidence interval, 1.00-1.04) were associated with a greater likelihood of losing 5% or more of initial weight. Overall, participants who had higher total self-efficacy and self-efficacy to resist eating when food was available were able to lose more weight. Therefore, cognitive-behavioral efforts promoting self-efficacy may be useful for bolstering individual's confidence to resist eating under various conditions and thereby improve weight loss outcomes.