Differences in Nutritional Intake,Total Body Fat,and BMI Score between Twins

The present study aimed to investigate the coincidence of obesity and nutritional intake in monozygotic twins compared to dizygotic twins. The data from the Korean Genome and Epidemiology Study (KoGES) from 2005 through 2014 were analyzed. Participants ≥ 20 years old were enrolled. The 1006 monozygotic twins and 238 dizygotic twins were analyzed for differences in self-reported nutritional intake, total body fat, and body mass index (BMI) using a linear regression model. The estimated values (EV) with 95% confidence intervals (95% CI) of the difference in dietary intake, total body fat, and BMI score were calculated. The monozygotic twin group and the dizygotic twin group showed similar differences in nutritional intake, DEXA fat, and BMI (all p > 0.05). The differences in nutritional intake of total calories and carbohydrates were lower in the monozygotic twin group than in the dizygotic twin group (all p < 0.05). The differences in total body fat were lower in monozygotic twins than in dizygotic twins (adjusted EV = 2427.86 g, 95% CI = 1777.19–3078.53 and adjusted EV = 1.90%, 95% CI = 1.33–2.46). Monozygotic twins had more similar dietary habits for total calories and carbohydrate intake. Other nutritional factors did not show differential similarity between monozygotic and dizygotic twins. Total body fat was more concordant in monozygotic twins.     

Waist circumference and weight following smoking cessation in a general population: the Inter99 study

OBJECTIVE: Central obesity is an independent risk factor of mortality. Change in waist circumference after smoking cessation has not been previously reported in a population-based prospective study of both sexes. METHODS: Population-based study, Inter99, 1999-2001 in Copenhagen, Denmark. 2408 daily smokers completed questionnaires and had their waist circumference and weight measured. Of these, 221 biochemically verified non-smokers and 1122 continuous smokers attended 1-year follow-up and had their waist circumference and weight measured. RESULTS: The mean increase in waist circumference was 3.88 cm (+/-5.4 cm) and 42% of the quitters had increased their waist circumference by > or = 5 cm. Quitters with high baseline tobacco consumption (OR 1.05, 95% CI=1.0-1.1) and quitters with self-reported reduced physical activity (OR 3.4, 95% CI=1.5-7.7) were more likely to have substantially increased waist circumference. The mean weight gain in quitters was 4.22 kg (+/-4.3 kg) and 41% had gained at least 5 kg. Female quitters gained more weight and had a higher increase in waist circumference than men. Abstinence from smoking was the most important predictor of substantial weight gain and substantial increase in waist circumference. CONCLUSIONS: Smoking cessation resulted in substantial increase in weight and central fat, which might attenuate some of the beneficial effects of smoking cessation. Quitters who reduced their physical activity and persons with high baseline tobacco consumption were more likely to have had a substantial increase in abdominal fat. Abstinence from smoking was the most important predictor of short-term weight gain and increase in waist circumference. It is a challenge for future smoking cessation interventions to achieve a combination of high quit rates and weight-control.     

Smoking cessation and health: A comment

This comment questions the conclusion of Jones (1994, 1995) that good health creates an incentive to quit smoking. It is argued that in a cross section, a “stock” of quitters and their present health are observed. Health at the time of cessation is unobserved, and the different time passed since quitting causes an unobserved heterogeneity, masking the true relation between health and smoking cessation. An empirical illustration shows that, at least among the elderly, recent quitters, who provide the most appropriate data on that relation, did so because of poor health.     

Prenatal Smoking Cessation Intervention and Gestational Weight Gain

BackgroundQuitting smoking is often associated with weight gain and prenatal cessation may lead to increased gestational weight gain (GWG). Although previous reports have suggested a link between prenatal smoking cessation and GWG, no studies have examined the relationship between cessation and guideline-recommended GWG, and there is little information about the relationship between the timing of prenatal cessation and GWG. Thus, we examine GWG among women in a community prenatal smoking cessation program and assess the relationship between the timing of prenatal cessation GWG.MethodsPregnant women from care clinics serving economically disadvantaged women who participated in a smoking cessation intervention offered free of charge, self-reported weight, and provided biochemical verification of smoking. Relationships between duration of cessation and GWG were evaluated in t-tests and regression models. GWG was calculated from self-reported weight before pregnancy and self-reported weight at the last visit before delivery.FindingsWomen who quit earlier during pregnancy had greater GWG (16.9 ± 7.5 kg) than did those who never quit (13.6 ± 8.9). After adjusting for timing of weight assessment and prepregnancy body mass index, however, GWG was not different between women who did and did not quit.ConclusionQuitting earlier in pregnancy is associated with greater GWG, but women who do and do not quit do not differ on total GWG. Despite increased GWG with early cessation, the maternal and fetal health benefits of prenatal smoking cessation outweigh risks of potential risks of excessive GWG.     

The heritability of smoking behaviour in pregnancy, and the birth weights of offspring of smoking-discordant twins

Questionnaire information on smoking habits in pregnancy was collated in 341 monozygotic (MZ) and 321 dizygotic (DZ) female twin pair cases from a population-based Norwegian Twin Panel. In a multifactorial model, the intra-pair correlation in smoking was 0.797 (+/- 0.042) in monozygotic (MZ) and 0.443 (+/- 0.075) in dizygotic (DZ) twin pairs, indicating a substantial genetic influence on liability to smoke in pregnancy. The questionnaire information was linked with birth records in the Medical Birth Registry of Norway, and birth weights of offspring of 62 MZ and 100 DZ smoking-discordant twin pairs were studied. Offspring of smoking MZ twins weighed 127 g less than birth order matched offspring of the non-smoking co-twins. This finding is additional evidence that smoking is a direct cause of reduced birth weight in offspring.     

Obesity in relation to smoking: A population study of women in Göteborg,Sweden

A population sample of 1,462 middle-aged women (participation rate 90.1%) was studied in 1968–1969, 1,302 of whom (participation rate 80.3%) were reexamined in 1974–1975. Cigarette smoking was more frequent among younger women. Current smokers were leaner than nonsmokers. A U-shaped relationship was found between obesity index and cigarette consumption. This relationship was not explained by differences in energy intake, physical activity, or social class. Cessation of smoking was correlated with weight gain, and commencement of smoking with weight loss. Of those who quit 13% gained weight ?10.0 kg and 22% gained between 5.0 and 9.9 kg compared with 4 and 14%, respectively, among those who did not change smoking habits. The average weight change was +3.5 and ?0.7 kg among those who quit smoking and started smoking, respectively, compared with +1.4 kg among those who did not change smoking habits. A greater weight gain with the amount smoked was found both in those who stopped smoking and in those who continued smoking. Increased physical activity and reduced energy intake need consideration at cessation of smoking, especially among heavy smokers. The quantitative aspects of the relationship between smoking and obesity, and between cessation of smoking and weight gain, are considered to be of special interest for health personnel engaged in antismoking campaigns.     

Weight concerns and smoking in a general population: the Inter99 study

OBJECTIVE: No previous studies have explored weight concerns in relation to smoking habits, or investigated how weight concerns affect smoking cessation in a general population. METHOD: Inter99 is a population-based lifestyle interventional study, conducted in 1999-2001 in Copenhagen, Denmark, comprising 30-60 year old men and women. All daily smokers (N=2408) were offered help to quit. The baseline investigation (N=6784) was used for analysing associations of smoking status with weight concerns (cross-sectional design). To analyse how weight concerns affected smoking cessation we included the 1387 daily smokers attending 1-year follow-up; 221 of these were verified quitters (longitudinal design). RESULTS: Daily smoking men and women had a significantly lower body mass index than never smokers (men: 3%, women 5%) but reported to be significantly less concerned of their weight (men: OR=0.64, 95%CI=0.4-0.9), women: 0.78(0.6-1.0)). Ex-smoking normal weight women were significantly more likely to be frequently concerned of their weight than never smoking normal weight women (OR=2.06, 95CI%=1.6-2.7). Fifty-two percent of the women and 32% of the men with a previous quit attempt reported that weight gain was a reason for relapse. Neither weight concerns nor eating patterns were predictive of point abstinence at 1-year follow-up. CONCLUSION: Smokers are believed to be very concerned of their weight but in this population-based study, daily smokers more frequently ate what they wanted, had a lower BMI and were significantly less concerned of their weight than never smokers. Weight concerns and eating patterns did not predict abstinence at 1-year follow-up. It seems that weight gain and weight concerns are independent factors.     

Comparison of the Concordance of Cardiometabolic Diseases and Physical and Laboratory Examination Findings between Monozygotic and Dizygotic Korean Adult Twins: A Cross-Sectional Study Using KoGES HTS Data

This study investigated the contribution of genetic and environmental factors to cardiometabolic diseases (CMDs) by comparing disease concordance in monozygotic and dizygotic twins. This cross-sectional study analyzed 1294 (1040 monozygotic and 254 dizygotic) twin pairs (>20 years) based on the Korean Genome and Epidemiology Study data (2005–2014). The odds ratios of disease concordance were calculated using binomial and multinomial logistic regression models. The occurrence of CMDs (hypertension, hyperlipidemia, type 2 diabetes, cerebral stroke, transient ischemic attack, and ischemic heart disease) and related physical and laboratory levels did not differ between the monozygotic and dizygotic twin groups. The odds for concordance of the presence/absence of CMDs and the likelihood of incident CMD within monozygotic twins were comparable to that of dizygotic twins. The absolute differences in hemoglobin A1c, insulin, low- and high-density lipoprotein cholesterol, total cholesterol, triglycerides, and systolic blood pressure were lower in monozygotic twins than in dizygotic twins. Absolute differences in fasting glucose and diastolic blood pressure did not differ between groups. Although baseline levels of several laboratory parameters related to CMD showed a strong likelihood of heritability in monozygotic twins, CMD phenotype appears to be largely affected by environmental factors.     

Decline in smoking cessation rate associated with high self-efficacy scores

BACKGROUND: Clinical observation indicates that self-efficacy, although generally linked with maintaining smoking cessation, can be excessive. METHODS: In the present study, this phenomenon was explicitly investigated by adding the squared component of self-efficacy to the logistic regression analyses for a treatment sample (n = 381) to predict long-term success. RESULTS: Quitters with very high posttreatment self-efficacy were found to be at a greater risk for unsuccessful smoking cessation than quitters with merely high posttreatment self-efficacy, and by accounting for this phenomenon, long-term success was better predicted. No such relation was found for self-efficacy change. CONCLUSIONS: It is possible that quitters with very high levels of self-efficacy overestimate their capacity to quit and thereby neglect the use of coping skills and possibly engage in more high-risk situations.     

Association Between Lifestyle Habits and the Prevalence of Abdominal Obesity After the Great East Japan Earthquake: The Fukushima Health Management Survey

BackgroundThe proportion of overweight individuals living in the evacuation zone of Fukushima increased after the Great East Japan Earthquake. However, the change in the prevalence of abdominal obesity has not been reported. Lifestyle habits and changes in these habits after the disaster might have affected the onset of abdominal obesity; however, the association between the two is unclear.MethodsThis study evaluated 19,673 Japanese participants of the Fukushima Health Management Survey. We used data from general health check-ups conducted in 13 municipalities between 2008 and 2010. Follow-up examinations were performed from June 2011 to March 2013. Changes in the proportion of individuals with abdominal obesity before and after the disaster were compared. Then, lifestyle habits affecting these changes were assessed.ResultsWe found that 34.2% and 36.6% of participants (P < 0.001), both evacuees (37.0% and 42.1% [P < 0.001]) and non-evacuees (32.8% and 34.0% [P < 0.001]), had abdominal obesity before and after the disaster, respectively. Abdominal obesity was positively associated with smoking cessation, snacking after dinner, and non-breakfast skipping after the disaster and alcohol drinking before and after the disaster (all P < 0.05). Smoking cessation was positively associated with abdominal obesity in both evacuees and non-evacuees and in both men and women (all P < 0.01).ConclusionThe prevalence of abdominal obesity increased among residents in the area affected by nuclear disaster. It might be associated with not only lifestyle habits before the disaster but also changes in these habits after the disaster, especially smoking cessation.Key words: The Great East Japan Earthquake, lifestyle, abdominal obesity, health check-ups, smoking cessation     

Examination of the use of smoking for weight control in restrained and unrestrained eaters

Recent research has examined the perceived benefits of smoking and suggests that continued smoking may be related to contemporary concerns for weight and shape. The present study examined the role of restrained eating in predicting smoking for reasons of weight control, reports of weight gain following cessation, and reasons for relapse and intentions to quit. Eighty-four restrained eaters and 83 unrestrained eaters completed a questionnaire examining their smoking behavior. The results suggest that the restrained eaters gave significantly greater endorsement than the unrestrained eaters to statements relating to smoking initiation and smoking maintenance for weight control, the role of weight gain in previous experiences of smoking relapse, intentions to quit following weight loss, and intentions to quit in 5 years. No differences were found between the restrained and unrestrained eaters in terms of experiences of post cessation weight gain, the number of attempts to quit, and intentions to quit in 6 months. The results are discussed in terms of developing a model of the relationship between smoking and weight concerns. © 1994 by John Wiley & Sons, Inc.     

Smoking cessation at the workplace: 1 year success of short seminars

Objectives: In search of less time-consuming methods of smoking cessation Allen Carr’ seminars performed at workplaces in Austria were evaluated. Methods: Of all the 357 smokers attending a seminar in summer 2002, 308 (86%), consented to participate in a repeated health survey, including the SF-36 questionnaire. After 3 months 268 (87%) gave computer-aided telephone interviews and 223 (72%) after 1 year. Analysis by logistic regression was done separately for males and females. Results: The 1-year quit rate was 40% (worst case assumption) to 55% (best estimate). In 96% of quitters an intensive counseling for 6 h without pharmaceutical aid thereafter was sufficient to maintain abstinence for 12 months. A long smoking history or many earlier unsuccessful attempts to quit did not predict failure. The risk of relapse was found higher in young men with a high number of pack-years and in women with good physical fitness but high Fagerstroem score and financial reasons for the intention to quit smoking. While an average weight gain of 3 kg in males was not associated with failure to quit smoking, we found the highest weight gain (4 kg) in females in the group abstinent at 3 months but smoking again at 12 months. In all participants subjective life quality scored by SF-36 improved. In quitters perception of general health improved more. Conclusions: Group counseling at the workplace was found to be an efficient method of smoking cessation, capable of increasing subjective life quality and health and to smooth the way to smoke-free enterprises. The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive license on a worldwide basis to permit this article (if accepted) to be published in Int Arch Occup Environ Health.     

Smoking status and maternal weight trajectories during pregnancy and postpartum: Preliminary results from a pilot study

ObjectiveTo preliminarily examine throughout pregnancy and 12 months postpartum: 1) the critical timings of abnormal gestational weight gain (GWG) among quitters and non-quitters; 2) the consequences of abnormal GWG on weight retention during postpartum; 3) the potential difference in GWG by timing of quitting (early vs. late).MethodsWe included 59 pregnant smokers (49 quitters and 10 non-quitters) from two clinical pilot studies. Smoking status and weight were repeatedly measured throughout pregnancy and postpartum. Weight trajectories were analyzed using mixed models with smoking cessation status, pregnancy week or postpartum month, their interaction term, and potential confounders.ResultsAt enrollment, mothers had a mean BMI of 28.7 (SD, 7.2) and mean age of 30.1 years (SD, 5.8). Both groups had a linear increase in GWG, but quitters had a much higher rate of GWG (0.87 vs. 0.22 pounds/week) than non-quitters throughout pregnancy. Before delivery, 63.3% of quitters and 20.0% of non-quitters had excessive total GWG, while 12.2% of quitters and 60.0% of non-quitters had inadequate total GWG (p-value=0.004). Early quitters (<21 weeks) had a higher risk of excessive GWG (85.0%) than late quitters (≥21 weeks, 36.4%) (p-value=0.026). After delivery, quitters’ weight remained stable following a rapid weight loss, whereas non-quitters’ weight increased continuously.ConclusionsNon-quitters have a high risk of inadequate GWG, while quitters, especially early quitters, have a high risk of excessive GWG. The group difference in weight trajectories lasted from conception to postpartum.     

Comparison of the Coincidence of Osteoporosis,Fracture, Arthritis Histories,and DEXA T-Score between Monozygotic and Dizygotic Twins: A Cross-Sectional Study Using KoGES HTS Data

We explored the genetic and environmental inter-relationships among osteoporosis, fracture, arthritis, and bone mineral density concordance in monozygotic twins compared to those in dizygotic twins. This cross-sectional research assessed data of 1032 monozygotic and 242 dizygotic twin pairs aged >20 years included in the Healthy Twin Study data of the Korean Genome and Epidemiology Study between 2005 and 2014. Outcomes of interest included illness concordance and absolute differences in dual-energy X-ray absorptiometry (DEXA) T-scores. We found comparable concordances of osteoporosis, fractures, osteoarthritis, and rheumatoid arthritis between monozygotic and dizygotic twins. Medical histories of osteoporosis, fractures caused by accident or falling, osteoarthritis, and rheumatoid arthritis were not distinct between monozygotic and dizygotic twins. Accidental fracture occurrence in both monozygotic twins showed significantly lower odds than that in dizygotic twins. Genetic influence on liability to fracture risk might thus be maintained. DEXA T-scores for bone mineral density indicated more comparable tendencies within monozygotic twin pairs than within dizygotic ones, suggesting the relative importance of genetic contribution to bone mineral density. The relative importance of genetic factors in bone mineral density is sustained between monozygotic twins; overt disease expression of osteoporosis, fractures, or arthritis may be affected by environmental factors.     

Patterns and predictors of smoking cessation among users of a telephone hotline.

Most former cigarette smokers in the United States have stopped without formal assistance. However, a large proportion of smokers desire and seek help other than by attending formal programs. It is important to recognize what factors are likely to influence the effectiveness of smoking cessation attempts among these persons. The authors report results of a prospective cohort study of 1,552 smokers who called a stop smoking hotline to request self-help smoking cessation information. The participants were classified into three groups based on reports at the 6-month followup: 242 quitters, 497 recidivists, and 813 nonquitters. Baseline and followup data were used to evaluate three comparisons: quitters versus nonquitters, quitters versus recidivists, and recidivists versus nonquitters. Nonquitters appear to be less motivated and more doubtful of their abilities to quit successfully compared with the other two groups. Quitters appear to live in a supportive environment for smoking cessation. Heavier smokers are more hesitant to try to quit, but once they make an attempt they are as likely to succeed as lighter smokers, when other factors are kept constant. Efforts to promote environments supportive of smoking cessation are likely to result in a larger number of successful quitters. Similarly, efforts to strengthen motivation and belief in personal ability to quit are likely to encourage more nonquitters to attempt to stop smoking. Finally, it appears that some smokers need a previous quit attempt before they are able to maintain cessation successfully.     

Smoking cessation and change in diastolic blood pressure, body weight, and plasma lipids. MRFIT Research Group.

Cigarette smoking cessation was examined for its impact on diastolic blood pressure, weight, and plasma lipids in 3,470 special intervention males in the Multiple Risk Factor Intervention Trial. Change in smoking status (quitters vs nonquitters) was not independently associated with change in diastolic blood pressure or the subsequent use of antihypertensive medication for smokers who were normotensive at entry. More quitters (35%) became hypertensive than nonquitters (27%, P less than 0.01), although the groups had similar baseline diastolic blood pressure levels. Weight gain subsequent to cessation probably contributed to this excess incidence of hypertension in quitters. Stepped-care antihypertensive therapy lowered diastolic blood pressure similarly for hypertensive quitters and nonquitters. Weight increases of 6 lb or more by the 72-month visit occurred in 47% of quitters vs 25% of nonquitters (P less than 0.01); quitters did not differ from nonquitters in their change in total kilocalories from baseline to the 72-month visit. Quitters who gained 6 lb or more tended to be less obese at baseline, be less physically active, and smoke more cigarettes per day than those who did not gain this amount. Finally, quitters relative to nonquitters experienced an adjusted increase of 2.4 mg/dl high-density lipoprotein cholesterol, but no difference in total or low-density lipoprotein cholesterol. The implications for intervention are discussed as they relate to the common, but not inevitable, increase in weight subsequent to cessation.     

Changes in body weight and food choice in those attempting smoking cessation: a cluster randomised controlled trial

ABSTRACT: BACKGROUND: Fear of weight gain is a barrier to smoking cessation and significant cause of relapse for many people. The provision of nutritional advice as part of a smoking cessation programme may assist some in smoking cessation and perhaps limit weight gain. The aim of this study was to determine the effect of a structured programme of dietary advice on weight change and food choice, in adults attempting smoking cessation. METHODS: Cluster randomised controlled design. Classes randomised to intervention commenced a 24-week intervention, focussed on improving food choice and minimising weight gain. Classes randomised to control received "usual care". RESULTS: Twenty-seven classes in Greater Glasgow were randomised between January and August 2008. Analysis, including those who continued to smoke, showed that actual weight gain and percentage weight gain was similar in both groups. Examination of data for those successful at giving up smoking showed greater mean weight gain in intervention subjects (3.9 (SD 3.1) vs. 2.7 (SD 3.7) kg). Between group differences were not significant (p=0.23, 95% CI -0.9 to 3.5). In comparison to baseline improved consumption of fruit and vegetables and breakfast cereal were reported in the intervention group. A higher percentage of control participants continued smoking (74% vs. 66%). CONCLUSIONS: The intervention was not successful at minimising weight gain in comparison to control but was successful in facilitating some sustained improvements in the dietary habits of intervention participants. Improved quit rates in the intervention group suggest that continued contact with advisors may have reduced anxieties regarding weight gain and encouraged cessation despite weight gain. Research should continue in this area as evidence suggests that the negative effects of obesity could outweigh the health benefits achieved through reductions in smoking prevalence. Trial registration: Current Controlled Trials ISRCTN73824458.     

Inflammation markers predict increased weight gain in smoking quitters

OBJECTIVE: Undesirable weight gain often follows smoking cessation. We investigated whether weight gain after smoking cessation is greater in those with higher levels of inflammatory markers. RESEARCH METHODS AND PROCEDURES: We studied weight gain and risk of a large gain (> or = 90th percentile) over 3 years in a cohort study of 11,687 U.S. men and women, 45 to 64 years old, with focus on the 2664 who continued and the 493 who quit smoking. RESULTS: Among new quitters, adjusted weight gain for those in the highest (vs. lowest) quartile of leukocytes was 0.56 kg/yr more (95% confidence interval, 0.17 to 0.95); for those in the highest (vs. lowest) quartile of fibrinogen, 0.60 kg/yr more (95% confidence interval, 0.27 to 0.92; p = 0.02 and 0.001 for adjusted smoking status by leukocyte and smoking status by fibrinogen interaction terms, respectively). In adjusted analyses, the odds ratio for a large gain associated with quitting (vs. continuing) was 6.2 for those in the highest quartile of leukocytes vs. 2.2 for those in the lowest leukocyte quartile (p = 0.03 for smoking status by inflammatory marker interaction). Similarly, the odds ratio for a large gain associated with quitting was 4.5 in the highest fibrinogen quartile vs. 2.5 in the lowest (p = 0. 09 for the interaction term). DISCUSSION: Weight gain after smoking cessation is increased in those with higher baseline levels of leukocytes and fibrinogen. These findings suggest a close relationship between inflammatory mediators and regulators of energy balance that may have important clinical implications.