Combination of BMI and Waist Circumference for Identifying Cardiovascular Risk Factors in Whites

OBJECTIVE: BMI (kilograms per meters squared) and waist circumference (WC) (measured in centimeters) are each associated with the risk of developing cardiovascular disease (CVD). Therefore, a combination of the two may be more effective in identifying subjects at risk than either alone. The present study sought to identify the combination of BMI and WC that has the strongest association with CVD risk factors in whites. RESEARCH METHODS AND PROCEDURES: Subjects were 8712 white men and women from the Third National Health and Nutrition Examination Survey. The optimal combination of BMI and WC was developed using logistic regression models with BMI and WC as predictors and CVD risk factors as outcomes. The combined measure of BMI and WC using current cut-off points was also examined. Sensitivity, specificity, and receiver operating characteristics curves were compared between the combined measures and BMI alone. RESULTS: For white men, the optimal combination of BMI and WC for identifying CVD risk factors was 0.68 x BMI + 0.32 x WC. This combination generated a score that better estimated the odds of having CVD risk factors than either alone. For white women, WC alone largely determined the likelihood of having CVD risks. The combination of BMI and WC using current cut-off points may provide an improved measure of CVD risk. Combined measures showed a higher sensitivity or a shorter distance in receiver operating characteristic curves in the identification of CVD risk factors. DISCUSSION: Combined measures of BMI and WC may provide a higher overall test performance for CVD risk factors and may be useful in some ethnic groups as an improved means of screening subjects for further evaluation in the clinical setting.     

北纬53°地区人群体质指数、腰臀比与高血压关系的调查

目的：解高寒地区人群超重肥胖、中心性肥胖发生率及其与高血压的关系。以期为肥胖和高血压的防治措施制定提供研究依据。方法对北极村1064例体检者进行身高、体重、腰围、臀围、血压等检测,并按照腰臀比值、体质指数进行分层分析各组与高血压相关性。结果受检者肥胖患病率为19.55%,超重的患病率为35.81%,中心性肥胖患病率为69.64%,高血压患病率为27.16%。正常人群随着BMI的增加,高血压的患病率呈明显上升趋势;中心性肥胖人群随着BMI的增加高血压的患病率显著上升(P<0.0001)。将WHR和BMI作为自变量对高血压的患病率进行相关性分析,结果显示,肥胖组和超重组高血压的患病率明显高于正常体重组(P<0.0001);中心性肥胖组的高血压率明显高于正常体型组(P<0.0001)。经多因素相关分析,WHR和BMI与高血压都有极显著性意义(P<0.0001)。结论该研究结果显示,超重,肥胖和中心性肥胖都是高血压的独立危险因素。即使BMI仍在标准范围的人,若是任由腰围一直变大,对健康而言,仍是一种非常不良的信号。因此,如果只注意体重,而忽视腹部脂肪过多,仍有发生慢性疾病的危险。     

腰围、腰臀比及腰身比对社区糖尿病人群早期发现的价值分析

目的:探讨社区糖尿病患病情况及腰围、腰臀比和腰身比等体征指标对社区早期发现糖尿病人群的价值.方法:所有调查对象来自2017年1月1 日—2019年12月31 日期间参加社区糖尿病筛查项目,共计1 440人,按糖尿病诊断标准分为正常及糖尿病人群,分别分析腰围、臀围、体质指数、腰臀比和腰身比等5项指标与糖尿病患病的统计关联...     

高血压家系中高血压与血糖、血脂、体质指数和腰围关系的研究

目的探讨在高血压家系中聚集的高血压危险因素。方法2003--2004年，在江苏常州地区5个社区中，收集高血压家系104个，含直系血亲523人，其中男性278人，女性245人；旁系（配偶）265人，其中男性81人，女性184人。检测其空腹血糖（FPG）、血脂、尿酸（UA）、体质指数（BMU及腰围，应用SPSS11．5软件包进行统计分析。结果调整年龄、性别后，3组间两两比较发现，直系高血压组UA、FPG、甘油三酯（TG）、BMI和腰围均高于直系正常血压组，高密度脂蛋白胆固醇（HDL-C）低于直系正常血压组，差别均有统计学意义（P〈0．01）；直系高血压组UA、FPG、TG、TC、BMI和腰围均高于旁系正常血压组，HDL—C低于旁系正常血压组，差别均有统计学意义（P〈0．01）；直系正常血压组TC、腰围高于旁系正常血压组，UA低于旁系正常血压组，差别有统计学意义（P〈0．05）。Logistic回归分析显示，在家族直系成员中，高血压发病与文化程度、吸烟、性格、BMI和FPG有关。结论在高血压家系中，其高血压病危险因素存在着一定的家族聚集现象。     

辽宁地区居民体重指数、腰围与血压关系的研究

目的探讨辽宁地区居民体重指数、腰围与血压值、高血压患病率的关系。方法按照多阶段整群随机抽样方法,对辽宁地区15岁及以上居民的血压、身高、体重、腰围等指标进行流行病学统计分析。结果体重指数(kg/m2)<18.5,18.5~23.9,24~27.9,≥28,血压均值分别为116.4/73.9mmHg、122.0/76.5mmHg、130.5/81.4mmHg、138.4/85.9mmHg,高血压患病率分别为13.6%、20.4%、35.2%和53.9%;腰围从正常到腹部肥胖,血压均值从121.7/76.6mmHg上升到133.6/82.9mmHg,高血压患病率从19.8%上升到42.8%。当体重指数≥24(kg/m2)或腰围进入腹部肥胖时,血压值、高血压患病率明显增加。经多元线性回归分析,血压值与体重指数和腰围呈正相关,而且腰围对血压均值的影响大于体重指数对血压的影响;Logistic回归分析显示,超重、肥胖和腹部肥胖与正常组相比发生高血压的相对危险性增加1.5、2.6和2.0倍。结论超重和肥胖是高血压的两个危险因素,保持理想的体重和腰围对控制高血压的发生起着决定性作用。     

Coffee Consumption and All-Cause,Cardiovascular, and Cancer Mortality in an Adult Mediterranean Population

We assessed the association between usual coffee consumption and all-cause, cardiovascular (CV), and cancer mortality in an adult population in Spain, taking into account both the amount and type of coffee consumed. We used baseline data on coffee consumption and other personal variables, and the number of deaths during an 18-year follow-up period, for 1567 participants aged 20 years and older from the Valencia Nutrition Study in Spain. Total, caffeinated, and decaffeinated coffee consumption was assessed using a validated food frequency questionnaire. Cox regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). During the 18-year follow-up period, 317 died; 115 due to CV disease and 82 due to cancer. Compared with no-consumption, the consumption of ≤1 cup per day and >1 cup per day of coffee was associated with a lower risk of all-cause mortality, HR = 0.73 (95% CI: 0.56–0.97) and HR 0.56 (95% CI: 0.41–0.77), respectively. A lower cancer mortality was observed among drinkers of more than 1 cup per day compared with nondrinkers, HR 0.41 (95% CI 0.20–0.86). Regarding the type of coffee, only the overall consumption of caffeinated coffee was associated with lower all-cause mortality at 12 and 18 years of follow-up, HR = 0.66 (95% CI:0.46–0.94) and HR = 0.59 (95% CI: 0.44–0.79), respectively. In conclusion, this study suggests that the moderate consumption of coffee, particularly caffeinated coffee (range 1–6.5 cups per day), is associated with a lower all-cause and cancer mortality after a long follow-up period. No significant association was found between coffee consumption and CVD mortality.     

Cutoff Points of Waist Circumference for Predicting Incident Non-Alcoholic Fatty Liver Disease in Middle-Aged and Older Korean Adults

This study aimed to determine the optimal cutoff value of waist circumference (WC) for predicting incident NAFLD. In this community-based prospective cohort study, we analyzed data from 5400 participants without NAFLD at baseline aged 40–69 years. NAFLD was defined as a NAFLD-liver fat score >−0.640. A Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for an association between body composition and NAFLD incidence. The predictive power of each body composition indicator was assessed by Harrell’s concordance index for Cox models. During a mean follow-up period of 12 years, there were 2366 new-onset NAFLD events. Compared with men with WC < 81 cm, the adjusted HR (95% CI) for incident NAFLD in those with WC ≥ 81 cm was 2.44 (2.23–2.67). Compared with women with WC < 78.5 cm, the adjusted HR (95% CI) for incident NAFLD in those with WC ≥ 78.5 cm was 2.54 (2.25–2.87). WC was the most significant risk factor for predicting incident NAFLD among body composition indicators in middle-aged and older Korean adults. The optimal WC cutoff point for predicting incident NALFD was 81 cm in men and 78.5 cm in women, which might assist in the early detection and prevention of NAFLD.     

中国汉族学龄儿童青少年腰围正常值

目的了解中国学龄儿童腰围正常值,为建立中国学龄儿童青少年超重/肥胖筛查标准提供依据。方法以2008年全国学生体质健康监测15省市区14.6万余名7～18岁汉族中小学生为参照人群,以LMS法建立腰围正常值。结果获得中国7～18岁汉族中小学生各年龄组男女腰围P3,P5,P10,P15,P25,P50,P75,P85,P90,P95和P97百分位数正常值及其LMS曲线。结论利用腰围正常值可在经疾病危险因素验证后建立腰围筛查超重、肥胖界值点的标准,并就验证过程一些必要的步骤和方法提出建议。     

Physical Activity,Weight, and Waist Circumference in Midlife Women

During midlife years, women are at risk of increasing body weight and waist circumference. We evaluated changes in weight and waist circumference from enrollment to 2 years later and examined the influence of physical activity level on those changes among 232 women aged between 40 and 50. Weight increased significantly for the entire sample. Those who increased their physical activity from enrollment to 2 years later had the smallest increase in weight and had a slight decrease in waist circumference. To maintain ideal weight and waist circumference, midlife women should be encouraged to increase physical activity before and during the menopausal transition.     

Leisure Activities and All-Cause Mortality Among the Chinese Oldest-Old Population: A Prospective Community-Based Cohort Study

ObjectiveTo investigate associations between leisure activities, examining each activity separately and in combination, and all-cause mortality among the Chinese oldest-old (≥80 years) population.DesignProspective cohort study.SettingCommunity-living, the oldest-old from 22 provinces in China.ParticipantsWe included 30,070 Chinese individuals aged ≥80 years (mean age: 92.7 years) from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014.MeasurementsCox proportional hazards models were used to estimate relationships between leisure activities and all-cause mortality, adjusting for covariates including sociodemographic and lifestyle factors, self-reported medical history, and other potential confounders.ResultsDuring 110,278 person-years of follow-up, 23,661 deaths were documented. Participants who engaged in watching TV or listening to the radio, playing cards or mah-jong, reading books or newspapers, gardening, keeping domestic animals or pets, or attending religious activities “almost every day” had a significantly lower mortality risk (adjusted hazard ratios ranged from 0.82 to 0.89; P < .01 for all) than did participants who “never” engaged in those activities. Furthermore, engagement in multiple leisure activities was associated with a reduced risk of all-cause mortality (P for the trend < .001).Conclusions and implicationsFrequent participation in leisure activities might help decrease the risk of death in the Chinese oldest-old population. This finding has important implications for public health policy and encourages the incorporation of a broad range of leisure activities into the daily lives of oldest-old individuals.     

Indoor Physical Activity Reduces All-Cause and Cardiovascular Disease Mortality Among Elderly Women

Objectives

The aim of this study was to investigate whether a medium to high degree of total physical activity and indoor physical activity were associated with reduced all-cause and cardiovascular mortality among elderly Korean women.

Methods

A prospective cohort study was done to evaluate the association between physical activity and mortality. The cohort was made up of elderly (≥65 years of age) subjects. Baseline information was collected with a self-administered questionnaire and linked to death certificates retrieved from a database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence interval (CI) levels.

Results

Women who did not suffer from stroke, cancer, or ischemic heart disease were followed for a median of 8 years (n=5079). A total of 1798 all-cause deaths were recorded, of which 607 (33.8%) were due to cardiovascular disease. The group with the highest level of total physical activity and indoor physical activity was significantly associated to a reduced all-cause mortality (HR, 0.60; 95% CI, 0.51 to 0.71 and HR, 0.58; 95% CI, 0.50 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Additionally, the group with the highest level of total physical activity and indoor physical activity was significantly associated to a lower cardiovascular disease mortality (HR, 0.53; 95% CI, 0.40 to 0.71 and HR, 0.51; 95% CI, 0.39 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity.

Conclusions

Our study showed that regular indoor physical activity among elderly Korean women has healthy benefits.     

Effect of Body Weight,Waist Circumference and Their Changes on Mortality: A 10-Year Population-Based Study

Objectives

To investigate the effect of body weight, waist circumference and their changes on all-cause and cardiovascular mortality.

Design

A nationwide population-based cohort study

Participants

627 community-dwelling older adults.

Measurements

Participants were interviewed for demographic and anthropometric data collected. Blood were drawn for testing biochemistry data. Central obesity was defined as waist circumference is greater than 80 cm for women and 90 cm for men. Obesity, overweight, normal and underweight were defined as BMI ≥27 kg/m2, ≥24 kg/m2,18.5-24 kg/m2 and <18.5 kg/m2. Cox proportion hazard model was used to explore the impact of body weight and its change on mortality.

Results

The distribution of weight changes and mortality was right skewed, but U-shape of waist change for all-cause mortality was observed. Compared to normal BMI at baseline, the association between underweight (HR: 1.7, 95% CI: 0.7-4.0), overweight (HR:0.7, 95% CI:0.4-1.2) and obesity (HR:1.3,95% CI:0.8-2.3) showed insignificantly associated with all-cause mortality. The HR of those weight loss >5% (HR: 1.7, 95% CI: 1.1-2.8) and waist decrease >5% (HR: 1.7, 95% CI: 1.0-2.8) were higher than those of stable weight/waist +/- 5% over a 6-year period. Compared to those stable weight/waist, the mortality risk was similar in those of weight gain or waist increase (HR 0.7,95%CI: 0.4-1.5 and HR:0.9, 95%CI:0.4-1.6).

Conclusion

Weight loss and waist decrease were significantly associated with long-term mortality risk, a life-course approach for body weight management is needed to pursuit the most optimal health benefits for the middle-aged and older adults.

     

Coffee Consumption and the Risk of All-Cause and Cause-Specific Mortality in the Korean Population

BackgroundThere is a dearth of information regarding the association between coffee consumption and its health effects with respect to mortality among Korean people.ObjectiveThe aim of this study was to examine the association between coffee consumption and all-cause mortality and cause-specific mortality risks in the Korean population.DesignThis prospective cohort study had a median follow-up period of 9.1 years.Participants/settingIn total, 173,209 participants aged 40 years and older from the Health Examinees study were enrolled between 2004 and 2013. The analytic sample included 110,920 participants without diabetes, cardiovascular disease (CVD), or cancer at baseline who could be linked with their death information.Main outcome measuresDeaths of participants until December 31, 2018 were ascertained using the death certificate database of the National Statistical Office. Cause of death was classified according to the International Classification of Diseases, 10th Revision.Statistical analyses performedParticipants were categorized according to the amount and type of coffee consumed. Cox proportional hazards regression analysis was performed to estimate the hazard ratio (HR) and 95%CI of all-cause mortality and cause-specific mortality, such as CVD and cancer mortality.ResultsCompared with nonconsumers of coffee, participants who consumed > 3 cups/day had a reduced risk of all-cause mortality (HR 0.79, 95% CI 0.66 to 0.95). Participants who consumed ≤1 cup/day and 1 to 3 cups/day had a reduced risk of CVD mortality (≤1 cup/day: HR 0.58, 95% CI 0.69 to 0.94; 1 to 3 cups/day: HR 0.62, 95% CI 0.41 to 0.96).ConclusionsThis study provides evidence that greater coffee consumption is associated with a decreased risk of all-cause mortality and moderate coffee consumption (approximately 3 cups/day) is associated with a decreased risk of CVD mortality, regardless of the type of coffee, in a Korean population.     

安徽省7～22岁学生腰围臀围及腰臀比的特征分析

目的描述安徽省7～22岁城乡男女学生腰围、臀围和腰臀比年龄特征，探讨儿童青少年腰围、臀围和腰臀比的性别和城乡差异。方法以参加安徽省2005年学生体质与健康调研的8450名7—22岁学生为研究对象，计算各个年龄组城乡男女学生腰围、臀围和腰臀比的百分位数、均数和标准差，通过两样本t检验分析各年龄组腰围，臀围和腰臀比的性别和城乡差异。结果城乡7—22岁男生及女生腰围、臀围和腰臀比随年龄变化总趋势一致，腰围和腰臀比男生大于女生。青春发育期女生臀围大于男生，农村青少年臀围的性别差异更为明显。各年龄组城乡男女学生中，城市男生腰围和腰臀比均最高。多数年龄组城市男生臀围明显高于农村（P（0．01或P〈0．05），城市女生腰围和臀围比农村稍高，城市男生腰臀比略高于农村，而农村女生的腰臀比较城市稍高。但腰臀比的城乡差异有统计学意义的年龄组较少。结论基于城乡不同性别和不同年龄组学生腰围、臀围和腰臀比的差异，建议制定全国统一的腰围和腰臀比参考值。     

Amount and Frequency of Alcohol Consumption and All-Cause Mortality in a Japanese Population: The JMS Cohort Study

Background

Lower mortality has been reported in light-to-moderate alcohol drinkers. We examined the association between the amount and frequency of alcohol consumption and all-cause mortality in a Japanese population.

Methods

We conducted a prospective cohort study among 8934 Japanese people (3444 men and 5490 women) who completed a baseline survey between 1992 and 1995. We confirmed the date and cause of death by referring to death certificates. The Cox proportional hazards model was used to evaluate the effect of alcohol consumption on risk for all-cause mortality, after adjustment for potential confounding factors.

Results

We identified 637 (397 men and 240 women) deaths during the 12.0 years of mean follow-up. Among men, as compared with non-drinkers, the relative risk was higher in ex-drinkers (hazard ratio [HR], 1.18), lower in light drinkers (HR, 0.95) and moderate drinkers (HR, 0.91), and significantly higher in heavy drinkers (HR, 1.67; 95% confidence interval, 1.10–2.55). Among women, light, moderate, and heavy drinkers were grouped into current drinkers. The relative risk was slightly higher in current drinkers (HR, 1.23), and that in ex-drinkers was near 1.0 (HR, 0.97). In stratified analysis, the harmful effects of heavy drinking were more severe among male smokers and younger men. In terms of frequency, men who drank only on special occasions had the highest mortality (HR, 1.28), regardless of alcohol intake per drinking session.

Conclusions

In men, a near J-shaped association was identified between alcohol consumption and all-cause mortality. Both the amount and frequency of alcohol consumption were related to mortality.Key words: cohort studies, alcohol drinking, mortality, Japan     

MetS Prevalence and Its Association with Dietary Patterns among Chinese Middle-Aged and Elderly Population: Results from a National Cross-Sectional Study

The prevalence of metabolic syndrome (MetS) increased dramatically over the past years among adults in a separate province in China; little is known about newly diagnosed MetS in middle-aged and above residents nationwide. We investigated the prevalence of MetS and its components, the dietary patterns, and their relationship among the middle-aged and above population of China by using data from a national cross-sectional survey. General information involving lifestyles and health stations was collected, and dietary intake using a 3-day 24 h dietary recall and weighing method for edible oil and condiments was conducted. Height, weight, waist circumference, and blood pressure were measured, and fasting serum lipids and glucose were tested by trained clinical staff. Dietary patterns were derived from 23 food categories by using cluster analysis, and a multivariate logistic regression model was used to evaluate the odd ratio of MetS and its component across obtained dietary patterns. The estimated prevalence of MetS was 37.1% among 40,909 middle-aged and older participants in the study. Participants were classified into diversity pattern, northern pattern, and southern pattern that, respectively, accounted for 9.8%, 47.2%, and 43.0% of the total. Compared with those inclined to the northern pattern, participants prone to the southern pattern decreased the risk of MetS (OR = 0.81, 95%CI: 0.75- 0.87; p < 0.001), central obesity (OR = 0.70, 95%CI: 0.65–0.76; p < 0.001), and HDL-C (OR = 0.82, 95%CI: 0.76–0.89; p < 0.001), and elevated BP (OR = 0.86, 95%CI: 0.79–0.93; p < 0.001) respectively. However, participants of the southern pattern tended to have a higher risk of elevated glucose; the OR (95%CI) was 1.13 (1.05, 1.22; p = 0.002) after adjusting for potential confounding factors. Greater adherence to diverse dietary patterns was negatively related to the risk of central obesity and elevated blood pressure with an OR (95%CI) of 0.82 (0.71, 0.94; p = 0.005) and 0.77 (0.67, 0.88; p < 0.001), respectively. We concluded that dietary improvement and health promotion for MetS should be based on the district-specific nutritional status of the Chinese middle-aged and elderly population.     

Dietary Predictors of 5-Year Changes in Waist Circumference

Background

Previous studies on the association between macronutrient intake and the development of abdominal obesity, which carries an increased health risk, have not shown a consistent pattern, possibly due to mixed effects of other aspects of the food intake.

Objective

This study investigated the association between intake from 21 food and beverage groups and the subsequent 5-year difference in waist circumference.

Methods

The study population consisted of 22,570 women and 20,126 men, aged 50 to 64 years at baseline, with complete data on baseline and follow-up waist circumference, baseline diet (192 items food frequency questionnaire), body mass index, and selected potential confounders (eg, smoking status, sport activities, and intake of alcoholic beverages). Multiple linear regression analyses were performed.

Results

For women, 5-year difference in waist circumference was inversely related to intake from red meat, vegetables, fruit, butter, and high-fat dairy products, whereas intake from potatoes, processed meat, poultry, and snack foods was positively associated. For men, red meat and fruit intakes were inversely associated with 5-year difference in waist circumference, whereas snack foods intake was positively associated. Sex differences occurred for vegetables, high-fat dairy products, and processed meat.

Conclusions

The results suggest that a diet low in fruits and red meat and high in snack foods was associated with larger waist circumference gains in both sexes. Furthermore, in women a diet low in vegetables, butter, and high-fat dairy products, and high in poultry, potatoes, and processed meat were likely determinants of subsequent gain at the waist.