Binge eating and self-esteem predict body image dissatisfaction among obese men and women seeking bariatric surgery

OBJECTIVE: We examined body image dissatisfaction (BID) in extremely obese men and women seeking bariatric surgery. METHODS: The following predictors of BID were examined in a consecutive series of 260 (44 men and 216 women) gastric bypass candidates: gender, ethnicity, body mass index (BMI), age at onset of overweight, childhood maltreatment, binge eating, depression, and self-esteem. RESULTS: Women reported significantly higher levels of BID than men. Stepwise multiple regression analyses revealed that gender, binge eating, and self-esteem levels accounted for 41% of the variance in BID. In predicting BID levels separately by gender, binge eating and self-esteem accounted for 56% of the variance among men and for 33% of the variance among women. DISCUSSION: Among bariatric surgery candidates, women reported significantly higher BID than men. Our findings suggest the importance of binge eating and lower self-esteem for understanding BID in both men and women who are extremely obese.     

Nocturia and obesity: a population-based study in Finland

The authors' aim in this study was to analyze the association of nocturia with overweight and obesity. In 2003-2004, a questionnaire was mailed to 6,000 randomly selected Finns aged 18-79 years who were identified from the Finnish Population Register Centre. Information on nocturia was collected through questionnaires using the Danish Prostatic Symptom Score and the American Urological Association Symptom Index. Self-reported body weight and height were used to calculate body mass index (BMI; weight (kg)/height (m)2). Subjects were classified on the basis of BMI as nonoverweight (BMI<25), overweight (BMI 25-29.9 kgm2), or obese (BMI>or=30). Of the 6,000 subjects, 62.4% participated. Among men, the age-standardized prevalence of nocturia, defined as at least one void per night, was 33.4% (95% confidence interval (CI): 28.5, 38.3) in the nonoverweight, 35.8% (95% CI: 31.4, 40.1) in the overweight, and 48.2% (95% CI: 38.8, 57.6) in the obese. Among women, the corresponding figures were 37.2% (95% CI: 33.0, 41.5) in the nonoverweight, 48.3% (95% CI: 42.5, 54.2) in the overweight, and 53.6% (95% CI: 43.9, 63.2) in the obese. The associations remained similar when nocturia was defined as two or more voids per night. The age-standardized attributable fraction (population) of increased BMI for nocturia was 17.7% for men and 18.5% for women, corresponding to an 8.5% increase in the crude prevalence of nocturia in men and a 13.9% increase in women. The authors conclude that obesity is associated with increased nocturia, more strongly among women than among men.     

Relationship of fruit, vegetable, and fat consumption to binge eating symptoms in African American and Hispanic or Latina women

African American (AA) and Hispanic or Latina (HL) women have the highest rates of overweight and obesity of any gender and ethnic groups. Binge eating disorder (BED) is the most common eating disorder in the United States and is linked to overweight and obesity. Traditional treatments for BED may not be appropriate or viable for AA and HL women, because they are less likely than whites to seek treatment for psychological conditions and may have less access to healthcare. Improving dietary habits in those with BED or subthreshold BED may reduce binge eating symptoms. The current study investigated the association of fruit, vegetable, and fat consumption to binge eating symptoms in AA and HL women. AA and HL women in the Health Is Power (HIP) study (N=283) reported fruit and vegetable intake, fat intake, and binge eating symptoms. Women were middle aged (M=45.8 years, SD=9.2) and obese (M BMI=34.5 kg/m(2), SD=7.5). Greater fat consumption was correlated with lower fruit and vegetable consumption (r(s)=-0.159, p<0.01). Higher BMI (r(s)=0.209, p<0.01), and greater fat consumption (r(s)=0.227, p<0.05) were correlated with increased binge eating symptoms. Multiple regression analysis demonstrated that for HL women (β=0.130, p=0.024), higher BMI (β=0.148, p=0.012), and greater fat consumption (β=0.196, p=0.001) were associated with increased binge eating symptoms (R(2)=0.086, F(3,278)=8.715, p<0.001). Findings suggest there may be a relationship between fat consumption and binge eating symptoms, warranting further study to determine whether improving dietary habits may serve as a treatment for BED in AA and HL women.     

Body weight,blood pressure,and mortality in a cohort of obese patients

The associations between body weight, raised blood pressure, and mortality remain controversial. The authors examined these relations by considering all degrees of obesity in the Düsseldorf Obesity Mortality Study (1961-1994). Among 6,193 obese German patients aged 18-75 years and having a body mass index (BMI) of > or =25 kg/m(2), 1,059 deaths were observed after a median follow-up of 14.8 years. The entire cohort was grouped into quartiles according to BMI (25-<32, 32-<36, 36-<40, > or =40 kg/m(2)) and systolic blood pressure (SBP) (<140, 140-<160, 160-<180, > or =180 mmHg). Cox proportional hazards analyses were performed to adjust for age. For women, the mortality risk curves for the four BMI groups in relation to SBP were flat without crossing, whereas the risk curve for moderately obese men (BMI 25-<32 kg/m(2)) crossed the risk curves for the higher BMI groups. In the group of patients with very high blood pressure (SBP > or = 180 mmHg), moderately obese subjects (BMI 25-<32 kg/m(2)) had a higher mortality risk for men when compared with the BMI group 32-<36 kg/m(2) (hazard ratio =1.62, 95% confidence interval: 1.0, 2.7) but not for women (hazard ratio = 0.71, 95% confidence interval: 0.4, 1.2). These findings support previous observations that the risk of death is lower for hypertensive men in high compared with low BMI groups.     

Disability, arthritis, and body weight among adults 45 years and older

OBJECTIVE: To examine the association between body weight and disability among persons with and without self-reported arthritis. RESEARCH METHODS AND PROCEDURES: Data were analyzed for noninstitutionalized adults, 45 years or older, in states that participated in the Behavioral Risk Factor Surveillance System. Self-reported BMI (kilograms per meter squared) was used to categorize participants into six BMI-defined groups: underweight (<18.5), normal weight (18.5 to < 25), overweight (25 to < 30), obese, class 1 (30 to < 35), obese, class 2 (35 to < 40), and obese, class 3 (> or = 40). RESULTS: Class 3 obesity (BMI > or = 40) was significantly associated with disability among participants both with and without self-reported arthritis. The adjusted odds ratio (AOR) for disability in participants with class 3 obesity was 2.75 [95% confidence interval (CI) = 2.22 to 3.40] among those with self-reported arthritis and 1.77 (95% CI = 1.20 to 2.62) among those without self-reported arthritis compared with those of normal weight (BMI 18.5 to < 25). Persons with self-reported arthritis who were obese, class 2 (BMI 35 to < 40) and obese, class 1 (BMI 30 to <35) and women with self-reported arthritis who were overweight (BMI 25 to < 30) also had higher odds of disability compared with those of normal weight [AOR = 1.72 (95% CI = 1.47 to 2.00), AOR = 1.30 (95% CI = 1.17 to 1.44), and AOR = 1.18 (95% CI = 1.06 to 1.32), respectively]. DISCUSSION: Our findings reveal that obesity is associated with disability. Preventing and controlling obesity may improve the quality of life for persons with and without self-reported arthritis.     

孕前BMI与胎次对妊娠期高血压疾病影响

目的探讨胎次与孕前BMI对妊娠期高血压疾病的影响。方法以2011年2月-2012年12月在安徽省合肥市第一人民医院进行孕产期检查并分娩的1 633名孕妇为研究对象, 采用 2检验和logistic回归模型分析胎次和孕前BMI与妊娠期高血压疾病的关系。结果孕妇孕前BMI均数为(20.20±2.418)kg/m², 消瘦367人(22.5%), 正常1 153人(70.6%), 超重或肥胖113人(6.9%);第一胎936人(57.3%), 第二胎及以上697人(42.7%);单因素logistic回归模型结果显示, 孕前超重或肥胖的孕妇第一胎、二胎及以上发生妊娠期高血压疾病的风险均升高(OR=2.722, 95%CI=1.074～6.900;OR=4.356, 95%CI=1.865～10.171);调整混杂因素孕妇实足年龄、文化程度、工作性质后的多因素logistic回归模型结果显示, 胎次是孕前超重或肥胖孕妇患妊娠期高血压疾病的危险因素(第2胎及以上:OR=3.535, 95%CI=1.472～8.491, P=0.005)。结论孕前超重及肥胖妇女妊娠胎次越多发生妊娠期高血压疾病的风险越高。     

Timing and sequence of the onset of overweight, dieting, and binge eating in overweight patients with binge eating disorder

OBJECTIVE: To examine the self-reported sequence and timing of onset of overweight, binge eating, and dieting in adult patients diagnosed with binge eating disorder (BED). METHOD: Participants were 284 treatment-seeking adults (73 men and 211 women) who met DSM-IV research criteria for BED. Patients were interviewed with structured diagnostic interviews and were queried regarding history of overweight, dieting, and binge eating behaviors. Questionnaires were also administered to assess current eating disturbances, body dissatisfaction, and general functioning. Participants were classified as Overweight First, Binge First, or Diet First, and the three groups were compared on developmental sequence and using the battery of measures. RESULTS: Sixty-three percent of the 284 participants reported becoming overweight prior to the onset of dieting or binge eating. Participants who reported they were overweight first had significantly greater BMI at the time of assessment. The 16% of the participants who reported binge eating first were significantly younger at the onset of BED diagnosis and reported significantly less dietary restraint. Onset order differed significantly by gender; proportionally more women (25%) than men (11%) reported that dieting preceded overweight or binge eating. CONCLUSION: Weight problems preceded dieting and binge eating behaviors for a majority of treatment-seeking overweight participants diagnosed with BED.     

Frequency of attendance at religious services, overweight, and obesity in American women and men: the Third National Health and Nutrition Examination Survey

PURPOSE: Few data have been published on the association of overweight and obesity and indices of religiousness, a putative protective factor for cardiovascular morbidity and mortality, in representative samples of multiethnic total populations. METHODS: To test the hypothesis that frequency of attendance at religious services is unrelated to the prevalence of overweight and obesity, the following data from American men and women aged 20 years and older (N = 16,657) in a cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey, were analyzed: self-reported frequency of attendance at religious services, cigarette smoking, health status, sociodemographic variables, and measured body mass index (BMI). RESULTS: In persons 20 years and older, 58% of frequent attenders (> or = 52 times/y) and 53% of others were overweight or obese (BMI > or = 25 kg/m2). After stratifying to eliminate interactions in a logistic regression model and controlling for sociodemographics, smoking, and health status, no significant association was seen in European-American women overall. In all others, the significant positive associations of frequency of attendance and overweight could be explained by these other variables (fully adjusted odds ratio, 1.16; 95% confidence interval, 0.98-1.36; p = 0.08). The same was true for obesity (BMI > or = 30 kg/m2). CONCLUSION: In a national sample of the US population, the prevalence of overweight or obesity is greater in self-reported frequent attenders of religious services than in others, but the association was explained by controlling for multiple sociodemographic and health variables.     

The impact of body weight on smoking cessation in German adults

OBJECTIVE: To assess the relevance of pre-existing body weight for successful smoking cessation among women and men. METHODS: We carried out a retrospective cohort analysis among 4270 ever smoking participants of a general health screening examination in Germany recruited from July 2000 to June 2002 aged 50 to 74, who provided lifetime histories of both body weight and smoking. RESULTS: In the extended Cox model, the relative cessation rate (RCR) increased significantly with increasing body mass index (BMI) among both genders (test for trend: P < 0.01 for women and P < 0.0001 for men). In women, this effect was mainly due to a lower cessation rate in low-weight (BMI <20) smokers (adjusted RCR = 0.76, 95% confidence interval (CI) 0.62-0.95), whereas in men, the effect was mainly due to a higher cessation rate among overweight and obese smokers (adjusted RCR = 1.26, 95% CI 1.11-1.35, and 1.38, 95% CI 1.17-1.63, respectively) compared to normal-weight smokers. CONCLUSIONS: While in men, overweight and obesity are associated with increased smoking cessation, possibly related to increased health concerns, in women, low weight is associated with decreased smoking cessation, possibly related to increased fear of weight gain.     

Psychosocial factors associated with binge eating among overweight and obese male veterans

The study's primary objective is to compare psychosocial characteristics of overweight/obese male Veterans who report binge eating with those who do not report binge eating. Participants include 111 overweight/obese male Veterans who completed questionnaires assessing binge eating, depression, stress, body image, self-efficacy for healthy eating and physical activity, and barriers to physical activity. Of the study sample, 25.2% are classified as binge eaters. Binge eating status is not significantly associated with age, race/ethnicity, weight, or BMI. Binge eating is associated with higher scores on measures of depression, barriers to exercise, self-classified weight, and lower self-efficacy for both healthy eating and exercise, but is not associated with body satisfaction or recent stress. Findings suggest that a sizable minority of overweight/obese male Veterans engage in binge eating. Depressive symptoms, self-efficacy, and perceived barriers all significantly predicted binge eating. These findings have implications both for identification of overweight/obese men at risk for binge eating disorder as well as for weight loss treatment in the Veteran population.     

Food habits, physical activity and body mass index in relation to smoking status in 40-42 year old Norwegian women and men

BACKGROUND: The aim of the study was to examine the associations between smoking habits, and dietary habits, physical activity and body mass index (BMI) in Norway in 1997-1999. METHODS: The study was cross-sectional. Data on smoking habits, consumption of selected foods and physical activity were collected by questionnaire while body height and weight were measured in 59,361 subjects 40-42 years in 11 Norwegian counties. RESULTS: In both genders, nearly twice as many never smokers than current smokers had fruit or vegetables at least twice a day; 25.5% versus 13.3% for women and 10.5% versus 4.6% for men. The proportion of non-smoking women with a high intake of fish and fruit/vegetables was considerably higher than that of non-smoking men. Mean BMI (95% confidence interval (CI)) was higher for never smokers than for current smokers; 25.2 (25.1-25.3) versus 24.7 (24.6-24.8) kg/m2 for women and 26.6 (26.5-26.7) versus 26.1 (26.0-26.2) kg/m2 for men. The prevalence of obesity (BMI > or =30 kg/m2) (mean and 95% CI) was 12.5% (11.9-13.1%) and 14.4% (13.7-15.1%) among never-smoking women and men, respectively, whereas in smokers, the prevalence of obesity was 10.3% (9.8-10.8%) in women and 12.3% (11.7-12.9%) in men. The prevalence of performing strenuous physical activity at least 1 h a week was approximately 10% lower among current smokers than among non-smokers for both men and women. CONCLUSION: We found that non-smokers had healthier eating habits and higher levels of physical activity than did smokers, whereas the prevalence of obesity was lower in smokers. On the other hand, there were considerable gender differences, and female smokers' eating habits were as healthy as non-smoking males' eating habits.     

孕前体重指数和孕期体重增加对大于胎龄儿和巨大儿发生风险的影响

  目的  探讨孕早期超重肥胖和孕中期高血糖对巨大儿和大于胎龄儿（LGA）发生的单独和联合作用。  方法  利用天津市妇幼卫生信息系统,收集分析2009 — 2010年在天津市市内6区和滨海新区妊娠早期接受第1次产检的35 554名孕妇的基本信息、孕早期体质指数（BMI）和50 g葡萄糖负荷试验（GCT）检测结果以及分娩信息,通过logistic回归分析孕早期超重肥胖单独/联合孕中期高血糖对巨大儿和LGA发生的影响。  结果  多因素logistics回归分析显示,同孕早期BMI 18.5～23.9 kg/m²者相比,超重和肥胖孕妇发生巨大儿的风险升高（OR = 1.886,95 % CI = 1.730～2.057;OR = 3.724,95 % CI = 3.280～4.228）;超重和肥胖孕妇发生LGA的风险也升高（OR = 1.721,95 % CI = 1.606～1.845;OR = 3.230,95 % CI = 2.908～3.586）。同GCT < 7.8 mmol/L相比,GCT ≥ 7.8 mmol/L的孕妇发生巨大儿的风险升高（OR = 1.402,95 % CI = 1.287～1.529）,发生LGA的风险也升高（OR = 1.342,95 % CI = 1.253～1.437）。多因素分析显示,同孕早期BMI < 24.0 kg/m²且GCT < 7.8 mmol/L相比,孕早期超重/肥胖使高血糖对巨大儿的风险OR值由1.392增加到3.438,对LGA的风险OR值由1.365增加到2.948。  结论  孕早期超重/肥胖和孕中期高血糖是巨大儿和LGA发生的独立危险因素,且二者对巨大儿和LGA的发生存在相加交互作用。     

Eating Slowly Is Associated with Undernutrition among Community-Dwelling Adult Men and Older Adult Women

The double burden of malnutrition refers to the co-occurrence of overweight and obesity and undernutrition. Eating quickly has been linked to overweight and obesity. However, no study has examined the association between eating speed and undernutrition. This retrospective, cross-sectional study analyzed data from 3529 community-dwelling residents. Eating speed was divided into three categories: fast, medium, and slow. Undernutrition was defined as body mass index (BMI) of <18.5 kg/m² in adults aged < 70 years (adults) and as <20 kg/m² in adults aged ≥ 70 years (older adults), in accordance with the Global Leadership Initiative on Malnutrition criteria for Asians. Multivariable logistic regression analysis was used to examine the association between eating speed and undernutrition. Among adult men, compared with eating quickly, eating slowly was associated with elevated prevalence of undernutrition (odds ratio (OR) 9.68, 95% confidence interval (CI) 2.32–40.51, p = 0.001). Among older adult women, the prevalence of undernutrition in the slow-eating group was higher than that in the fast-eating group (OR 3.82, 95% Cl 1.51–9.69, p = 0.005). Eating slowly is independently associated with the prevalence of undernutrition among community-dwelling adult men and older adult women in Japan.     

Exercise, body mass index, caloric intake, and cardiovascular mortality

BACKGROUND: The association of physical inactivity and elevated body mass index (BMI) with cardiovascular disease (CVD) risk is well established. The relationship of dietary caloric intake and CVD risk is less certain. METHODS: The epidemiologic follow-up of the First National Health and Nutrition Examination Survey (1971-1992) was examined to determine the relationship of caloric intake, BMI, and physical activity to CVD mortality. Of 14,407 participants, 9790 subjects aged 25 to 74 years met inclusion criteria. The CVD mortality rate was the outcome. RESULTS: During the 17 years of follow-up, there were 3183 deaths, 1531 of which were due to CVD (9.11/1000 person-years). People with relatively less physical activity, lower caloric intake, and who were overweight (BMI 25 to 29.9 kg/m(2)) and obese (BMI > or =30 kg/m(2)) had a less favorable baseline CVD risk profile than did those who were more active and of normal weight and had greater caloric intake. Age- and race/ethnicity-adjusted CVD mortality rates were highest among those with the least physical activity and lowest caloric intake, and who were overweight or obese. Moreover, subjects of normal weight who exercised most were more likely to have high caloric intake and lower CVD mortality (5.9 vs 14.7 per 1000 person-years, p =0.01) than subjects who were obese and exercised least. In Cox regression analysis, controlling for relevant CVD risk factors, least physical activity was independently associated with increased CVD mortality (hazard ratio=1.32, 95% confidence interval [CI]=1.13-1.53); and obesity was associated with increased CVD mortality (hazard ratio=1.24, 95% CI=1.06-1.44). Although highest dietary caloric intake was associated with reduced CVD mortality (hazard ratio=0.83, 95% CI=0.74-0.93), after adjusting for physical activity and BMI, there was no significant association of highest caloric intake with CVD mortality (hazard ratio=0.91, 95% CI=0.81-1.01). CONCLUSIONS: In this large general population sample, lower levels of physical activity and obesity were independently associated with decreased CVD survival. Moreover, when BMI, physical activity, and other relevant characteristics were taken into account, caloric intake was not related to CVD mortality.     

Means of transportation to work and overweight and obesity: a population-based study in southern Sweden

OBJECTIVES: To investigate the association between means of transportation to work and overweight+obesity and obesity. METHODS: The 2004 public health survey in Sk?ne is a cross-sectional postal questionnaire study of the population aged 18-80 with a 59% response rate including 16,705 employed participants. RESULTS: Forty-six percent of men and 26.6% of women were overweight (BMI 25.0-29.9); 11.6% of men and 10.3% of women were obese (BMI 30.0-); 18.2% of men and 25.9% of women bicycled and/or walked to work and 10.4% and 16.2% used public transportation, respectively. In contrast, 68.3% of men and 55.8% of women went to work by car. The odds ratios of overweight+obesity among persons who walked or bicycled were significantly lower and remained 0.62 (95% CI 0.51-0.76) among men and 0.79 (95% CI 0.67-0.94) among women in the models including all confounders compared to the car driving reference category. The odds ratios of obesity were initially significantly lower among both men and women who walked or bicycled, but in the final models only among women. The odds ratios of overweight+obesity as well as obesity were also lower among men using public transportation. CONCLUSIONS: Walking and bicycling to work are significantly negatively associated with overweight+obesity and, to some extent, obesity. Public transportation is significantly negatively associated with overweight+obesity and obesity among men.     

1992至2002年北京大学社区队列人群体质指数的变化

目的 对比1992年和2002年北京大学社区队列人群体质指数、超重率、肥胖率10年间的变化,进一步探讨个体体质指数的变化特点。方法 1992年采用分层随机抽样的方法抽取北京大学社区35～64岁人群中的1985人进行基线调查,通过体检和问卷调查获得队列人群的个体相关资料,经过长期的心血管疾病随访研究,于2002年对此队列人群进行第2次体检和问卷调查,对2次调查资料均完整的1437人进行分析。结果 (1)10年间男性体重平均增加了4．89kg,女性增加了3．08kg;体质指数(BMI)均值男性由10年前的23．49kg／m^2上升到10年后的25．22kg／m^2,女性由10．年前的23．30kg／m^2上升到10年后的25．02kg／m^2。(2)10年间男性超重率、肥胖率分别增长了47．8％和124．2％,女性则分别增长了29．5％和131．3％。(3)男性10年前超重者中有74．9％的人10年后仍超重,22．9％的人变成肥胖;肥胖者中85．7％的人10年后仍肥胖。女性10年前超重者中58．2％的人10年后仍超重,34．5％的人变成肥胖;肥胖者中93．7％的人10年后仍肥胖。结论北京大学社区队列人群10年间。BMI均值、超重率和肥胖率均有所增加。10年前基线BMI为超重或肥胖者中的大部分人10年后仍为超重或肥胖,恢复为正常者很少,而且BMI超重者比BMI正常者更容易变成肥胖,这说明超重或肥胖一旦形成则很难恢复。因此,控制超重和肥胖的关键在于早期预防。     

Discrimination of health risk by combined body mass index and waist circumference

OBJECTIVE: NIH Clinical Guidelines (1998) recommend the measurement of waist circumference (WC, centimeters) within body mass index (BMI, kilograms per square meter) categories as a screening tool for increased health risk. RESEARCH METHODS AND PROCEDURES: The Canada Heart Health Surveys (1986 through 1992) were used to describe the prevalence of the metabolic syndrome in Canada and to test the use of the NIH guidelines for predicting metabolic risk factors. The sample included 7981 participants ages 20 to 74 years who had complete data for WC, BMI, high-density lipoprotein-cholesterol, triglycerides, diabetic status, and systolic and diastolic blood pressures. National Cholesterol Education Program Adult Treatment Panel III risk categories were used to identify the metabolic syndrome and associated risk factors. Logistic regression was used to test the hypothesis that WC improves the prediction of the metabolic syndrome, within overweight (25 to 29.9 kg/m(2)) and obese I (30 to 34.9 kg/m(2)) BMI categories. RESULTS: The prevalence of the metabolic syndrome was 17.0% in men and 13.2% in women. The odds ratios (OR) for the prediction of the metabolic syndrome were elevated in overweight [OR, 1.85; 95% confidence interval (95%CI), 1.02 to 3.35] and obese (OR, 2.35; 95%CI, 1.25 to 4.42) women with a high WC compared with overweight and obese women with a low WC, respectively. On the other hand, WC was not predictive of the metabolic syndrome or component risk factors in men, within BMI categories. DISCUSSION: In women already at increased health risk because of an elevated BMI, the additional measurement of WC may help identify cardiovascular risk.     

Obesity and risk of nonfatal unintentional injuries

BACKGROUND: Obesity is recognized as a risk factor for multiple chronic diseases. Yet, it is unclear whether obesity is also associated with an increased risk of nonfatal unintentional injury. METHODS: A population-based survey was conducted among adults aged > or = 18 years from January 1999 through October 2000. The relationship was investigated between body mass index (BMI), defined as weight in kilograms divided by the square of the height in meters (kg/m2), and risk of nonfatal unintentional injuries among 2575 respondents aged > or = 20 years by comparing percentage of adults between obese and nonobese respondents who had injuries. Multivariate logistic regression further examined this relationship by controlling for confounding demographics. RESULTS: A total of 370 respondents reported injuries in the previous year. We observed a linear dose-response trend among women. An estimated 7.0% of underweight individuals (BMI <18.5) reported injuries. In contrast, 26.0% of men and 21.7% of women with a BMI > or = 35.0 reported injuries. The odds ratio of injuries for individuals with a BMI > or = 35.0 was 2.00 (95% confidence interval=1.07-3.74, p<0.05) after controlling for gender, age, education level, marital status, family poverty status, and area of residence. CONCLUSIONS: A marginally significant association between extreme obesity and elevated risk of injuries was observed. Efforts to promote optimal body weight may reduce not only the risk of chronic diseases but also the risk of unintentional injury among overweight and obese individuals.     

Obesity and prostate cancer screening in the USA

OBJECTIVE: To estimate the association between body mass index (BMI: kg/m2) and prostate-specific antigen (PSA) cancer screening in a nationally representative sample of US men aged 50 years and older using data from the 2001 Behavioral Risk Factor Surveillance Survey. RESPONDENTS: Men aged 50 years or older classified by BMI as healthy weight range (18.5-24.9), overweight (25-29.9), obese class I (30-34.9), obese class II (35-39.9), and obese class III (> or =40). OUTCOME MEASURES: Interval since most recent screening for PSA. RESULTS: Adjusting for age, race, smoking, education, employment, income and health insurance status, we found that, compared with men in the healthy weight range, men in the overweight [odds ratio (OR)=1.13; 95% confidence interval (95% CI)=1.04-1.35], obese class I (OR=1.26; 95% CI=1.06-1.36) and obese class II (OR=1.14, 95% CI=1.02-1.26) categories were significantly more likely to have obtained a PSA test within the previous year. A similar pattern was observed when we examined other screening intervals (e.g. within past 2 years, within past 3 years, etc.). CONCLUSIONS: Among men aged 50 years and older, overweight and obesity is associated with obtaining a PSA test.     

Epidemiology of overweight and obesity and its determinants in Belo Horizonte (MG), Brazil: a cross-sectional population-based study]

OBJECTIVE: To determine the prevalence of overweight and obesity and to study potential risk factors for these conditions in persons over 18 years of age in the metropolitan area of Belo Horizonte, Brazil. METHODS: Data were obtained from a population-based study conducted in 1996 and 1997 by the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IBGE) with a random sample of 1 105 individuals. Height and weight were measured by trained personnel. Overweight (body mass index [BMI] > or = 25.0 kg/m2) and obesity (BMI > or = 30.0 kg/m2) were the dependent variables. Bivariate analysis and multivariate logistic regression were used to identify potential risk factors for overweight and obesity. RESULTS: The prevalence of overweight and obesity was 31.1% (95% confidence interval 195% CI]: 27.3 to 35.2) and 5.7% (95% CI: 4.0 to 8.1), respectively, in men, and 25.9% (95% CI: 22.4 to 29.8) and 14.7% (95% CI: 11.9 to 17.9), respectively, in women. Multivariate analysis revealed that age and marital status were independent risk factors for overweight, whereas age, sex, and education were independent risk factors for obesity. Being female and well-educated showed a protective effect against overweight (odds ratio [OR] = 0.52; 95% CI: 0.33 to 0.83), but not against obesity (OR = 3.01; IC 95%: 1.14 to 7.94). Women with low education had a significantly greater risk (OR = 5.95; 95%CI: 2.51 to 14.12) of developing obesity than men having a high educational level. CONCLUSIONS: These results suggest that overweight and obesity may be serious public health problems in the metropolitan area of Belo Horizonte, Brazil. It is important to carry out further studies in order to explore the potential relationship between overweight and obesity on the one hand, and behavioral variables, such as smoking and alcohol consumption, on the other.