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PubMed2000

Reliability of anthropometric measurements in overweight and lean subjects: consequences for correlations between anthropometric and other variables.

OBJECTIVE: To estimate the reliability of anthropometric measurements in overweight and lean subjects, and to examine the influence of this reliability on correlations to other variables, since low reliability leads to underestimation of correlations. DESIGN: Replicate measurements by two observers in 26 overweight and 25 lean subjects measured at two occasions. MEASUREMENTS: Sagittal abdominal diameter (SAD), waist circumference (waist), waist-to-hip ratio (W/H) and skinfold measurements. RESULTS: Intra-class correlation coefficients (ICCs) for SAD and waist were higher than for W/H (0.98 vs. 0.90, P<0.001, and 0.97 vs. 0.90, P = 0.001, respectively). For waist, the ICC was lower for overweight than for lean subjects (0.85 vs 0.95, P=0.030), but the ICC values were comparable for SAD and W/H (0.92 vs. 0.95 and 0.78 vs. 0.83, respectively). Intra-observer variations (IOV) for SAD and waist were lower than for W/H (coefficients of variation; 1.6%, 1.4% and 2.3%, respectively), as were intra-subject variations (ISV) (2.7%, 3.0% and 3.4%, respectively). ICC values ranged from 0.84 to 0.93 and were lower for overweight than for lean subjects for biceps, subscapular and umbilical skinfolds (P=0.031, P<0.001 and P=0.048, respectively). Coefficients of variations for skinfold measurements ranged between 7.3% and 16.0% for IOV and between 14.9% and 20.8% for ISV. CONCLUSIONS: The low ICC values imply that correlations can be underestimated in overweight groups. We propose that, because of their higher reliability, SAD and waist have a higher predictive capacity for cardiovascular risk than W/H. SAD is the only measurement with high reliability in both weight groups and its use is recommended.

Abdomen↗
PubMed2000

The relationship between body mass index and waist circumference: implications for estimates of the population prevalence of overweight.

OBJECTIVE: Body mass index (BMI) based on self-reported height and weight is a systematically biased, but acceptable measure of adiposity and is commonly used in population surveys. Recent studies indicate that abdominal obesity is more strongly associated with obesity-related health problems than is adiposity measured by BMI. The purpose of this study was to determine the relationships of both measured and self-reported BMI with measured waist circumference in a randomly selected sample of Australian adults. DESIGN: Cross-sectional survey with self-reported and laboratory-based measures of adiposity. SUBJECTS: 1140 randomly-selected Australian adults aged 18-78 y resident in the city of Adelaide, South Australia. MEASUREMENTS: Data on self-reported and measured height and weight as well as measured waist circumference were drawn from the Pilot Survey of the Fitness of Australians database. The proportion of men and women with acceptable BMI (BMI</=25 kg/m2) and with excess abdominal adiposity (>/=94 cm for men and >/=80 cm for women) was determined. Differences in the prevalence of overweight based on BMI alone or BMI and waist circumference were also determined. RESULTS: Compared with the prevalence based on self-reported BMI alone, the prevalence of overweight among men based on self-reported BMI and waist circumference combined was 2.4%, 5.3%, 19.1% and 7.5% greater for men aged 18-39 y, 40-59 y, 60-78 y and for all men, respectively. Among women, compared with the prevalence based on self-reported BMI alone, the prevalence of overweight based on the combined measures was 9.9%, 24.0%, 33.3% and 20.6% greater for women aged 18-39 y, 40-59 y, 60-78 y and for all women, respectively. CONCLUSIONS: If waist circumference is used as the criterion, then the prevalence of overweight among Australian adults, and probably other Caucasian populations, may be significantly greater than indicated by surveys relying on self-reported height and weight. The development of valid self-reported measures of waist circumference for use in population surveys may allow more accurate epidemiological monitoring of overweight and obesity.

Abdomen↗
PubMed2000

Dietary intakes, eating style and overweight in the Stanislas Family Study.

OBJECTIVES: To describe the eating patterns of members of French families and to assess the relationships between dietary intakes, eating style and overweight. DESIGN: Cross-sectional analysis of nutritional and behavioural characteristics. SUBJECTS: 1,320 members of 387 families (age 11-65y) attending the Centre for Preventive Medicine for a routine medical check-up. MEASUREMENTS: Individual body weight and height were measured. Food intake was assessed using a three day dietary record. Eating style was measured using the French validated version of the Dutch Eating Behaviour Questionnaire. RESULTS: In each of the four groups (men, women, boys and girls), dietary restraint was positively correlated with overweight (P< or =0.001) and associated with lower energy intakes (P < or = 0.05-P < or = 0.001). A negative association between energy intake and overweight was found in girls only (P< or =0.001). In all cases, overweight and dietary restraint exaggerated any existing macronutrient imbalance in energy intake (ie higher protein and fat contributions, lower carbohydrate contribution). Emotional eating was positively correlated to body mass index in women only (P< or =0.01). External eating was mainly a characteristic of children (P< or =0.001). CONCLUSION: As in overweight subjects, clear relationships were found in this sample of general population between dietary intakes and eating style. The population will be followed up for 10y. In the long term, these results should have implications in the prevention of obesity.

Adolescent↗
PubMed2002

Trends in overweight and obesity in middle-aged subjects from southwestern France, 1985-1997.

The trends in overweight and obesity between 1985 and 1997 were assessed in southwestern France using data from three independent, cross-sectional representative samples of the population aged 35-64 y: 678 men and 645 women in 1985-1987, 586 men in 1989-1991, and 614 men and 569 women in 1995-1997. Men had higher rates of overweight, whereas prevalence rates for obesity were similar between genders. In men, prevalence rates for overweight and obesity were respectively 50 and 10% in 1985-1987, 49 and 13% in 1989-1991, and 50 and 13% in 1995-1997; in women, prevalence rates were respectively 26 and 11% in 1985-1987 and 25 and 11% in 1995-1997; only the prevalence of obesity increased significantly in men. In both genders, prevalence rates of overweight and obesity increased with age group. We conclude that overweight and obesity have remained relatively stable in southwestern France, but the reasons for such a stability remain to be assessed.

Adult↗
PubMed2002

Trends in overweight and obesity among adults in Canada (1970-1992): evidence from national surveys using measured height and weight.

PURPOSE: To examine secular trends in obesity and overweight among Canadian adults between 1970 and 1992. The impact of education level and smoking on weight trends is explored. DATA: Adults aged 20-69 participating in three national health surveys which obtained measured height and weight: the Nutrition Canada Survey conducted between 1970 and 1972 (analysis sample n=5963); the Canada Health Survey of 1978-1979 (analysis sample n=3622); and the Canadian Heart Health Surveys conducted between 1986 and 1992 (analysis sample n=17 699). METHODS: Comparison of percentage overweight (age-standardized body mass index (BMI) 25.0-29.9) and obese (age-standardized BMI > or = 30.0) by sex, education level and smoking status across the three surveys. RESULTS: Among men, the proportion overweight and obese increased steadily from 1970-1972 to 1986-1992. Among women, there was a substantial increase in the proportion overweight and obese between 1970-1972 and 1978-1979, then an increase in proportion obese, but not overweight, between 1978-1979 and 1986-1992. Although the prevalence of obesity increased in all education levels, the sub-groups with the greatest relative increase are men in the primary education category, and women in the secondary and post-secondary between 1970-1972 and 1986-1992. An increase in the prevalence of obesity was greatest among current smokers and, to a lesser extent, among former smokers. CONCLUSION: While excess weight has become an increasing public health problem among Canadian adults, the rate of increase in prevalence of obesity since 1970 varied with sex, education level and smoking status. There is a need for new data on measured heights and weights of Canadian adults and children and youth to update trends.

Adult↗
PubMed2002

Why lose weight? Reasons for seeking weight loss by overweight but otherwise healthy men.

OBJECTIVE: To identify the reasons for seeking weight loss in overweight or obese but otherwise healthy men. DESIGN: Interviews, prior to intervention, with subjects who had volunteered to participate in a work-site-based weight loss study. SUBJECTS: Ninety-one overweight/obese male workers. Mean age 41, range 18-55 y, mean body mass index (BMI) 31.0, range 26.2-41.6 kg/m(2). MEASUREMENTS: Anthropometric measurements; body weight and height. Body mass index calculated. A short interview using open questions to determine the individuals reason for seeking weight loss. RESULTS: The message that weight loss is beneficial to health for the overweight was recognized by all subjects regardless of BMI, and was reported as the main factor for attempting weight loss. Improved fitness and effects on appearance and well-being were reported half as often as the primary reason for weight loss. CONCLUSION: Overweight lay members of the public have accepted the health education message that weight loss can improve health. Overweight but otherwise healthy men who responded, of their own accord, to an electronic mail message offering help to lose weight did not regard obesity and overweight as primarily a cosmetic issue. This is still, however, important, especially to younger people. doi:10.1038/sj.ijo.0801999

Adolescent↗
PubMed2002

Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982-1997.

OBJECTIVE: To examine the prevalence of overweight and obesity in the entire population of 5- and 6-y-old children entering school in Germany, Bavaria, and to assess time trends over the last 15 y and the impact of ethnicity. DESIGN: Cross-sectional studies were based on the obligatory school entry health examinations: all health districts of Bavaria in 1997 (n=127 735); three health districts every 5 y from 1982 to 1997 (n=16 281). MEASUREMENTS: Body mass index (BMI; kg/m(2)) was calculated and the prevalence of overweight and obesity was defined based on national and international agreed cut-off points. Ethnicity was measured as German and non-German nationality. RESULTS: The prevalence of overweight and obese children as defined by international reference values was 9.4 and 3.1% for 5-y-old boys, 10.0 and 2.9% for 6-y-old boys, 12.2 and 3.3% for 5-y-old girls and 12.4 and 3.3% for 6-y-old girls. The whole BMI distribution in non-German children compared to German children was shifted to the right with median values in non-German children 0.3-0.5 kg/m(2) higher. In these the prevalence of overweight/obesity was 1.9/2.4 times higher for boys and 1.5/1.9 times higher for girls. The time trend between 1982 and 1997 shows an increase of the BMI distribution in the upper percentiles, whereas the lower percentiles did not change substantially. The increased prevalences of overweight/obesity for both sexes as defined by international references increased from 8.5/1.8% in 1982 to 12.3/2.8% in 1997. CONCLUSION: This large study on all children entering school in Bavaria in 1997 shows patterns of overweight and obesity which are comparable with other European data but are lower than US and Australian data. Increasing prevalences since 1982 indicate that overweight and obesity in children are of increasing public health importance in Bavaria. The upwards shift of the BMI distribution in non-German children needs further investigation.

Age Distribution↗
PubMed2002

Possible risk factors in the development of eating disorders in overweight pre-adolescent girls.

OBJECTIVES: To investigate concerns about weight, shape and eating, dietary restraint, self-esteem and symptoms of depression in overweight girls. To investigate the relationship between concerns and self-esteem and depressive symptoms in this group. METHOD: Eighteen overweight girls and 18 average-weight girls completed the child version of the Eating Disorders Examination, the Harter Self-Perception Profile and the Short Moods and Feelings Questionnaire. RESULTS: Overweight girls had more concerns about weight, shape and eating and attempted dietary restraint more often. They had more negative self-esteem related to their athletic competence, physical appearance and global self-worth and more symptoms of depression. There was an association between concerns and self-esteem based on physical appearance in the overweight group. CONCLUSION: Overweight girls show some of the psychological features associated with the development of eating disorders, including a link between concerns and self-esteem based on physical appearance. This may help to explain why childhood obesity increases the risk of a later eating disorder.

Affect↗
PubMed2003

Insulin sensitivity is increased and fat oxidation after a high-fat meal is reduced in normal-weight healthy men with strong familial predisposition to overweight.

OBJECTIVE: To evaluate whether postprandial abnormalities of energy expenditure and/or lipid oxidation are present in healthy, normal-weight subjects with a strong family history of obesity and thus at high risk to become obese. DESIGN: Case-control study. SUBJECTS: A total of 16 young healthy men participated in the study. Eight subjects had both parents overweight (father's and mother's body mass index (BMI) >25 kg/m(2)) and eight had both parents with normal body weight (father's and mother's BMI<25 kg/m(2), respectively). The group of subjects with overweight parents was similar to that with normal-weight parents (control group) in terms of BMI (23.7+/-1.7 vs 22.7+/-1.1 kg/m(2)) (M+/-s.d.) and fat-free body mass (FFM) (60.5+/-4.9 vs 58.4+/-2.0 kg), but was slightly older than the control group (25.4+/-3.3 vs 22.7+/-2.4 y; P<0.05). MEASUREMENTS: Energy expenditure (EE) was measured by indirect calorimetry, and blood samples were taken for the evaluation of metabolic variables in the fasting state and every hour for 8 h after a standard fat-rich meal (protein 15%, carbohydrate 34%, fat 51%, 4090 kJ). RESULTS: Fasting plasma glucose, cholesterol, HDL-cholesterol, triglyceride, free fatty acid (FFA) and leptin concentrations were similar in both groups of participants, but subjects with overweight parents has significantly lower plasma insulin concentrations (5.11+/-0.51 vs 7.07+/-1.56 microU/ml; P<0.007) and HOMA index of insulin resistance (1.1+/-0.1 vs 1.6+/-0.4; P<0.01). Postprandial plasma glucose, triglyceride, FFA and leptin concentrations were similar in the two groups, whereas insulin levels were significantly lower in the group with both parents overweight at 3, 5, 6, 7 and 8 h. Fasting and postprandial EE, and fasting lipid and carbohydrate oxidation were similar in both groups. On the contrary, postprandial carbohydrate oxidation (incremental area under curve) was significantly higher (196.25+/-94.75 vs 75.88+/-74.72 mg/kg FFM x 8 h; P<0.007) and that of lipid oxidation lower (90.93+/-80.32 vs 163.68+/-108.22 mg/kg FFM x 8 h; P<0.05) in the group of subjects with overweight parents. CONCLUSION: Normal-weight subjects with a strong family history of obesity present a reduced lipid oxidation in the postprandial period and a metabolic profile characterized by low plasma insulin levels and the HOMA index, which is compatible with increased insulin sensitivity. These metabolic characteristics may be considered as early predictors of weight gain and are probably genetically determined.

Adult↗
PubMed2003

Sitting time and work patterns as indicators of overweight and obesity in Australian adults.

BACKGROUND: Increasing levels of physical inactivity and sedentariness are contributing to the current overweight and obesity epidemic. In this paper, the findings of two recent studies are used to explore the relationships between sitting time (in transport, work and leisure), physical activity and body mass index (BMI) in two contrasting samples of adult Australians. METHODS: Data on sitting time, physical activity, BMI and a number of demographic characteristics were compared for participants in two studies-529 women who were participants in a preschool health promotion project ('mothers'), and 185 men and women who were involved in a workplace pedometer study ('workers'). Relationships between age, number of children, physical activity, sitting time, BMI, gender and work patterns were explored. Logistic regression was used to predict the likelihood of being overweight or obese, among participants with different physical activity, sitting time and work patterns. RESULTS: The total reported time spent sitting per day (across all domains) was almost 6 h less among the mothers than the workers (P<0.001), and compared with the mothers, a significantly greater proportion of the workers was classified as overweight or obese (BMI > or =25 kg/m(2)). Univariate analysis found that, compared with men in full-time work, women who worked full-time (OR=0.42, CI: 0.24-0.74), part-time (OR=0.35, CI: 0.20-0.59) or in full-time home duties (OR=0.51, CI: 0.29-0.88) were about half as likely to be overweight or obese. Participants who reported high daily levels of sitting (> or =7.4 h) were also significantly more likely than those who reported 'low' levels (<4.7 h/day) to be overweight or obese (OR=1.68, CI: 1.16-2.42). Multivariate analysis (including physical activity, work patterns and sitting time) confirmed that full-time and part-time working women (but not 'home duties' women) were less likely to report BMI > or =25 kg/m(2) than full-time working men (full-time: OR=0.44, CI: 0.25-0.78; part-time: OR=0.45, CI: 0.24-0.86), but the OR for BMI > or =25 among those in the high sitting category was attenuated (OR=1.61, CI 0.96-2.71). CONCLUSIONS: The findings suggest a need for inclusion of measures of both activity and inactivity in future studies, so that the complex relationships between these behavioural determinants of BMI can be clarified.

Adolescent↗
PubMed2004

Overweight Japanese with body mass indexes of 23.0-24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians.

OBJECTIVE: The degree of obesity of Asians is less than that of Caucasians. It has been suggested that Japanese, categorized as having normal weight (BMI<25.0), as defined by WHO (2000), have a tendency toward increased incidences of dyslipidemia and diabetes. Our objective was to analyze parameters constituting obesity-associated disorders in overweight Japanese and Mongolians with a body mass index (BMI) of 23.0-24.9, and to assess the suitability for Asians of the Regional Office for Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000). DESIGN: Cross-sectional study in a workplace setting. SUBJECTS: A total of 386 Japanese men and 363 Japanese women, and 102 Mongolian men and 155 Mongolian women. MEASUREMENTS: Anthropometric measurements (weight, height, waist circumference, hip circumference and blood pressure) and metabolic measurements (plasma levels of total cholesterol, HDL cholesterol, triglyceride, glucose and insulin). RESULTS: Graded increases in BMI of Japanese and Mongolians were positively associated with body fat percent, waist circumference, hip circumference and waist/hip ratio. The Japanese were categorized as 22% overweight, 22% obese I, 3% obese II; the Mongolians rated as 18% overweight, 34% obese I, 19% obese II, based on the WPRO BMI criteria. The Mongolians had a higher prevalence of obesity and a higher body fat percent, but a lesser gradation of dyslipidemia, than did the BMI-matched Japanese groups. Overweight Japanese (BMI 23.0-24.9), in comparison to normal Japanese (BMI 18.5-22.9), had significant differences in systolic blood pressure, HDL-cholesterol and triglyceride in men, and in systolic and diastolic blood pressure, HDL-cholesterol, triglyceride, insulin and Homoeostasis model assessment-insulin resistance in women. In contrast, the Mongolians showed no significant differences in metabolic parameters between overweight and normal subjects, except for diastolic blood pressure. CONCLUSION: Since the relationship between abdominal fat mass and BMI is ethnic-specific, a universal BMI cutoff point is inappropriate for Asian populations such as the Japanese and Mongolians. The present investigation suggests that, while the WPRO criteria are suitable for Japanese, the WHO criteria are more appropriate for Mongolians.

Adult↗
PubMed2004

Association between stunting and overweight among 10-15-y-old children in the North West Province of South Africa: the THUSA BANA Study.

OBJECTIVE: To investigate the relationship between stunting and overweight among 10-15-y-old children of the North West Province in South Africa. DESIGN: A single cross-sectional study design was used. The study formed part of the THUSA BANA project. SUBJECTS: The total study population of the THUSA BANA project comprised of 1257 randomly selected subjects, aged 10-15 y. MEASUREMENTS: Stunting was described as the height below the 5th percentile for age using the CDC standard percentiles. Furthermore, the definitions of overweight and obesity according to the International Obesity Task Force (IOTF) were used, where the cutoff points for body mass index (BMI) corresponds with the adult BMI of 25 and 30, respectively. Anthropometrical variables namely triceps (TSF) and subscapular skinfolds (SSF), waist circumference, weight, height and BMI of the 10-15-y-old subjects were analysed. RESULTS: Stunting was most prevalent in the rural areas (girls 23.7% and boys 26.7%) compared with urban areas (girls 11.6%, boys 17.1%). The odds ratio and the 95% CI for the association between stunting and overweight in boys and girls were 0.45 (CI 0.16, 1.30) and 0.50 (CI 0.21, 1.19) respectively. Stunted children, 10-14-y-old and living in rural areas and informal settlements, had significantly lower mean BMI and skinfold thicknesses than nonstunted children. The mean BMI and sum of TSF and SSF (TSF+SSF) were similar in stunted and nonstunted children living in urban areas. CONCLUSION: There is no significant association between stunting and overweight in 10-15-y-old children in the North West Province. However, there is a tendency for girls older than 14 y to start to gain subcutaneous fat, even though at these ages they were still stunted and underweight. Stunted girls in established urban areas had a higher mean TSF+SSF than stunted girls in informal townships. This tendency in urban stunted girls is evident at the onset of menarche and could predict possible problems of overweight as they get older.

Adolescent↗
PubMed2004

Insulin sensitivity is increased and fat oxidation after a high-fat meal is reduced in normal-weight healthy men with strong familial predisposition to overweight.

OBJECTIVE: To evaluate whether postprandial abnormalities of energy expenditure and/or lipid oxidation are present in healthy, normal-weight subjects with a strong family history of obesity and thus at high risk to become obese. DESIGN: Case-control study. SUBJECTS: A total of 16 young healthy men participated in the study. Eight subjects had both parents overweight (father's and mother's body mass index (BMI) >25 kg/m(2)) and eight had both parents with normal body weight (father's and mother's BMI<25 kg/m(2), respectively). The group of subjects with overweight parents was similar to that with normal-weight parents (control group) in terms of BMI (23.7+/-1.7 vs 22.7+/-1.1 kg/m(2)) (M+/-s.d.) and fat-free body mass (FFM) (60.5+/-4.9 vs 58.4+/-2.0 kg), but was slightly older than the control group (25.4+/-3.3 vs 22.7+/-2.4 y; P<0.05). MEASUREMENTS: Energy expenditure (EE) was measured by indirect calorimetry, and blood samples were taken for the evaluation of metabolic variables in the fasting state and every hour for 8 h after a standard fat-rich meal (protein 15%, carbohydrate 34%, fat 51%, 4090 kJ). RESULTS: : Fasting plasma glucose, cholesterol, HDL-cholesterol, triglyceride, free fatty acid (FFA) and leptin concentrations were similar in both groups of participants, but subjects with overweight parents has significantly lower plasma insulin concentrations (5.11+/-0.51 vs 7.07+/-1.56 microU/ml; P<0.007) and HOMA index of insulin resistance (1.1+/-0.1 vs 1.6+/-0.4; P<0.01). Postprandial plasma glucose, triglyceride, FFA and leptin concentrations were similar in the two groups, whereas insulin levels were significantly lower in the group with both parents overweight at 3, 5, 6, 7 and 8 h. Fasting and postprandial EE, and fasting lipid and carbohydrate oxidation were similar in both groups. On the contrary, postprandial carbohydrate oxidation (incremental area under curve) was significantly higher (196.25+/-94.75 vs 75.88+/-74.72 mg/kg FFM x 8 h; P<0.007) and that of lipid oxidation lower (90.93+/-80.32 vs 163.68+/-108.22 mg/kg FFM x 8 h; P<0.05) in the group of subjects with overweight parents. CONCLUSION: Normal-weight subjects with a strong family history of obesity present a reduced lipid oxidation in the postprandial period and a metabolic profile characterized by low plasma insulin levels and the HOMA index, which is compatible with increased insulin sensitivity. These metabolic characteristics may be considered as early predictors of weight gain and are probably genetically determined.

Adult↗
PubMed2004

The influence of the stigma of obesity on overweight individuals.

OBJECTIVE: To investigate the internalization of anti-fat bias among overweight individuals across a variety of attitudes and stereotypes. DESIGN: Two studies were conducted using the Implicit Association Test (IAT), a performance-based measure of bias, to examine beliefs among overweight individuals about 'fat people' vs 'thin people'. Study two also contained explicit measures of attitudes about obese people. SUBJECTS: Study 1 participants were 68 overweight patients at a treatment research clinic (60 women, 8 men; mean Body Mass Index (BMI) of 37.1+/-3.9 kg/m(2)). Study 2 involved 48 overweight participants (33 women, 15 men) with a BMI of 34.5+/-4.0 kg/m(2). RESULTS: Participants exhibited significant anti-fat bias on the IAT across several attributes and stereotypes. They also endorsed the explicit belief that fat people are lazier than thin people. CONCLUSION: Unlike other minority group members, overweight individuals do not appear to hold more favorable attitudes toward ingroup members. This ingroup devaluation has implications for changing the stigma of obesity and for understanding the psychosocial and even medical impact of obesity on those affected.

Adult↗
PubMed2004

Overweight and obesity and the burden of disease and disability in elderly men.

OBJECTIVE: To examine the prevalence of disease burden and disability associated with overweight and obesity in men aged 60-79 y and to assess whether the current WHO weight guidelines are appropriate in the elderly. DESIGN: Cross-sectional survey 20 y after enrollment. SETTING: General practices in 24 British towns. PARTICIPANTS: In total, 4232 men aged 60-79 y (77% of survivors) with measured weight and height. MAIN OUTCOME MEASURES: Cardiovascular (CV) risk factors, prevalence of diabetes, cardiovascular disease, cancer, disability and regular medication. RESULTS: In total, 17% of the men were obese (body mass index (BMI) >/=30 kg/m(2)) and a further 52% were overweight (BMI 25-29.9 kg/m(2)). Prevalence of hypertension, low HDL-cholesterol, high triglycerides and insulin resistance and the prevalence of most disease outcomes increased with increasing degrees of overweight/obesity. Men in the normal weight range (18.5-24.9 kg/m(2)) had the lowest prevalence of ill health. Compared with normal weight men, obese men showed a two-fold risk of major CVD (odds ratio (OR)=1.96, 95% CI 1.44-2.67) and locomotor disability (OR=2.26, 95% CI 1.66, 3.09) and were nearly three times as likely to have diabetes, CV interventions or to be on CV medication. Over 60% of the prevalence of high insulin resistance was attributable to overweight and obesity as was over a third of diabetes and hypertension, a quarter of locomotor disability and a fifth of major CVD. CONCLUSION: In elderly men, overweight and obesity are associated with a significantly increased burden of disease, in particular CV-related disorders and disability. The current guidelines for overweight and obesity appear to be appropriate in elderly men.

Aged↗
PubMed2005

Schema and parental bonding in overweight and nonoverweight female adolescents.

OBJECTIVE: To investigate whether family functioning and cognitions in a group of overweight female adolescents differ significantly from those in a group of normal weight female adolescents. DESIGN: Cross-sectional study. SUBJECTS: In all, 23 overweight female adolescents (mean age: 17.6 y, mean body mass index (BMI: 27.8 kg/m2), and 23 normal weight female adolescents (mean age: 17.7 y, mean BMI: 20.2 kg/m2). MEASUREMENTS: The following self-report measures were completed: the Parental Bonding Inventory, the Young Schema Questionnaire-short version, the Eating Attitudes Test, the Beck Depression Inventory and the Eating Disorder Belief Questionnaire. RESULTS: Overweight female adolescents reported more negative self-beliefs and greater belief in schema relating to emotional deprivation, fears of abandonment, subjugation and insufficient self-control. They also perceived their fathers as being significantly more overprotective and significantly less caring. Within this group perceived level of maternal care correlated negatively with negative self-beliefs and schema. CONCLUSIONS: Overweight female adolescents show some of the cognitive features associated with the development of an eating disorder. However, positive parent-child relationships may serve to protect overweight adolescents from developing clinical eating disorders and from psychological distress later in life.

Adolescent↗
PubMed2005

Disc degeneration of the lumbar spine in relation to overweight.

OBJECTIVE: To study the association between overweight and lumbar disc degeneration. DESIGN: Population-based 4-y follow-up magnetic resonance imaging (MRI) study. SUBJECTS: The subjects were 129 working middle-aged men selected to the baseline magnetic resonance imaging (MRI) study from a cohort of 1832 men representing three occupations: machine drivers, construction carpenters, and office workers. The selection was based on the paticipants' age (40-45 y) and place of residence. MR images of the lumbar spines were obtained at baseline and at 4-y follow-up. MEASUREMENTS: Signal intensity of the nucleus pulposus of the discs L2/L3-L4/L5 was visually assessed by two readers using the adjacent cerebrospinal fluid as an intensity reference. The weight (at age 25 and 40-45 y) and height of the subjects, history of car driving, smoking, and back injuries were assessed by questionnaire. RESULTS: Multiple regression analyses allowing for occupation, history of car driving, smoking, and back injuries showed that persistent overweight (body mass index (BMI) > or =25 kg/m(2) at both ages) associated strongly with an increased risk of the number of lumbar discs with decreased signal intensity of nucleus pulposus at follow-up, adjusted odds ratio (OR) being 4.3 (95% confidence intervals (95% CIs) 1.3-14.3). Overweight at young age (risk ratio (RR) 3.8; 95% CI 1.4-10.4) was a stronger predictor of an increase in the number of degenerated discs during follow-up than overweight in middle age (RR 1.3; 95% CI 0.7-2.7). CONCLUSIONS: The study provides evidence that the BMI above 25 kg/m(2) increases the risk of lumbar disc degeneration. Overweight at young age seems to be particularly detrimental.

Adult↗
PubMed2003

Does maternal smoking during pregnancy cause childhood overweight?

The objective of this study was to examine a possible association between maternal smoking in pregnancy and childhood overweight. From a population-based cohort of 5722 women from Trondheim, Bergen (Norway) and Uppsala (Sweden) enrolled in early pregnancy during 1986-92, a random sample of 482 women was selected for participation. They were followed up throughout pregnancy, and their children from birth until 5 years of age. Data on maternal smoking and diet, socio-economic determinants and breast feeding were recorded prospectively. During pregnancy and childhood, anthropometric measures were also recorded. Maternal smoking status was based on reported number of cigarettes smoked in week 17 of pregnancy. Child overweight was defined by body mass index (BMI) and sum of skinfold thickness (SFT) >or= 85th percentile at 5 years of age. Children of mothers who smoked in pregnancy had increased risk of overweight at 5 years of age (RR 2.5, 95% CI 1.5, 4.2 for BMI; and RR 1.8, 95% CI 1.1, 3.0 for SFT). Adjusting for maternal diet, breast feeding, maternal obesity and socio-economic status did not suggest confounding. However, adjustment for birthweight increased the observed risk. A linear increase in BMI and SFT was observed with increasing number of cigarettes smoked. In conclusion, smoking during pregnancy may be a risk factor for development of childhood overweight. This study may support the hypothesis of 'fetal origin of adult disease', but the risk of overweight associated with smoking during pregnancy was independent of intrauterine growth retardation, and may thus be attributed to specific effects of cigarette smoke.

Birth Weight↗