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PubMed1987

Geographical and socioeconomic distribution of overweight and morbidity in a rural Swedish county.

This report overweight is based on a cross-sectional study in Skaraborg County, Sweden, in 1977. Mean values of Body Mass Index (BMI) are higher in this county than in other areas studied in Sweden and abroad. In correlation analysis the strongest association was found between overweight and hypertension. This is of particular interest since other studies have shown that Skaraborg county, has one of Sweden's highest proportions of treated hypertensives and also higher mortality during the 1970s in hypertension and obesity related diseases. The BMI varied between the municipalities of the county. Overweight was most common in the agricultural municipalities. The mean value of the BMI was higher among workers and persons with less formal education. This is contradictory to earlier Swedish studies with regard to men but not women. Physically demanding jobs accounted for more overweight individuals whereas high physical activity during leisure time was correlated with low body weight.

Adult↗
PubMed2004

Primary cartilage lesions of the knee joint in young male adults. Overweight as a predisposing factor. An arthroscopic study.

BACKGROUND AND AIMS: This study was undertaken to evaluate the relationship between overweight and severity of arthroscopically confirmed primary cartilage lesions of the knee. MATERIAL AND METHODS: The hospital records of 88 young male adults (98 knees), who underwent arthroscopy of the knee and were diagnosed of primary cartilage lesion during 1997-98, were reviewed. The depth of the lesions was graded according to Beguin and Locker classification. RESULTS: 73.5 % of the lesions were patellar and 12.0 % in the medial condyle of the femur. 74.5 % of the patients had superficial (grade I-II) and 25.5 % deep (grade III-IV) lesions. Patients with deep lesions had a significantly higher body mass index (BMI 25.3 vs. 22.9, p < 0.001) and they were older (20.8 vs. 19.7 years, p = 0.023) than other patients. Similarly, patients with overweight (BMI > or = 25.0) had significantly more often deep lesions than other patients (50 % vs. 10.4 %, p < 0.001). CONCLUSIONS: These results suggest, that overweight may predispose young patients to more severe cartilage lesions independent of other etiologic factors, and support the hypothesis of the cumulative effect of overweight on cartilage injuries during early adult life.

Adult↗
PubMed2005

Measuring body composition in overweight individuals by dual energy x-ray absorptiometry.

BACKGROUND: Dual energy x-ray absorptiometry (DXA) is widely used for body composition measurements in normal-weight and overweight/obese individuals. The limitations of bone densitometers have been frequently addressed. However, the possible errors in assessing body composition in overweight individuals due to incorrect positioning or limitations of DXA to accurately assess both bone mineral density and body composition in obese individuals have not received much attention and are the focus of this report. DISCUSSION: We discuss proper ways of measuring overweight individuals and point to some studies where that might not have been the case. It appears that currently, the most prudent approach to assess body composition of large individuals who cannot fit under the scanning area would be to estimate regional fat, namely the regions of thigh and/or abdomen. Additionally, using two-half body scans, although time consuming, may provide a relatively accurate measurement of total body fat, however, more studies using this technique are needed to validate it. SUMMARY: Researchers using bone densitometers for body composition measurements need to have an understanding of its limitations in overweight individuals and address them appropriately when interpreting their results. Studies on accuracy and precision in measurements of both bone and soft tissue composition in overweight individuals using available densitometers are needed.

Journal Article↗
PubMed2005

Ethnic variation in validity of classification of overweight and obesity using self-reported weight and height in American women and men: the Third National Health and Nutrition Examination Survey.

BACKGROUND: Few data have been published on the validity of classification of overweight and obesity based on self-reported weight in representative samples of Hispanic as compared to other American populations despite the wide use of such data. OBJECTIVE: To test the null hypothesis that ethnicity is unrelated to bias of mean body mass index (BMI) and to sensitivity of overweight or obesity (BMI > or = 25 kg/m2) derived from self-reported (SR) versus measured weight and height using measured BMI as the gold standard. DESIGN: Cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey (NHANES III) conducted in 1988-1994. PARTICIPANTS: American men and women aged 20 years and over (n = 15,025). MEASUREMENTS: SR height, weight, cigarette smoking, health status, and socio-demographic variables from home interview and measured weight and height. RESULTS: In women and Mexican American (MA) men SR BMI underestimated true prevalence rates of overweight or obesity. For other men, no consistent difference was seen. Sensitivity of SR was similar in non-Hispanic European Americans (EA) and non-Hispanic African Americans (AA) but much lower in MA. Prevalence of obesity (BMI > or = 30 kg/m2) is consistently underestimated by self-report, the gap being greater for MA than for other women, but similar for MA and other men. The mean difference between self-reported and measured BMI was greater in MA (men -0.37, women -0.76 kg/m2) than in non-Hispanic EA (men -0.22, women -0.62 kg/m2). In a regression model with the difference between self-reported and measured BMI as the dependent variable, MA ethnicity was a significant (p < 0.01) predictor of the difference in men and in women. The effect of MA ethnicity could not be explained by socio-demographic variables, smoking or health status. CONCLUSION: Under-estimation of the prevalence of overweight or obesity based on height and weight self-reported at interview varied significantly among ethnic groups independent of other variables.

Adult↗
PubMed2005

Training enhances ANP lipid-mobilizing action in adipose tissue of overweight men.

PURPOSE: This study was designed to evaluate whether a 4-month endurance training program could improve ANP- as well as isoproterenol-mediated (beta-adrenergic receptor agonist) in situ lipolysis and adipose tissue blood flow (ATBF) in the subcutaneous adipose tissue (SCAT) of untrained overweight subjects. METHODS: Ten overweight men aged 26.0 +/- 1.4 yr with a mean body mass index of 27.6 +/- 0.2 kg.m(-2), performed aerobic exercise 5 d.wk(-1) for 4 months. Before and after the training period, SCAT responsiveness was investigated in situ during a 60-min infusion of 1 micromol.L(-1) isoproterenol and 10 micromol.L(-1) ANP through microdialysis probes. Plasma metabolic parameters and physical fitness variables were measured as well. RESULTS: Endurance training significantly increased fat-free mass and VO2max, while reducing plasma insulin, glucose, NEFA, low density lipoprotein (LDL)-C and the respiratory exchange ratio at rest. Training significantly lowered resting dialysate glycerol levels in SCAT. The lipid-mobilizing effect of ANP was markedly enhanced (by 191%, P < 0.05) after training as was that of isoproterenol (by 145%, P < 0.05). Resting adipose tissue blood flow as well as ANP- and isoproterenol-mediated rise in ATBF was increased after training. CONCLUSION: The present study shows that endurance training improves ANP- as well as beta-adrenergic-receptor-mediated lipid mobilization and ATBF in the SCAT of overweight subjects. The recovery of a higher lipolytic efficiency in adipose tissue is an important benefit of a training program in overweight subjects.

Adipose Tissue↗
PubMed2002

Negative affect and binge eating in overweight women.

OBJECTIVES: Binge eating among overweight women is associated with adverse physical and psychological consequences, and is known to occur in response to negative affect. This study sought to examine the role played by individual differences in coping style in the relationship between negative affect and binge eating. METHOD: Overweight women (N = 105) completed a battery of questionnaires that assessed their binge eating severity, negative affect, and dispositional coping style. RESULTS: Women with higher levels of negative affect had more severe binge eating problems than those who generally experienced a low level of affective distress. Among those who were low in negative affect, however, those who tended to use the dysfunctional strategy of disengagement to cope with stress reported more severe binge eating than those who reported they were less likely to employ this coping style. CONCLUSIONS: The findings from this study emphasize the complexity and multicausality of affect-related binge eating in overweight women. Prospective studies are required to establish the role of negative affect and coping style in the onset and progression of recurrent binge eating among overweight individuals.

Journal Article↗
PubMed2000

Clinical evaluation of the overweight patient.

Evaluation of an overweight patient is the first step in any therapeutic program. The syndromes of obesity can be classified in several ways. The first is an anatomic classification based on the size, number, and distribution of fat cells and fat tissue. The second is an etiologic classification based on identification of specific diseases and settings that produce obesity. Hypothalamic injury and endocrine disease such as Cushing's disease and the polycystic ovary syndrome are three identifiable causes of obesity. In this medicated society drugs are always candidates to produce weight gain. The most common causes, however, are stopping smoking, overconsumption of high-fat foods, a decrease in the level of activity, and aging. The natural history of obesity provides a useful framework in which to view both preventive and therapeutic strategies. Some individuals will never become overweight, but of those who do, about one-third will do so during the first two decades, and the remaining two-thirds will become overweight after age 20. A number of epidemiological and metabolic factors can serve as a guide to those individuals who are at high risk. Having overweight parents tops the list, but multiple births, cessation of smoking, and a sedentary lifestyle are additional factors. Therapeutic decisions should be based on risk-benefit decisions. The risk can be assessed from the body mass index, the distribution of fat in upper or lower body obesity, the rate of weight gain, and the degree of physical inactivity. After assessing risk, the therapeutic choices can be selected from the age category of the patient. With any therapeutic activity, involvement of the patient in a realistic approach to the treatment process is essential.

Adipose Tissue↗
PubMed2003

The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers.

Obesity occurs less frequently in Japanese than in various other ethnic populations. A person with abnormal glucose tolerance is often found to have one or more of the other cardiovascular disease risk factors, such as obesity, hypertension and hyperlipidemia. This clustering has been labeled as metabolic syndrome (WHO, 1998). It was suggested that Japanese, categorized as having normal weight (BMI of less than 25.0), as defined by the WHO (2000), have an increasing tendency toward metabolic syndrome. Our objective was to analyze metabolic syndrome in "Overweight" with BMI of 23.0-24.9 in Japanese workers, and to assess the suitability for Asians of the Regional Office for the Western Pacific Region of WHO criteria pertaining to obesity (WPRO criteria, 2000). We conducted a cross-sectional study in the workplace setting and investigated the relationship between BMI classification based on WPRO criteria and metabolic syndrome by gender and age group (18-44 yr vs. 45-60 yr). Three hundred seventy-nine men and 432 women Japanese workers participated in this study. BMI were categorized as 20% "Overweight" (23.0-24.9 BMI), 20% "Obese I" (25.0-29.9 BMI) and 2% "Obese II" (over 30.0 BMI), based on WPRO criteria. Graded increases in BMI were positively associated with body fat percentage, waist circumference, hip circumference and waist/hip ratio in both genders and age groups. A progressively increasing BMI category in the elder group aged 45-60 yr in both genders was positively related with parameters constituting metabolic syndrome. Graded increases in BMI classes in elder workers based on WPRO criteria were positively associated with prevalence of metabolic syndrome, and "Overweight" elder women had significantly higher prevalence of metabolic syndrome. The present investigation, based on the increasing risks of "Overweight" with a BMI of 23.0-24.9, suggests that WPRO criteria are suitable for Japanese workers aged over 45 yr.

Adolescent↗
PubMed2002

Television viewing and television in bedroom associated with overweight risk among low-income preschool children.

CONTEXT: Television (TV) viewing is associated with obesity among school-aged children, adolescents, and adults, but this relationship has not been evaluated in preschool-aged children. OBJECTIVE: To describe the TV/video viewing habits of a multiethnic, low-income preschool population of children and to determine whether TV/video viewing is related to their adiposity. DESIGN: Cross-sectional survey of parents/guardians with measurements of children's height and weight. SETTING AND PARTICIPANTS: Two thousand seven hundred sixty-one adults with children, 1 through <5 years, from 49 New York State agencies of the Supplemental Nutrition Program for Women, Infants, and Children. OUTCOME MEASURES: Cross-sectional relationships between the amount of time the child spends viewing TV/video and the presence of a TV set in the child's bedroom, with the prevalence of overweight children (body mass index [BMI] >85th percentile) after adjustment for potential confounders. RESULTS: Mean TV/video viewing times were higher among black children and Hispanic children than white children and increased with the child's age. In multiple logistic regression, the odds ratio of children having a BMI >85th percentile was 1.06 (95% confidence interval [CI]: 1.004-1.11) for each additional hour per day of TV/video viewed, independent of child age, child sex, parental educational attainment, and race/ethnicity. Almost 40% of children had a TV set in their bedroom; they were more likely to be overweight and spent more time (4.6 hours per week) watching TV/video than children without a TV in their bedroom. In multiple logistic regression, the odds ratio of having a BMI >85th percentile was 1.31 (95% CI: 1.01-1.69) among those with a TV in their bedroom versus those without a TV, after statistical adjustment for child age, child sex, child TV/video viewing hours per week, maternal BMI, maternal education, and race/ethnicity. CONCLUSIONS: This study extends the association between TV viewing and risk of being overweight to younger, preschool-aged children. A TV in the child's bedroom is an even stronger marker of increased risk of being overweight. Because most children watch TV by age 2, educational efforts about limiting child TV/video viewing and keeping the TV out of the child's bedroom need to begin before then.

Body Height↗
PubMed2003

[Overweight and obesity prevalences in male adolescents in Northeast Brazil, 1980-2000].

This study aimed to determine the prevalence rates for overweight and obesity among male adolescents in the States of Northeast Brazil from 1980 to 2000, and to compare them over time to identify trends. The Brazilian Army database was used, with information on 316,925 adolescent conscripts. Overweight was defined as body mass index (BMI) from 25 to 29.9Kg/m and obesity as BMI > 30Kg/m . An upward curve was identified, showing that the secular tendency in the last twenty years increased for both overweight and obesity. The upward trend in overweight and obesity prevalence rates was observed in all States of Northeast Brazil. Although lower prevalence rates were observed than in developed countries, the speed of increase is cause for concern.

Adolescent↗
PubMed2003

[Food intake in overweight and normal-weight adolescents in the city of Rio de Janeiro].

This article compares the food intake of overweight and normal-weight adolescents from 12 to 17.9 years of age (71.8% of the original sample). Data were obtained in a survey performed in the city of Rio de Janeiro, Brazil, in 1995-1996. Food intake was assessed by a semi-quantitative food frequency questionnaire, and nutritional status was assessed by body mass index (BMI = weight/stature ). Adolescents classified as overweight reached the 90th percentile of the 1989 Brazilian BMI distribution. Food intake of overweight and non-overweight subjects was similar. Both groups showed below-minimum-recommended food-group intakes and higher intake of high-density food items. These nutritional habits are risk factors for obesity and chronic diseases later in life.

Adolescent↗
PubMed2003

Prevalence of overweight and obesity among Costa Rican elementary school children.

OBJECTIVE: Given that excessive body weight during childhood influences the development of several chronic diseases in adulthood, this study was conducted to determine the prevalence of overweight and obesity in urban and rural Costa Rican elementary school children. METHODS: The study was carried out from July 2000 to April 2001. A total of 1 718 students ages 7-12 were selected from 34 schools in the capital city of San José and in other nearby urban and rural areas. Both younger children (ones aged 7 through 9 years) and older children (ones aged 10 through 12 years) with a body mass index (BMI) at or above the sex-specific 85th percentile were considered overweight. The younger children were classified as being obese if their triceps skinfold was greater than or equal to the 85th percentile for age and sex using the percentiles by age for children in the United States of America as normative standards. The older children were considered obese if they had a BMI at or above the sex-specific 85th percentile and both the triceps and subscapular skinfold thickness at or above the 90th percentile. RESULTS: The prevalence of overweight was 34.5%. Children aged 7-9, boys, children from urban areas, and children of a higher socioeconomic status had a higher prevalence of overweight. The prevalence of obesity was 26.2%. A higher prevalence of obesity was found among children aged 7-9, boys, children from urban areas, and children of middle socioeconomic status. CONCLUSIONS: Given the high prevalence of obesity that we found in the Costa Rican children, primary and secondary prevention measures are needed in order to reduce the proportion of deaths due to chronic nontransmissible diseases among Costa Rican adults in the coming decades.

Age Factors↗
PubMed2000

New NHLBI clinical guidelines for obesity and overweight: will they promote health?

OBJECTIVES: The purpose of this study was to assess the justification, on the basis of mortality, of the new National Heart, Lung, and Blood Institute (NHLBI) guidelines on obesity and overweight and to discuss the health implications of declaring all adults with a body mass index of 25 through 29 "overweight." METHODS: The relationships between NHLBI body mass index categories and mortality for individuals older than 31 years were analyzed for 6253 Alameda County Study respondents aged 21 through 75 years. Time-dependent proportional hazards models were used to adjust for changes in risk factors and weight during follow-up. RESULTS: Adjusted relative risks of mortality for 4 NHLBI categories compared with the category "normal" indicated that only being underweight or moderately/extremely obese were associated with higher mortality. Specific risk varied significantly by sex. CONCLUSIONS: Our results are consistent with other studies and fail to justify lowering the overweight threshold on the basis of mortality. Current interpretations of the revised guidelines stigmatize too many people as overweight; fail to account for sex, race/ethnicity, age, and other differences; and ignore the serious health risks associated with low weight and efforts to maintain an unrealistically lean body mass.

Adult↗
PubMed2003

Portrayals of overweight and obese individuals on commercial television.

OBJECTIVES: This study examined the distribution and individual characteristics of body types on prime-time television. METHODS: Five episodes of each of the 10 top-rated prime-time fictional programs on 6 broadcast networks during the 1999-2000 season were quantitatively analyzed. RESULTS: Of 1018 major television characters, 14% of females and 24% of males were overweight or obese, less than half their percentages in the general population. Overweight and obese females were less likely to be considered attractive, to interact with romantic partners, or to display physical affection. Overweight and obese males were less likely to interact with romantic partners and friends or to talk about dating and were more likely to be shown eating. CONCLUSIONS: Overweight and obese television characters are associated with specific negative characteristics.

Adult↗
PubMed2004

Measuring the prevalence of overweight in Texas schoolchildren.

OBJECTIVES: We describe results from year 1 of a surveillance system to monitor body mass index in children at the state level. METHODS: A sample of 6630 children attending Texas public schools, weighted to represent 4th, 8th, and 11th grades within race/ethnic subpopulations, was assessed. Body mass index was calculated from measured height and weight; demographic information was obtained from a questionnaire. RESULTS: Prevalence of overweight was 22.4%, 19.2%, and 15.5% for 4th-, 8th-, and 11th-grade students, respectively. Overweight prevalence was highest among Hispanic boys (29.5%-32.6%), fourth-grade Hispanic girls (26.7%), and fourth- and eighth-grade African American girls (30.8% and 23.1%, respectively). Eleventh-grade White/other girls had the lowest prevalence of overweight (5.5%). CONCLUSIONS: These data confirm the increasing prevalence of overweight among US children, especially among Hispanic and African American students compared to White/other students and fourth-grade students relative to 8th- and 11th-grade students.

Adolescent↗
PubMed2004

Public health and clinical recommendations for physical activity and physical fitness: special focus on overweight youth.

Numerous physical activity and physical fitness recommendations exist for youth. To date, however, no investigator has systematically reviewed these public health and clinical guidelines to determine whether the recommendations address overweight youth. This review examines youth-oriented physical activity and physical fitness recommendations for both the public health community and the clinical community, and assesses how overweight youth are specifically targeted by each of these two groups. Our review determined the extent to which the recommendations assessed four components of physical activity (i.e. frequency, intensity, duration and type) and four components of physical fitness (i.e. cardiorespiratory capacity, strength, flexibility and body composition). We further reviewed clinical recommendations to determine how they included two facets of the physician-patient encounter: assessment and counselling. After identifying all current physical activity and physical fitness recommendations for youth, we evaluated whether public health (n = 13) and clinical recommendations (n = 12) addressed physical activity and physical fitness for overweight youth. Findings revealed inconsistent, yet explicit, recommendations for the public health community where most organisations (12 of 13, 92%) included > or =3 physical activity components. In addition, organisations encouraged volumes of daily moderate- to vigorous-intensity physical activity for youth ranging from 30-60 or more minutes. Recommendations for the clinical community generally did not provide explicit physical activity and fitness recommendations to advise physicians on the assessment and counselling of patients and their families. Overweight youth were addressed within some recommendations (6 of 12, 50%) for the clinical community, but within few recommendations (2 of 13, 15%) for the public health community. To best inform public health and clinical communities, organisations developing future recommendations should include information fully documenting the decision-making processes used to develop the recommendations. In cases where mutual goals exist, public health and clinical communities should consider collaborating across agencies to develop joint recommendations.

Adolescent↗
PubMed2004

Trying to lose weight, losing weight, and 9-year mortality in overweight U.S. adults with diabetes.

OBJECTIVE: The aim of this study was to examine the relationships between intention to lose weight, actual weight loss, and all-cause mortality among overweight individuals with diabetes. RESEARCH DESIGN AND METHODS: We performed a prospective analysis among 1,401 overweight diabetic adults aged > or =35 years sampled in the National Health Interview Survey. The previous year intention to lose weight and weight change were assessed by self-report. Nine-year mortality rates were examined according to intent to lose weight and weight loss, which were adjusted for age, sex, education, ethnicity, smoking, initial body weight, and diabetes complications. RESULTS: Individuals trying to lose weight had a 23% lower mortality rate (hazard rate ratio [HRR] 0.77, 95% CI 0.61-0.99) than those who reported not trying to lose weight. This association was as strong for those who failed to lose weight (0.72, 0.55-0.96) as for those who succeeded in losing weight (0.83, 0.63-1.08). Trying to lose weight was beneficial for overweight (BMI 25-30 kg/m2) individuals (0.62, 0.46-0.83) but not for obese (BMI>30) individuals (1.17, 0.72-1.92). Overall weight loss, without regard to intent, was associated with an increase of 22% (1.22, 0.99-1.50) in the mortality rate. This increase was largely explained by unintentional weight loss, which was associated with a 58% (1.58, 1.08-2.31) higher mortality rate. CONCLUSIONS: Overweight diabetic adults trying to lose weight have a reduced risk of all-cause mortality, independent of whether they lose weight. Actual weight loss is associated with increased mortality only if the weight loss is unintentional.

Adolescent↗
PubMed1989

Stereotypical beliefs about overweight and smoking and decision-making in assignments to sales territories.

This study examined job bias associated with business students' role-playing as sales managers who assigned trainees to sales territories. Personal characteristics of being extremely overweight and being a heavy smoker were studied. Research participants were given a personnel record (training record) of a sales trainee and asked to make a sales territory assignment decision; three vacant territories were also described. The participants were told to assign the trainee to one of the territories or to indicate a preference to not have the recruit assigned to any territory within the role-playing manager's region. Analysis indicates that a sales recruit described as extremely overweight was less likely to be assigned to an important or desirable sales territory and more likely to be assigned to an undesirable territory or not selected at all for an assignment within a sales region. Those described as heavy smokers were similarly treated but to a lesser degree. Overweight saleswomen were discriminated against more than overweight salesmen.

Decision Making↗