Weight problem
Food Deserts and Childhood Obesity
Pedro Alviola, Rodolfo Nayga & Michael Thomsen
Applied Economic Perspectives and Policy, March 2013, Pages 106-124
Abstract:
We utilize a panel data set from 2007 to 2009 on the state of Arkansas to identify and determine the effect of food deserts on school district obesity rates. We define food deserts as low-income areas with limited food access. Using both classical panel data models and spatial error models, we find no statistically significant relationship between school district obesity rates and the existence of food deserts in Arkansas. This finding is consistent across different model specifications, in spatial, panel or cross-sectional analysis, and with or without urban school districts in the data.
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Framing Childhood Obesity: How Individualizing the Problem Affects Public Support for Prevention
Colleen Barry, Victoria Brescoll & Sarah Gollust
Political Psychology, forthcoming
Abstract:
Political actors recognize the power of framing problems using personalized examples and causal stories to shape public opinion. Yet little is known about how these frames interact. This research presents the results of three studies designed to investigate the effect of "individualizing" the problem of childhood obesity, in combination with information about causes of obesity, on public support for obesity prevention policies (Studies 1 and 2) and to examine how frequently the news media rely on individual depictions of obese children to portray the problem in actual news coverage (Study 3). Results from two experiments consistently demonstrated that, regardless of how the cause of childhood obesity was framed, when a news report identified an individual obese child, participants were less likely to support prevention policies than when the report described the problem in more general terms. A content analysis indicated that news articles relatively infrequently frame the problem using individualized depictions of a specific child. When specific overweight or obese children were mentioned, news coverage emphasized internal (behavioral and genetic) causes rather than factors external to the child such as neighborhood, economic, or food-industry factors. Findings underscore the importance of considering attitudes toward a policy's target population when assessing how individual depictions of a policy problem influence public sentiment.
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45-Year Trends in Women's Use of Time and Household Management Energy Expenditure
Edward Archer et al.
PLoS ONE, February 2013
Context: Relationships between socio-environmental factors and obesity are poorly understood due to a dearth of longitudinal population-level research. The objective of this analysis was to examine 45-year trends in time-use, household management (HM) and energy expenditure in women.
Design and Participants: Using national time-use data from women 19-64 years of age, we quantified time allocation and household management energy expenditure (HMEE) from 1965 to 2010. HM was defined as the sum of time spent in food preparation, post-meal cleaning activities (e.g., dish-washing), clothing maintenance (e.g., laundry), and general housework. HMEE was calculated using body weights from national surveys and metabolic equivalents.
Results: The time allocated to HM by women (19-64 yrs) decreased from 25.7 hr/week in 1965 to 13.3 hr/week in 2010 (P<0.001), with non-employed women decreasing by 16.6 hr/week and employed women by 6.7 hr/week (P<0.001). HMEE for non-employed women decreased 42% from 25.1 Mj/week (6004 kilocalories per week) in 1965 to 14.6 Mj/week (3486 kcal/week) in 2010, a decrement of 10.5 Mj/week or 1.5 Mj/day (2518 kcal/week; 360 kcal/day) (P<0.001), whereas employed women demonstrated a 30% decrement of 3.9 Mj/week, 0.55 Mj/day (923 kcal/week, 132 kcal/day) (P<0.001). The time women spent in screen-based media use increased from 8.3 hr/week in 1965 to 16.5 hr/week in 2010 (P<0.001), with non-employed women increasing 9.6 hr/week and employed women 7.5 hr/week (P<0.001).
Conclusions: From 1965 to 2010, there was a large and significant decrease in the time allocated to HM. By 2010, women allocated 25% more time to screen-based media use than HM (i.e., cooking, cleaning, and laundry combined). The reallocation of time from active pursuits (i.e., housework) to sedentary pastimes (e.g., watching TV) has important health consequences. These results suggest that the decrement in HMEE may have contributed to the increasing prevalence of obesity in women during the last five decades.
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Associations of Food Stamp Participation With Dietary Quality and Obesity in Children
Cindy Leung et al.
Pediatrics, forthcoming
Objective: To determine if obesity and dietary quality in low-income children differed by participation in the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program.
Methods: The study population included 5193 children aged 4 to 19 with household incomes ≤130% of the federal poverty level from the 1999-2008 NHANES. Diet was measured by using 24-hour recalls.
Results: Among low-income US children, 28% resided in households currently receiving SNAP benefits. After adjusting for sociodemographic differences, SNAP participation was not associated with a higher rate of childhood obesity (odds ratio = 1.11, 95% confidence interval [CI]: 0.71-1.74). Both SNAP participants and low-income nonparticipants were below national recommendations for whole grains, fruits, vegetables, fish, and potassium, while exceeding recommended limits for processed meat, sugar-sweetened beverages, saturated fat, and sodium. Zero percent of low-income children met at least 7 of 10 dietary recommendations. After multivariate adjustment, compared with nonparticipants, SNAP participants consumed 43% more sugar-sweetened beverages (95% CI: 8%-89%), 47% more high-fat dairy (95% CI: 7%, 101%), and 44% more processed meats (95% CI: 9%-91%), but 19% fewer nuts, seeds, and legumes (95% CI: -35% to 0%). In part due to these differences, intakes of calcium, iron, and folate were significantly higher among SNAP participants. Significant differences by SNAP participation were not evident in total energy, macronutrients, Healthy Eating Index 2005 scores, or Alternate Healthy Eating Index scores.
Conclusions: The diets of low-income children are far from meeting national dietary recommendations. Policy changes should be considered to restructure SNAP to improve children's health.
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The Consequences of Rising Youth Obesity for U.S. Military Academy Admissions
John Cawley & Johanna Catherine Maclean
Applied Economic Perspectives and Policy, March 2013, Pages 32-51
Abstract:
This study estimates the percentage of the U.S. age-eligible population that exceeds weight-for-height admission standards of U.S. Military Academies, the undergraduate institutions that train officers for the U.S. Armed Forces. We analyze data from the National Health and Nutrition Examination Surveys, and document that the fraction of age-eligible civilians exceeding the weight and fat standards for admission has more than doubled for men and nearly quadrupled for women between 1959 and 2010. Among women, exceeding these standards is roughly 13 percentage points more likely among African-Americans than whites, representing a challenge to the military, which strives for a racially-diverse officer corps. Simulations indicate that further increases in weight and fat of just 1% would result in a 16.5% increase for men, and 10.9% increase for women, in ineligibility for admission to the U.S. Military Academy at West Point. Overall, these results indicate that the current prevalence of and future trends in obesity threaten to reduce the quality of the officer corps, and thereby decrease U.S. military readiness.
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Fred Danner & Michael Toland
Journal of Early Adolescence, April 2013, Pages 293-314
Abstract:
This study assessed how socioeconomic status (SES), race/ethnicity, and birth weight interacted to predict differential patterns of body mass index (BMI) growth among U.S. children born in the early 1990s. Three BMI growth trajectories emerged - one above the 50th percentile across the age range of 5 to 14, one in which children rapidly became obese before adolescence, and one where children started out and remained seriously obese. Hispanic and African American children were more likely to show accelerated patterns of weight gain as were those of lower SES and/or higher birth weights. However, SES interacted with both race/ethnicity and birth weight. For girls of all race/ethnicity groups tested, lower SES and higher birth weights predicted membership in the seriously obese BMI growth trajectory. For African American and Asian boys, however, the higher the SES the more likely they were to be on a trajectory for rapidly developing obesity by early adolescence.
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Richard Boles et al.
Journal of Nutrition Education and Behavior, forthcoming
Objective: To develop and test a home food and activity instrument to discriminate between the home environments of obese and healthy weight preschool children.
Design: A modified questionnaire about home environments was tested as an observation tool.
Setting: Family homes.
Participants: A total of 35 obese children with at least 1 obese caregiver were compared with 47 healthy weight children with no obese caregivers.
Main Outcome Measures: Home observation assessments were conducted to evaluate the availability of devices supporting activity behaviors and foods based on availability, accessibility, and readiness to be eaten.
Analysis: Agreement statistics were conducted to analyze psychometrics and MANOVAs were conducted to assess group differences, significance, P < .05.
Results: Home observations showed acceptable agreement statistics between independent coders across food and activity items. Families of obese preschoolers were significantly less likely to have fresh vegetables available or accessible in the home, were more likely to have a television in the obese child's bedroom, and had fewer physical activity devices compared with healthy weight preschoolers.
Conclusions and Implications: Families of young children live in home environments that were discriminatively characterized based on home observations. Future tool refinement will further clarify the impact of the home environment on early growth.
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Obesity and US Mortality Risk Over the Adult Life Course
Ryan Masters, Daniel Powers & Bruce Link
American Journal of Epidemiology, 1 March 2013, Pages 431-442
Abstract:
In this study, we analyzed age variation in the association between obesity status and US adult mortality risk. Previous studies have found that the association between obesity and mortality risk weakens with age. We argue that existing results were derived from biased estimates of the obesity-mortality relationship because models failed to account for confounding influences from respondents' ages at survey and/or cohort membership. We employed a series of Cox regression models in data from 19 cross-sectional, nationally representative waves of the US National Health Interview Survey (1986-2004), linked to the National Death Index through 2006, to examine age patterns in the obesity-mortality association between ages 25 and 100 years. Findings suggest that survey-based estimates of age patterns in the obesity-mortality relationship are significantly confounded by disparate cohort mortality and age-related survey selection bias. When these factors are accounted for in Cox survival models, the obesity-mortality relationship is estimated to grow stronger with age.
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Heidi Dressler & Chery Smith
Appetite, forthcoming
Abstract:
The higher rate of obesity among low-income women has widely been attributed to environmental barriers; however, many low-income women are still able to maintain a healthy weight despite obesogenic environments. To better understand personal and behavioral attributes related to food choice and weight, overweight/obese women and lean/normal weight women living in similar low-income environments, participated in focus groups, and taste testing sessions to investigate food liking (n =83). During focus groups, lean/normal weight participants reported that health was influential in food choice, while overweight/obese participants expressed cost as being more of a factor. Both BMI (kg/m2) groups reported that taste was of greatest importance. Personal factors, like emotional eating, and overeating were also discussed with differences noted between BMI (kg/m2) groups. Quantitative data also showed cost to be more important for overweight/obese women. Taste testing results revealed that overweight/obese participants had a higher overall liking for both healthy and less healthy foods, as well as food categories. Additionally, these women had a higher liking of fat in the context of spreadable fats. Our results show that a variety of complex factors interact to influence eating behavior and present weight status of women living in similarly impoverished environments. However, findings from this exploratory study should be confirmed through further research.
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Nutrient Signaling: Evolutionary Origins of the Immune-Modulating Effects of Dietary Fat
Joe Alcock, Melissa Franklin & Christopher Kuzawa
Quarterly Review of Biology, September 2012, Pages 187-223
Abstract:
Many dietary fatty acids (FA) have potent effects on inflammation, which is not only energetically costly, but also contributes to a range of chronic diseases. This presents an evolutionary paradox: Why should the host initiate a costly and damaging response to commonly encountered nutrients? We propose that the immune system has evolved a capacity to modify expenditure on inflammation to compensate for the effects of dietary FA on gut microorganisms. In a comprehensive literature review, we show that the body preferentially upregulates inflammation in response to saturated FA that promote harmful microbes. In contrast, the host often reduces inflammation in response to the many unsaturated FA with antimicrobial properties. Our model is supported by contrasts involving shorter-chain FA and omega-3 FA, but with less consistent evidence for trans fats, which are a recent addition to the human diet. Our findings support the idea that the vertebrate immune system has evolved a capacity to detect diet-driven shifts in the composition of gut microbiota from the profile of FA consumed, and to calibrate the costs of inflammation in response to these cues. We conclude by extending the nutrient signaling model to other nutrients, and consider implications for drug discovery and public health.
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Headless, Hungry, and Unhealthy: A Video Content Analysis of Obese Persons Portrayed in Online News
Rebecca Puhl et al.
Journal of Health Communication, forthcoming
Abstract:
The news media has substantial influence on public perceptions of social and health issues. This study conducted a video content analysis to examine portrayals of obese persons in online news reports about obesity. The authors downloaded online news videos about obesity (N = 371) from 5 major news websites and systematically coded visual portrayals of obese and nonobese adults and youth in these videos. The authors found that 65% of overweight/obese adults and 77% of overweight/obese youth were portrayed in a negative, stigmatizing manner across multiple obesity-related topics covered in online news videos. In particular, overweight/obese individuals were significantly more likely than were nonoverweight individuals to be portrayed as headless, with an unflattering emphasis on isolated body parts, from an unflattering rear view of their excess weight, eating unhealthy foods, engaging in sedentary behavior, and dressed in inappropriately fitting clothing. Nonoverweight individuals were significantly more likely to be portrayed positively. In conclusion, obese children and adults are frequently stigmatized in online news videos about obesity. These findings have important implications for public perceptions of obesity and obese persons and may reinforce negative societal weight bias.
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To Buy or Not to Buy: Consumers' Demand Response Patterns for Healthy Versus Unhealthy Food
Debabrata Talukdar & Charles Lindsey
Journal of Marketing, March 2013, Pages 124-138
Abstract:
The authors integrate research on impulsivity from the psychology area with standard economic theories of consumer demand to make novel predictions about the effects of market price changes on consumers' food consumption behavior. The results from multiple studies confirm that consumers exhibit undesirable asymmetric patterns of demand sensitivity to price changes for healthy and unhealthy food. For healthy food, demand sensitivity is greater for a price increase than for a price decrease. For unhealthy food, the opposite holds true. The research further shows that the undesirable patterns are attenuated or magnified for key policy-relevant factors that have been shown to decrease or increase impulsive purchase behavior, respectively. As the rising obesity trend brings American consumers' food consumption behavior under increased scrutiny, the focal findings hold significant implications for both public policy makers and food marketers.
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Obesity Has Few Effects on Future Psychosocial Functioning of Adolescents
Robert Roberts & Duong Hao
Eating Behaviors, forthcoming
Abstract:
We reexamine the effects of obesity on a wide range (n = 17) of indicators of functioning drawn from five broad domains: interpersonal problems, psychological problems, suicidal behaviors, academic performance, and psychiatric disorders. Evidence on this question is mixed. Data are analyzed from a large community sample of adolescents 11 - 17 at baseline (n = 4175) who were followed up a year later (n = 3,134). Using measured height and weight, overweight was defined as 95th > BMI ≤ 85th percentile and obese as BMI > 95th percentile. At baseline, obesity was associated with increased odds only for any mood disorder and poor perceived mental health. For boys, there were no significant associations, but girls had higher odds of problems at school, poor perceived mental health, and mood disorders. Results from the two-wave cohort reveal obesity increased future risk only for poor perceived mental health. For boys, the same pattern was observed, but for girls there were no significant associations. Overall, we found that weight status had few deleterious effects on adolescent social functioning, in multivariate, prospective analyses. If there is an effect of obesity on functioning, it may operate through mediators such as body image.
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The combined effect of ratee's bodyweight and past performance information on performance judgments
Levi Nieminen et al.
Journal of Applied Social Psychology, forthcoming
Abstract:
Few studies have examined how various biases operate in combination to influence performance judgments. Along these lines, the current study used experimental methods to test four competing models of the combined influence of ratee's bodyweight and past performance information on performance judgments. Results were consistent with an additive model, such that ratee's bodyweight and information about ratee's past performance combined independently to affect performance judgments. Consistent with a double disadvantage effect, the least favorable performance judgments were made for an overweight ratee with poor previous performance. Finally, mixed evidence was obtained for the interaction of ratee's bodyweight and perceptions of ratee's physical attractiveness, such that high-perceived attractiveness buffered against the otherwise negative performance ratings associated with overweight status.
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Núria Ibarrola-Jurado et al.
PLoS ONE, February 2013
Introduction: Prospective studies have consistently suggested that nut consumption is inversely related to fatal and non-fatal coronary heart disease. Limited data are available on the epidemiological associations between nut intake and cardiometabolic risk factors.
Objective: To evaluate associations between frequency of nut consumption and prevalence of cardiometabolic risk factors [obesity, metabolic syndrome (MetS), type-2 diabetes, hypertension, and dyslipidemia] in a Mediterranean population at high cardiovascular risk.
Materials and Methods: Cross-sectional study of 7,210 men and women (mean age, 67 y) recruited into the PREDIMED study. MetS was defined by the harmonized ATPIII and IDF criteria. Diabetes and hypertension were assessed by clinical diagnosis and dyslipidemia (high triglycerides, low HDL-cholesterol, and hypercholesterolemia) by lipid analyses. Nut consumption was assessed using a validated food frequency questionnaire and categorized as <1, 1-3, and >3 servings/wk. Control of confounding was done with multivariate logistic regression.
Results: Compared to participants consuming <1 serving/wk of nuts, those consuming >3 servings/wk had lower adjusted odds ratios (OR) for obesity (0.61, 95% confidence interval 0.54 to 0.68; P-trend <0.001), MetS (0.74, 0.65 to 0.85; P-trend<0.001), and diabetes (0.87, 0.78 to 0.99; P-trend = 0.043). Higher nut consumption was also associated with lower risk of the abdominal obesity MetS criterion (OR 0.68, 0.60 to 0.79; P-trend<0.001). No significant associations were observed for the MetS components high blood pressure, dyslipidemia, or elevated fasting glucose.
Conclusions: Nut consumption was inversely associated with the prevalence of general obesity, central obesity, MetS, and diabetes in subjects at high cardiovascular risk.
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Differences in body mass indices for males imprisoned in the 19th century American South
Scott Alan Carson
Journal of Bioeconomics, April 2013, Pages 1-16
Abstract:
A limited but increasing amount of research is being done on historical body mass index values. This paper uses 19th century Tennessee State Penitentiary records to demonstrate that Southern BMI values were in the normal range. There is little evidence of a Southern mulatto BMI advantage. Farmer BMIs were consistently heavier than non-farmers. Southern black BMIs remained constant throughout the late 19th and early 20th centuries; however, white BMIs declined during the early 20th century.
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Worry as a Predictor of Nutrition Behaviors: Results From a Nationally Representative Survey
Rebecca Ferrer, Hannah Bergman & William Klein
Health Education & Behavior, February 2013, Pages 88-96
Abstract:
Worry has been shown to predict a variety of health behaviors, such as cancer screening, yet there are few studies linking worry and nutrition. This study used nationally representative data from National Cancer Institute's Food Attitudes and Behavior Survey (n = 3,397) to examine the association between health-related worry and a variety of nutrition behaviors. Greater worry was associated with higher fruit and vegetable consumption (B = 0.19, p < .01), but also more meals eaten when watching television (B = 0.34, p < .01) and fewer with family (B = -0.13, p = .02). Importantly, and counterintuitively, greater worry appeared to reverse the conventional relationship between self-efficacy and dietary restriction; those who were self-efficacious and worried were less likely to restrict unhealthy foods. Similarly, worry attenuated the relationship between perceived benefits and special effort to buy produce. A complex relationship between worry and nutrition emerged, with potentially important clinical implications.
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Gayaneh Kyureghian, Rodolfo Nayga & Suparna Bhattacharya
Applied Economic Perspectives and Policy, March 2013, Pages 69-88
Abstract:
This paper combines national-level retail food availability information with data on actual purchases to determine the effect that availability of different types of food stores and income have on fruit and vegetable purchases. The results of our mixed effects analysis suggest that the densities of supermarkets and other retail outlets in metropolitan statistical areas do not have significant effects on household fruit and vegetable purchases. Income, however, has a positive significant effect on fruit and vegetable purchases. Results also indicate that while neither food access nor income account for the variability in fruit and vegetable purchases, the interaction of these terms has a small but significant impact indicating that policy actions designed to address access and affordability issues in isolation are not likely to succeed.
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Marijn Stok et al.
British Journal of Health Psychology, forthcoming
Objectives: While healthy eating patterns are of high importance in adolescence, most adolescents portray quite unhealthy eating behaviour. One reason for this may be that social norms among peers tend to be unsupportive of healthy eating. The current study investigates whether communicating health-promoting descriptive and injunctive norms influences adolescents' intended and actual fruit consumption.
Design: The study employed an experimental prospective design.
Methods: A norm message manipulation (descriptive vs. injunctive vs. no-norm control) was administered to high school students, after which fruit intake intention (N = 96) was assessed. At follow-up, actual fruit intake over 2 days (N = 80) was recorded.
Results: Adolescents receiving the descriptive norm did not report higher fruit intake intentions than the control group, but did consume significantly more fruit in the following 2 days (2.3 portions per day) than the control condition (1.7 portion per day). Adolescents receiving the injunctive norm reported lower fruit intake intentions than the other two groups, but actual fruit consumption (1.5 portions per day) was similar to that of the control group.
Conclusions: Health-promoting injunctive norms not only had no positive effects on fruit intake but actually caused a decrease in fruit intake intentions, indicating that injunctive norms may be vulnerable to reactance. A health-promoting descriptive norm was found to positively affect fruit intake in adolescents. No effect on fruit intake intention was found. Results show that simple single-sentence norm messages hold the potential to substantially influence health behaviour.
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Adelheid Soubry et al.
BMC Medicine, February 2013
Background: Data from epidemiological and animal model studies suggest that nutrition during pregnancy may affect the health status of subsequent generations. These transgenerational effects are now being explained by disruptions at the level of the epigenetic machinery. Besides in vitro environmental exposures, the possible impact on the reprogramming of methylation profiles at imprinted genes at a much earlier time point, such as during spermatogenesis or oogenesis, has not previously been considered. In this study, our aim was to determine associations between preconceptional obesity and DNA methylation profiles in the offspring, particularly at the differentially methylated regions (DMRs) of the imprinted Insulin-like Growth Factor 2 (IGF2) gene.
Methods: We examined DNA from umbilical cord blood leukocytes from 79 newborns, born between July 2005 and November 2006 at Duke University Hospital, Durham, NC. Their mothers participated in the Newborn Epigenetics Study (NEST) during pregnancy. Parental characteristics were obtained via standardized questionnaires and medical records. DNA methylation patterns at two DMRs were analyzed by bisulfite pyrosequencing; one DMR upstream of IGF2 (IGF2 DMR), and one DMR upstream of the neighboring H19 gene (H19 DMR). Multiple regression models were used to determine potential associations between the offspring's DNA methylation patterns and parental obesity before conception. Obesity was defined as body mass index (BMI) [greater than or equal to]30 kg/m2.
Results: Hypomethylation at the IGF2 DMR was associated with paternal obesity. Even after adjusting for several maternal and newborn characteristics, we observed a persistent inverse association between DNA methylation in the offspring and paternal obesity (beta-coefficient was -5.28, P = 0.003). At the H19 DMR, no significant associations were detected between methylation patterns and paternal obesity. Our data suggest an increase in DNA methylation at the IGF2 and H19 DMRs among newborns from obese mothers, but a larger study is warranted to further explore the potential effects of maternal obesity or lifestyle on the offspring's epigenome.
Conclusions: While our small sample size is limited, our data indicate a preconceptional impact of paternal obesity on the reprogramming of imprint marks during spermatogenesis. Given the biological importance of imprinting fidelity, our study provides evidence for transgenerational effects of paternal obesity that may influence the offspring's future health status.
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The contribution of feeding mode to obesogenic growth trajectories in American Samoan infants
N.L. Hawley et al.
Pediatric Obesity, forthcoming
Background: Samoans are recognized for their particularly high body mass index and prevalent adult obesity but infants are understudied.
Objective: To examine the prevalence of overweight and obesity and determine the contribution of feeding mode to obesogenic growth trajectories in American Samoan infants.
Methods: Data were extracted from the well baby records of 795 (n = 417 male) Samoan infants aged 0-15 months. Mixed-effects growth models were used to produce individual weight and length curves. Further mixed-effects models were fitted with feeding mode (breastfed, formula- or mixed-fed) as a single observation at age 4 (±2) months. Weight and length values were converted to z-scores according to the Centers for Disease Control 2000 reference.
Results: At 15 months, 23.3% of boys and 16.7% of girls were obese (weight-for-length > 95th percentile). Feeding mode had a significant effect on weight and length trajectories. Formula-fed infants gained weight and length faster than breastfed infants. Formula-fed boys were significantly more likely to be obese at 15 months (38.6%) than breastfed boys (23.4%), χ2 = 8.4, P < 0.01, odds ratio = 2.05, 95% confidence interval (1.04, 4.05).
Conclusion: Obesity in American Samoans is not confined to adults. Obesity prevention efforts should be targeted at early life and promotion of breastfeeding may be a suitable intervention target.
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Tiffany Powell-Wiley et al.
Journal of Public Health, March 2013, Pages 99-106
Background: We compared cardiovascular (CV) risk factors (CVRFs) of community-based participatory research (CBPR) participants with the community population to better understand how CBPR participants relate to the population as a whole.
Methods: GoodNEWS participants in 20 African-American churches in Dallas, Texas were compared with age/sex-matched African-Americans in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents. DHS characteristics were sample-weight adjusted to represent the Dallas County population.
Results: Despite having more education (college education: 75 versus 51%, P< 0.0001), GoodNEWS participants were more obese (mean body mass index: 34 versus 31 kg/m2, P< 0.001) and had more diabetes (23 versus 12%, P< 0.001) and hyperlipidemia (53 versus 14%, P< 0.001) compared with African-Americans in Dallas County. GoodNEWS participants had higher rates of treatment and control of most CVRFs (treated hyperlipidemia: 95 versus 64%, P< 0.001; controlled diabetes: 95 versus 21%, P< 0.001; controlled hypertension: 70 versus 52%, P= 0.003), were more physically active (233 versus 177 metabolic equivalent units-min/week, P< 0.0001) and less likely to smoke (10 versus 30%, P< 0.001).
Conclusions: Compared with African-Americans in Dallas County, CBPR participants in church congregations were more educated, physically active and had more treatment and control of most CVRFs. Surprisingly, this motivated population had a greater obesity burden, identifying them as a prime target for CBPR-focused obesity treatment.
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Fabrice Etile
Economics & Human Biology, forthcoming
Abstract:
This paper contributes to the debate over the effectiveness of education policies in reducing overall health inequalities as compared to public health actions directed at the less-educated. Recentered Influence Function (RIF) regressions are used to decompose the contribution of education to the changing distribution of Body Mass Index (BMI) in France, between 1981 and 2003, into a composition effect (the shift in population education due to a massive educational expansion), and a structure effect (a changing educational gradient in BMI). Educational expansion has reduced overall BMI inequality by 3.4% for women and 2.3% for men. However, the structure effect on its own has produced a 10.9% increase in overall inequality for women, due to a steeper education gradient starting from the second quartile of the distribution. This structure effect on overall inequality is also large (7.6%) for men, albeit insignificant as it remains concentrated in the last decile. Educational expansion policies can thus reduce overall BMI inequalities; but attention must still be paid to the BMI gradient in education even for policies addressing overall rather than socioeconomic health inequalities.
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L. Högberg et al.
Human Reproduction, February 2013, Pages 480-487
Study question: Does the intergenerational influence on birthweight and birth length remain within female dizygotic and monozygotic twin pairs?
Summary answer: The intergenerational influence on birthweight and birth length remained within dizygotic but not within monozygotic twin pairs.
Study design, size, duration: This is a register-based cohort study with a nested within-twin-pair comparison. The study is retrospective, but based on prospectively collected information. The study population included 8685 monozygotic and like-sexed dizygotic female twins born in Sweden from 1926 to 1985, who had given birth to their first infant between 1973 and 2009.
Participants/materials, setting, methods: This study is set in Sweden and used data from the Swedish Twin Register and the Swedish Medical Birth Register. We used generalized estimating equations to obtain regression coefficients with 95% confidence intervals (CI) for the outcomes: offspring birthweight and birth length. To control for genetic and shared environmental factors, we performed within-twin-pair analyses in 1479 dizygotic and 1526 monozygotic twin pairs.
Main results and the role of chance: In the cohort of both dizygotic and monozygotic twins, there was an association between mother's and offspring's size at birth. Within-dizygotic twin pairs, a 500-g increase from the twin pair's mean birthweight was associated with increased offspring birthweight [70 g (95% CI: 35-106)] and birth length [0.22 cm (95% CI: 0.07-0.38)]. The corresponding increase in birth length of 1 cm was estimated to increase offspring's birthweight by 26g (95% CI: 12-40) and birth length by 0.11 cm (95% CI: 0.04-0.17). Within-monozygotic twin pairs there were no such associations.
Wider implications of the findings: The intergenerational influence on size at birth is suggested to be due to direct or indirect genetic factors.