Greater Increase In Waist Circumference Research Articles

Adipose and Plasma microRNAs miR-221 and 222 Associate with Obesity, Insulin Resistance, and New Onset Diabetes after Peritoneal Dialysis.

The correlation between microRNA, obesity, and glycemic intolerance in patients on peritoneal dialysis (PD) is unknown. We aimed to measure the adipose and plasma miR-221 and -222 levels, and to evaluate their association with adiposity, glucose intolerance, and new onset diabetes mellitus (NODM) after the commencement of PD. We prospectively recruited incident adult PD patients. miR-221 and -222 were measured from adipose tissue and plasma obtained during PD catheter insertion. These patients were followed for 24 months, and the outcomes were changes in adiposity, insulin resistance, and NODM after PD. One hundred and sixty-five patients were recruited. Patients with pre-existing DM had higher adipose miR-221 (1.1 ± 1.2 vs. 0.7 ± 0.9-fold, p = 0.02) and -222 (1.9 ± 2.0 vs. 1.2 ± 1.3-fold, p = 0.01). High adipose miR-221 and -222 levels were associated with a greater increase in waist circumference (miR-221: beta 1.82, 95% CI 0.57-3.07, p = 0.005; miR-222: beta 1.35, 95% CI 0.08-2.63, p = 0.038), Homeostatic Model Assessment for Insulin Resistance (HOMA) index (miR-221: beta 8.16, 95% CI 2.80-13.53, p = 0.003; miR-222: beta 6.59, 95% CI 1.13-12.05, p = 0.018), and insulin requirements (miR-221: beta 0.05, 95% CI 0.006-0.09, p = 0.02; miR-222: beta 0.06, 95% CI 0.02-0.11, p = 0.002) after PD. The plasma miR-222 level predicted the onset of NODM (OR 8.25, 95% CI 1.35-50.5, p = 0.02). miR-221 and -222 are associated with the progression of obesity, insulin resistance, and NODM after PD.

Age, income and sleep duration were associated with outcomes in children participating in weight management.

AimTo explore associations between baseline factors and weight‐related outcomes among participants enrolled in a paediatric obesity trial.MethodsWe included children aged 6–12 years participating in a 2‐year multidisciplinary family programme who attended a postintervention follow‐up 36 months from baseline (n = 62). Outcome measures were change in body mass index standard deviation score (BMI SDS), reduction in BMI SDS ≥0.25 and change in waist circumference (WC). Independent variables included in linear and logistic regression models were age, sex, household income, parents' education, sleep duration, screen time and physical activity.ResultsAltogether, 26 children (42%) attained a reduction of BMI SDS ≥0.25. Higher family income and longer sleep duration were associated with greater change in BMI SDS (−0.05 per 100.000 NOK, p = 0.02, and −0.24 per hour, p = 0.02, respectively). Higher age was associated with greater change in WC (−2.1 cm per year, p = 0.01) but lower odds of attaining a reduction in BMI SDS ≥0.25 (OR per year 0.70, p = 0.04). There was a borderline statistically significant trend towards greater increase in WC with longer daily screen time (p = 0.05).ConclusionAge, family income and sleep duration at baseline were associated with weight‐related outcomes 1‐year postintervention.

The association between time-of-day of habitual exercise training and changes in relevant cancer health outcomes among cancer survivors.

ObjectiveTo assess the relationship between time-of-day of exercise training and changes in relevant cancer health outcomes among cancer survivors.MethodsRetrospective analysis of data collected from 2016–2019 from a hospital-based exercise oncology program. Descriptive statistics were calculated for demographic, clinical, and exercise timing characteristics (e.g. AM, PM, or mix) among survivors with available data for exercise training time (n = 233). For the total sample and a breast cancer sub-analysis, univariate analysis of covariance, adjusted for age, was carried out by exercise training time, for change in the following outcomes collected during the program’s assessment sessions: cardiorespiratory fitness and muscular endurance (human performance variables), physical function, anthropometrics, self-reported fatigue, and quality of life (QoL). Change in body mass index (BMI) and body weight was included in the breast cancer analysis.ResultsOverall, 37.3% of survivors habitually engaged in AM exercise (e.g. ≥ 75% AM training), 34.3% in PM exercise, and 28.3% in a mix of AM and PM exercise training throughout the program. Median time in the program was 17 weeks. Significant improvements in most human performance and physical function variables were observed in the total sample regardless of exercise training time-of-day. Among breast cancer survivors, PM but not AM or mixed was associated with improvements in fitness, and lower-body muscular endurance and function. Mixed exercise timing was linked with greater increase in waist circumference (total sample: 3.02cm, 95%CI 1.55, 4.49; breast cancer: 3.57cm 95%CI 0.96, 6.18), body weight (breast cancer: 1.6kg, 95%CI 0.3, 2.8) and BMI (breast cancer: 0.6kg/m2, 95%CI 0.1, 1.0). AM and PM exercise, but not mixed, was associated with improvements in fatigue and QoL.ConclusionTime-of-day of exercise training may differentially impact changes in human performance and physical function variables. Mixed exercise training time may result in less favorable outcomes related of weight management variables among cancer survivors.

Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort

BackgroundGreater whole grain (WG) consumption is associated with reduced risk of cardiovascular disease (CVD); however, few prospective studies have examined WG or refined grain (RG) intake and intermediate cardiometabolic risk factors. ObjectivesWe examined the longitudinal association between WG and RG intake on changes in waist circumference (WC); fasting HDL cholesterol, triglyceride, and glucose concentrations; and blood pressure. MethodsSubjects were participants in the Framingham Offspring cohort study [n = 3121; mean ± SD baseline age: 54.9 ± 0.2 y; BMI (kg/m2) 27.2 ± 0.1]. FFQ, health, and lifestyle data were collected approximately every 4 y over a median 18-y follow-up. Repeated measure mixed models were used to estimate adjusted mean changes per 4-y interval in risk factors across increasing categories of WG or RG intake. ResultsGreater WG intake was associated with smaller increases in WC (1.4 ± 0.2 compared with 3.0 ± 0.1 cm in the highest compared with the lowest category, respectively; P-trend < 0.001), fasting glucose concentration (0.7 ± 0.4 compared with 2.6 ± 0.2 mg/dL; P-trend < 0.001), and systolic blood pressure (SBP; 0.2 ± 0.5 compared with 1.4 ± 0.3 mm Hg; P-trend < 0.001) per 4-y interval. When stratified by sex, a stronger association with WC was observed among females than males. Higher intake of WG was associated with greater increases in HDL cholesterol and declines in triglyceride concentrations; however, these differences did not remain significant after adjustment for change in WC. Conversely, greater RG intake was associated with greater increases in WC (2.7 ± 0.2 compared with 1.8 ± 0.1 cm, P-trend < 0.001) and less decline in triglyceride concentration (−0.3 ± 1.3 compared with −7.0 ± 0.7 mg/dL, P-trend < 0.001). ConclusionsAmong middle- to older-age adults, replacing RG with WG may be an effective dietary modification to attenuate abdominal adiposity, dyslipidemia, and hyperglycemia over time, thereby reducing the risk of cardiometabolic diseases.

Comparison of Indices of Carbohydrate Quality and Food Sources of Dietary Fiber on Longitudinal Changes in Waist Circumference in the Framingham Offspring Cohort.

The long-term impact of carbohydrate quality on abdominal weight gain is not fully understood. We aimed to examine the prospective relation of a carbohydrate quality index (CQI; defined by four criteria: dietary fiber, glycemic index, whole grain-to-total grain ratio, and solid-to-total carbohydrate ratio), total, cereal grain, vegetable, and fruit fiber, carbohydrate-to-total fiber ratio, and carbohydrate-to-cereal fiber ratio with changes in waist circumference (WC). Subjects were middle-aged to older, mostly white, participants in the Framingham Offspring cohort (n = 3101 subjects), with mean baseline age 54.9 ± 0.2 years (mean ± SE) and body mass index (BMI) 27.2 ± 0.1 kg/m2. Food frequency questionnaire (FFQ), health, and lifestyle data were collected approximately every four years over a median total follow-up of 18 years. Repeated measure mixed models were used to estimate adjusted mean change in WC per four-year interval across quartiles of carbohydrate variables. In the most adjusted model, a higher CQI was marginally associated with a smaller increase in WC (2.0 ± 0.1 vs. 2.4 ± 0.1 cm in highest vs. lowest quartile, p-trend = 0.04). Higher ratios of carbohydrate-to-fiber and carbohydrate-to-cereal fiber were associated with greater increases in WC per four-year interval (2.6 ± 0.1 vs. 2.0 ± 0.1 cm, p-trend < 0.001, and 2.5 ± 0.1 vs. 2.1 ± 0.1 cm in highest versus lowest categories, p-trend = 0.007, respectively); whereas higher intake of total fiber (1.8 ± 0.1 vs. 2.7 ± 0.1 cm, p-trend < 0.001), cereal fiber (2.0 ± 0.1 vs. 2.5 ± 0.1 cm, p-trend = 0.001), and fruit fiber (2.0 ± 0.1 vs. 2.7 ± 0.1 cm, p-trend < 0.001) were associated with smaller increases in WC compared to lower intakes. There was a significant interaction between total fiber and total carbohydrate (as % of total energy intake). After stratification, the association between fiber intake and change in WC was not maintained in the context of a high carbohydrate diet. Better carbohydrate quality, primarily higher fiber intake and lower carbohydrate-to-fiber ratios, may help attenuate increases in abdominal adiposity over time.

Weight-related quality of life and temperament as predictors and moderators of outcomes among treatment-seeking, low-income, ethnically diverse children with obesity.

Within any childhood obesity treatment program, some children have better outcomes than others. Little is known about predictors or moderators of more positive outcomes. We aimed to identify whether child temperament and weight-related quality of life predict or moderate childhood obesity treatment outcomes at 6 months. From 2015 to 2016, children (n = 97) ages 5-11 years old with obesity were randomized to a clinic-community (Bull City Fit) or a clinic-only treatment program. Linear regression was used to explore whether dimensions of child temperament and weight-related quality of life predicted or moderated 6-month anthropometric and physical activity outcomes. Children who had more social avoidance due to their weight at baseline had significantly better improvements in body fat percent in the clinic-community model compared with the clinic-only model at 6 months. Across programs, better baseline social quality of life predicted greater increases in waist circumference; conversely, better physical quality of life predicted a decrease in percent of the 95th percentile. Also, children with longer attention spans had greater increases in physical activity. Our findings suggest that children who have social avoidance due to their weight may benefit most from comprehensive clinic-community treatment. Weight-related quality of life may influence outcomes across all treatments, and practitioners need to carefully counsel children experiencing weight negatively.

Changes in Waist Circumference in HIV-Infected Individuals Initiating a Raltegravir or Protease Inhibitor Regimen: Effects of Sex and Race

BackgroundThis study investigates the association of clinical and demographic predictors with abdominal fat gain, measured using waist circumference (WC) and self-reported abdominal size.MethodsWe analyzed data from ACTG A5257, a clinical trial that randomized treatment-naïve HIV-infected participants to 1 of 3 antiretroviral regimens: raltegravir (RAL) or the protease inhibitors (PIs) atazanavir/ritonavir (ATV/r) or darunavir/ritonavir (DRV/r), each in combination with tenofovir disoproxil fumarate/emtricitabine. Associations of treatment and baseline/demographic characteristics with 96-week WC change were assessed using repeated-measures models. Ordinal logistic regression was used to examine the associations of predictors with week 96 self-reported abdominal changes.ResultsThe study population (n = 1809) was 76.0% male and predominantly black non-Hispanic (41.9%) and white non-Hispanic (34.1%). Mean baseline WC was 90.6 cm, with an average 96-week increase of 3.4 cm. WC increases were higher in the RAL arm compared with DRV/r (P = .0130). Females experienced greater increases in WC on RAL vs ATV/r than males (P = .0065). Similarly, a larger difference in WC change was found for RAL vs DRV/r for black vs nonblack individuals (P = .0043). A separate multivariable model found that in addition to the treatment regimen, higher baseline viral load and lower CD4+ were also associated with WC increases.ConclusionsWith antiretroviral therapy initiation, higher WC increases in the RAL arm compared with PIs were more pronounced in female and black participants, and a more advanced baseline HIV disease state was a strong predictor of larger abdominal increases. Understanding factors predisposing individuals to abdominal fat gain could inform health management after therapy initiation.

Increases in waist circumference independent of weight in Mongolia over the last decade: the Mongolian STEPS surveys

BackgroundIn Mongolia, mean waist circumference (WC) has increased dramatically over the last decade, however, it is unknown whether these increases have been greater than corresponding increases in weight. In this study we aimed to assess whether recent increases in WC were greater than expected from changes in weight in Mongolian adults.MethodsWe used data on 13260 Mongolian adults, aged between 18 and 64 years, who participated in one of three (2005, 2009, 2013) nationally representative cross-sectional surveys. Linear regression was used to estimate changes in mean WC over time, adjusted for age, sex, height and weight. We also estimated the age-standardised prevalence for four obesity classification categories (not obese; obese by WC only; obese by body mass index (BMI) only; obese by both BMI and WC) at each survey year.ResultsThe estimated mean WC in 2009 and 2013, respectively, was 1.26 cm (95% CI: 0.35 to 2.17) and 1.88 cm (95% CI: 1.09 to 2.67) greater compared to 2005, after adjusting for age, sex, height and weight. Between 2005 and 2013, the age-standardised prevalence of those obese according to both BMI and WC increased from 8.0 to 13.6% for men and from 16.5 to 25.5% for women. During the same period, the percentage who were obese by WC only increased from 1.8 to 4.8% for men and from 16.5 to 26.8% for women. In contrast, the percentage who were obese by BMI only remained relatively stable (women: 2.4% in 2005 to 1.0% in 2013; men: 2.7% in 2005 to 4.0% in 2013).ConclusionOver the last decade, among Mongolian adults, there has been substantially greater increase in WC and the prevalence of abdominal obesity than would be expected from increases in weight. Women are at greater risk than men of being misclassified as not obese if obesity is defined using BMI only. Obesity should be monitored using WC in addition to BMI to ensure the prevalence of obesity is not underestimated.

Residential proximity to urban centres, local-area walkability and change in waist circumference among Australian adults

Consistent associations have been observed between macro-level urban sprawl and overweight/obesity, but whether residential proximity to urban centres predicts adiposity change over time has not been established. Further, studies of local-area walkability and overweight/obesity have generated mixed results. This study examined 4-year change in adults' waist circumference in relation to proximity to city centre, proximity to closest suburban centre, and local-area walkability. Data were from adult participants (n=2080) of a cohort study on chronic conditions and health risk factors in Adelaide, Australia. Baseline data were collected in 2000–03 with a follow-up in 2005–06. Multilevel regression models examined in 2015 the independent and joint associations of the three environmental measures with change in waist circumference, accounting for socio-demographic covariates. On average, waist circumference rose by 1.8cm over approximately 4years. Greater distance to city centre was associated with a greater increase in waist circumference. Participants living in distal areas (20km or further from city centre) had a greater increase in waist circumference (mean increase: 2.4cm) compared to those in proximal areas (9km or less, mean increase: 1.2cm). Counterintuitively, living in the vicinity of a suburban centre was associated with a greater increase in adiposity. Local-area walkability was not significantly associated with the outcome. Residential proximity to city centre appears to be protective against excessive increases in waist circumference. Controlled development and targeted interventions in the urban fringe may be needed to tackle obesity. Additional research needs to assess behaviours that mediate relationships between sprawl and obesity.

Physical Activity, Television Viewing Time, and 12-Year Changes in Waist Circumference.

ABSTRACTPurposeBoth moderate-to-vigorous physical activity (MVPA) and sedentary behavior can be associated with adult adiposity. Much of the relevant evidence is from cross-sectional studies or from prospective studies with relevant exposure measures at a single time point before weight gain or incident obesity. This study examined whether changes in MVPA and television (TV) viewing time are associated with subsequent changes in waist circumference, using data from three separate observation points in a large population-based prospective study of Australian adults.MethodsData were obtained from the Australian Diabetes, Obesity, and Lifestyle study collected in 1999–2000 (baseline), 2004–2005 (wave 2), and 2011–2012 (wave 3). The study sample consisted of adults age 25 to 74 yr at baseline who also attended site measurement at three time points (n = 3261). Multilevel linear regression analysis examined associations of initial 5-yr changes in MVPA and TV viewing time (from baseline to wave 2) with 12-yr change in waist circumference (from baseline to wave 3), adjusting for well-known confounders.ResultsAs categorical predictors, increases in MVPA significantly attenuated increases in waist circumference (P for trend < 0.001). TV viewing time change was not significantly associated with changes in waist circumference (P for trend = 0.06). Combined categories of MVPA and TV viewing time changes were predictive of waist circumference increases; compared with those who increased MVPA and reduced TV viewing time, those who reduced MVPA and increased TV viewing time had a 2-cm greater increase in waist circumference (P = 0.001).ConclusionDecreasing MVPA emerged as a significant predictor of increases in waist circumference. Increasing TV viewing time was also influential, but its impact was much weaker than MVPA.

Prospective associations between sedentary time, physical activity, fitness and cardiometabolic risk factors in people with type 2 diabetes

Aims/hypothesisThe aim of this study was to examine the prospective associations between objectively measured physical activity energy expenditure (PAEE), sedentary time, moderate-to-vigorous-intensity physical activity (MVPA), cardiorespiratory fitness (CRF) and cardiometabolic risk factors over 4 years in individuals with recently diagnosed diabetes.MethodsAmong 308 adults (mean age 61.0 [SD 7.2] years; 34% female) with type 2 diabetes from the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION)-Plus study, we measured physical activity using individually calibrated combined heart rate and movement sensing. Multivariable linear regression models were constructed to examine the associations between baseline PAEE, sedentary time, MVPA, CRF and cardiometabolic risk factors and clustered cardiometabolic risk (CCMR) at follow-up, and change in these exposures and change in CCMR and its components over 4 years of follow-up.ResultsIndividuals who increased their PAEE between baseline and follow-up had a greater reduction in waist circumference (−2.84 cm, 95% CI −4.84, −0.85) and CCMR (−0.17, 95% CI −0.29, −0.04) compared with those who decreased their PAEE. Compared with individuals who decreased their sedentary time, those who increased their sedentary time had a greater increase in waist circumference (3.20 cm, 95% CI 0.84, 5.56). Increases in MVPA were associated with reductions in systolic blood pressure (−6.30 mmHg, 95% CI −11.58, −1.03), while increases in CRF were associated with reductions in CCMR (−0.23, 95% CI −0.40,−0.05) and waist circumference (−3.79 cm, 95% CI −6.62, −0.96). Baseline measures were generally not predictive of cardiometabolic risk at follow-up.Conclusions/interpretationEncouraging people with recently diagnosed diabetes to increase their physical activity and decrease their sedentary time may have beneficial effects on their waist circumference, blood pressure and CCMR.

Age-related increase in alanine aminotransferase correlates with elevated levels of plasma amino acids, decanoylcarnitine, Lp-PLA2 Activity, oxidative stress, and arterial stiffness.

We investigated plasma metabolite profiles that correlated with age-related serum alanine aminotransferase (ALT) levels. The study included 602 healthy, nondiabetic subjects (aged 30-65 years); 393 individuals had normal ALT levels at baseline. Fifty-three (13.5%) individuals developed elevated ALT levels after 3 years. The remaining 340 subjects with normal ALT were matched to the elevated-ALT group (n = 53) for age, gender, BMI, fasting glucose, and ALT to form the control group (n = 53). At the 3-year follow-up, the elevated-ALT group exhibited greater increases in waist circumference, serum free fatty acid, ALT, aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), bilirubin, plasma oxidized LDL, Lp-PLA2 activity, urinary 8-epi-prostaglandin F2α (8-epi-PGF2α), and brachial-ankle pulse-wave velocity (ba-PWV) compared to the control group after baseline adjustment. The elevated-ALT group exhibited greater increases in plasma l-valine (q = 0.036), l-leucine (q = 0.012), l-phenylalanine (q = 0.012), and decanoylcarnitine (q = 0.002). Mean ALT levels positively correlated with changes in these four metabolites, which correlated with changes in AST, GGT, Lp-PLA2 activity, urinary 8-epi-PGF2α, and ba-PWV. Mean ALT changes did not significantly correlate with HOMA-insulin resistance. These results suggest that increased plasma levels of l-valine, l-leucine, l-phenylalanine, and decanoylcarnitine precede insulin resistance during periods of elevated ALT. This metabolic disturbance coincides with enhanced risk factors for cardiovascular disease.

Long-Term Aircraft Noise Exposure and Body Mass Index, Waist Circumference, and Type 2 Diabetes: A Prospective Study

Background: Long-term aircraft noise exposure may increase the risk of cardiovascular disease, but no study has investigated chronic effects on the metabolic system.Objectives: The aim of this study was to investigate effects of long-term aircraft noise exposure on body mass index (BMI), waist circumference, and type 2 diabetes. Furthermore, we explored the modifying effects of sleep disturbance.Methods: This prospective cohort study of residents of Stockholm County, Sweden, followed 5,156 participants with normal baseline oral glucose tolerance tests (OGTT) for up to 10 years. Exposure to aircraft noise was estimated based on residential history. Information on outcomes and confounders was obtained from baseline and follow-up surveys and examinations, and participants who developed prediabetes or type 2 diabetes were identified by self-reported physician diagnosis or OGTT at follow-up. Adjusted associations were assessed by linear, logistic, and random-effects models.Results: The mean (± SD) increases in BMI and waist circumference during follow-up were 1.09 ± 1.97 kg/m2 and 4.39 ± 6.39 cm, respectively. The cumulative incidence of prediabetes and type 2 diabetes was 8% and 3%, respectively. Based on an ordinal noise variable, a 5-dB(A) increase in aircraft noise was associated with a greater increase in waist circumference of 1.51 cm (95% CI: 1.13, 1.89), fully adjusted. This association appeared particularly strong among those who did not change their home address during the study period, which may be a result of lower exposure misclassification. However, no clear associations were found for BMI or type 2 diabetes. Furthermore, sleep disturbances did not appear to modify the associations with aircraft noise.Conclusions: Long-term aircraft noise exposure may be linked to metabolic outcomes, in particular increased waist circumference.Citation: Eriksson C, Hilding A, Pyko A, Bluhm G, Pershagen G, Östenson CG. 2014. Long-term aircraft noise exposure and body mass index, waist circumference, and type 2 diabetes: a prospective study. Environ Health Perspect 122:687–694; http://dx.doi.org/10.1289/ehp.1307115

Twelve-year weight change, waist circumference change and incident obesity: The Australian diabetes, obesity and lifestyle study

This study aimed to describe the changes in weight and waist circumference (WC), examine the incidence of obesity as defined by body mass index (BMI) and WC, and describe the changes in the prevalence of obesity over 12 years. In 1999/2000, 11,247 adults aged ≥25 years were recruited from 42 randomly selected areas across Australia. In total, 44.6% of eligible participants completed follow-up in 2011/12. Height, weight, and WC were measured at both surveys. People who were 25-34 years of age at baseline gained an average of 6.7 kg weight and 6.6 cm WC, whereas those aged ≥75 years lost an average of 4.5 kg and gained an average of 0.8 cm. Women had a greater increase in WC than men, but did not differ in terms of weight gain. The 12-year incidence of obesity was 15.0% when defined by BMI and 31.8% when defined by WC. According to BMI and WC combined, the percentage of the cohort that was normal weight decreased from 33 to 21% and the percentage that was obese increased from 32 to 49% between baseline and 2012. In addition to BMI, assessment of WC should be incorporated more frequently when assessing population trends of obesity and the burden of disease associated with excess adiposity.

Social relationships and longitudinal changes in body mass index and waist circumference: the coronary artery risk development in young adults study.

Few studies have examined longitudinal associations between close social relationships and weight change. Using data from 3,074 participants in the Coronary Artery Risk Development in Young Adults Study who were examined in 2000, 2005, and 2010 (at ages 33-45 years in 2000), we estimated separate logistic regression random-effects models to assess whether patterns of exposure to supportive and negative relationships were associated with 10% or greater increases in body mass index (BMI) (weight (kg)/height (m)(2)) and waist circumference. Linear regression random-effects modeling was used to examine associations of social relationships with mean changes in BMI and waist circumference. Participants with persistently high supportive relationships were significantly less likely to increase their BMI values and waist circumference by 10% or greater compared with those with persistently low supportive relationships after adjustment for sociodemographic characteristics, baseline BMI/waist circumference, depressive symptoms, and health behaviors. Persistently high negative relationships were associated with higher likelihood of 10% or greater increases in waist circumference (odds ratio = 1.62, 95% confidence interval: 1.15, 2.29) and marginally higher BMI increases (odds ratio = 1.50, 95% confidence interval: 1.00, 2.24) compared with participants with persistently low negative relationships. Increasingly negative relationships were associated with increases in waist circumference only. These findings suggest that supportive relationships may minimize weight gain, and that adverse relationships may contribute to weight gain, particularly via central fat accumulation.

Physical Environment May Modify the Association Between Depressive Symptoms and Change in Waist Circumference: The Multi-Ethnic Study of Atherosclerosis

Although the bidirectional association between depressive symptoms and adiposity has been recognized, the contribution of neighborhood factors to this relationship has not been assessed. This study evaluates whether physical and social neighborhood environments modify the bidirectional relationship between depressive symptoms and adiposity (measured by waist circumference and body mass index). Using data on 5,122 men and women (ages 45 to 84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) we investigated whether neighborhood physical (i.e., walking environment and availability of healthy food) and social (i.e., safety, aesthetics, and social coherence) environments modified the association between the following: (1) baseline elevated depressive symptoms (Center for Epidemiologic Study Depression Scale score ≥ 16) and change in adiposity (as measured by waist circumference and body mass index) and (2) baseline overweight/obesity (waist circumference > 102 cm for men and >88 cm for women, or body mass index ≥ 25 kg/m(2)) and change in depressive symptoms using multilevel models. Neighborhood-level factors were obtained from the MESA Neighborhood Study. A greater increase in waist circumference in participants with vs without elevated depressive symptoms was observed in those living in poorly-rated physical environments but not in those living in better-rated environments (interaction p = 0.045). No associations were observed with body mass index. Baseline overweight/obesity was not associated with change in depressive symptoms and there was no modification by neighborhood-level factors. Elevated depressive symptoms were associated with greater increase in waist circumference among individuals living in poorly-rated physical environments than in those in better-rated physical environments. No association was found between overweight/obesity and change in depressive symptoms.

Weight change, waist circumference change and incident of obesity in Australian adults between 1999 and 2012: The Australian diabetes, obesity and lifestyle (AusDiab) study

Background: The prevalence of obesity in Australian adults continues to increase. However, assessment of obesity commonly relies on body mass index (BMI) without accounting for waist circumference (WC). This study aimed to describe changes in weight and WC, and examine the incidence of obesity as defined by BMI and WC. Methods: In 1999/2000, 11,247 adults aged 25 years and over were recruited from 42 randomly selected areas across Australia. 44.6% of eligible participants completed follow-up in 2011/12. Height, weight and waist circumference were measured at both surveys. Results: The age and sex adjusted mean 12-year change in weight and WC was 2.6 kg and 5.3 cm, respectively. When examined according to age, those aged 25—34 years gained an average of 6.6 kg weight and 6.6 cmWC over 12 years. By comparison, those aged 75 and over lost an average of 4.5 kg and gained an average of 0.8 cm. Women had a greater increase in WC than men but did not differ in terms of weight gain. The 12-year incidence of obesity was 14.9% when defined by BMI and 31.6% when defined by WC. Increases in weight, WC and incidence of obesity were generally greater with lower socio-economic position. Conclusion: Assessment of WC in addition to the traditionally measured BMI should be considered when assessing trends of obesity in the population and the burden of disease associated with excess adiposity.

Risk of birth weight and nutrient intake on nutritional status of 6–12 months old children

Background: The prevalence of obesity in Australian adults continues to increase. However, assessment of obesity commonly relies on body mass index (BMI) without accounting for waist circumference (WC). This study aimed to describe changes in weight and WC, and examine the incidence of obesity as defined by BMI and WC. Methods: In 1999/2000, 11,247 adults aged 25 years and over were recruited from 42 randomly selected areas across Australia. 44.6% of eligible participants completed follow-up in 2011/12. Height, weight and waist circumference were measured at both surveys. Results: The age and sex adjusted mean 12-year change in weight and WC was 2.6 kg and 5.3 cm, respectively. When examined according to age, those aged 25—34 years gained an average of 6.6 kg weight and 6.6 cmWC over 12 years. By comparison, those aged 75 and over lost an average of 4.5 kg and gained an average of 0.8 cm. Women had a greater increase in WC than men but did not differ in terms of weight gain. The 12-year incidence of obesity was 14.9% when defined by BMI and 31.6% when defined by WC. Increases in weight, WC and incidence of obesity were generally greater with lower socio-economic position. Conclusion: Assessment of WC in addition to the traditionally measured BMI should be considered when assessing trends of obesity in the population and the burden of disease associated with excess adiposity.

Changes in BMI and waist circumference in Scottish adults: use of repeated cross-sectional surveys to explore multiple age groups and birth-cohorts

To document changes in body mass index (BMI) and waist circumference (WC) over a 10-year period 1998-2008, in representative surveys of adults. Adults aged 18-72 in the Scottish Health Surveys conducted in 1998, 2003 and 2008 were divided, separately for men and women, into eleven 5-year age bands. 'Synthetic birth-cohorts' were created by dividing participants into thirteen 5-years-of-birth bands (n=20 423). Weight, height and WC were objectively measured by trained observers. SUBJECTS with data available on BMI/WC were 7743/6894 in 1998, 5838/4437 in 2003 and 4688/925 in 2008 with approximately equal gender distributions. Mean BMI and waist were both greater in successive surveys in both men and women. At most specific ages, people were consistently heavier in 2008 than in 1998 by about 1-1.5 BMI units, and WCs were greater by about 2-6 cm in men and 5-7 cm in women. Greater increases were seen at younger ages between 1998 and 2003 than between 2003 and 2008, however increases continued at older ages, particularly in waist. All birth-cohorts observed over the 10 years 1998-2008 showed increases in both BMI and waist, most marked in the younger groups. The 10-year increases in waist within birth-cohorts (mean 7.4 cm (8.1%) in men and 8.6 cm (10.9%) in women) were more striking than in BMI (mean 1.8 kg m(-2) (6.6%) in men and 1.5 kg m(-2) (6.4%) in women) were particularly steep in older women. People were heavier and fatter in 2003 than those of the same age in 1998, with less marked increases in WC between 2003 and 2008 than between 1998 and 2003. There were proportionally greater increases in WC than in BMI, especially in older women. This suggests a disproportionate increase in body fat, compared with muscle, particularly among older women.

Less frequent eating predicts greater BMI and waist circumference in female adolescents

Little is known about the effect of eating frequency on adiposity. The study aim was to assess the prospective relation of an objective measure of eating frequency with adiposity in girls from ages 9-10 to 19-20 y. By using data from 3-d diet records collected from 2372 girls in the National Heart, Lung, and Blood Institute Growth and Health Study, meal, snack, and total eating frequencies aggregated over the first 2 study years were examined in relation to 10-y change in BMI and waist circumference (WC). Eating frequency was lower in black and older girls than in white and younger girls (P < 0.0001). In whites, lower initial snack and total eating frequencies were related to greater 10-y increases in BMI (P = 0.023 and 0.012, respectively) and WC (P = 0.030 and 0.015, respectively). In blacks, lower initial meal and snack frequencies were related to greater increases in BMI (P = 0.004 and 0.022, respectively) and WC (P = 0.052 and 0.005, respectively). Also, in blacks, lower initial total eating frequency was related to greater increases in WC (P = 0.010). After adjustment for baseline adiposity measure, race, parental education, physical activity, television and video viewing, total energy intake, and dieting for weight loss, lower initial total eating frequency remained related to greater 10-y increases in BMI (P = 0.013) and WC (P = 0.036). A lower eating frequency predicts a greater gain in adiposity in adolescent females. Intervention trials are needed to test if changing the frequency of eating can affect obesity risk.