Overweight US Research Articles

A mixed‐method exploratory study of weight‐based mistreatment at work

AbstractAcross two studies, this exploratory research examines stigma faced by larger‐bodied people by exploring the phenomenon of weight‐based mistreatment (WBM), defined as interpersonal disrespect levied on a person explicitly due to their larger body size, at work. Through qualitative research we first describe distinct forms of WBM experienced by 175 self‐defined overweight US employees, as well as consequences of WBM for bullied targets and their organizations. Next, through a quantitative survey distributed to a separate sample of larger‐bodied workers, our exploratory evaluation of WBM found that it is all‐too common in many forms, including overt and covert aggression, microaggression, incivility, and benevolent, yet disrespectful comments oriented around a person's weight. One or more forms of these behaviours were experienced by 75% of our 1008‐person sample, with overt and covert aggression being most common, and coworkers most often perpetrating WBM. Drawing on objectification theory, we observe a host of harmful consequences ranging from diminished engagement, worsened professional interactions, and a lack of self‐care. Altogether, results reveal WBM is a substantial problem, and thus they serve as a call to action for HR professionals, managers, and inclusion advocates to better understand the experiences of this vulnerable population.

Nutrition-Focused Wellness Coaching Promotes a Reduction in Body Weight in Overweight US Veterans

Diet plays a critical role in the pathogenesis of major chronic diseases common in populations of US veterans. The role of nutrition-focused wellness coaching in improving dietary behavior and/or reducing weight in overweight and obese US veterans is not known. At the San Francisco Veterans Affairs Medical Center, US veterans aged 25 to 80 years were randomized to receive nutrition coaching on eating behaviors at baseline only (control group, n=22) or an additional eight times over the course of 6 months (intervention group, n=28) in 2010-2011. Multiple coaching contacts decreased intake of energy, fat, and carbohydrate by 31% (P≤0.001) as evaluated by the 2005 Block food frequency questionnaire, which is composed of 111 food items. A weight loss of 5% from baseline (92.8 to 88.2 kg; P<0.01) was observed in the intervention group with mean body mass index decreasing from 30.4 to 28.9 (P<0.05). The control group showed a decrease in fat intake by 20% (P=0.01), but no statistically significant changes in intake of other nutrients or body weight (88.7 to 87.4 kg). Those in the intervention group reported diets at follow-up that were lower in cholesterol, saturated fat, sodium, sugar (P≤0.01), calcium (P< 0.05), and vitamin D (P<0.01), although when adjusted for energy (ie, nutrient density) calcium intake increased and vitamin D remained unchanged. Veterans' readiness to change eating behavior for weight loss improved with nutrition coaching. This study demonstrates that intermittent nutrition coaching can be an effective strategy to promote reductions in energy intake, body weight, and body mass index in overweight US veterans. Further research is needed to determine whether nutrition coaching improves other clinical outcomes and sustains weight loss.

Food Security Impacts Accuracy of Weight Perception among Overweight US Males but Not Females

Food Security Impacts Accuracy of Weight Perception among Overweight US Males but Not Females

Changes in the propensity of overweight US women to under-assess their body weight status

National data indicate that there was almost no change in the accuracy of body weight assessments of overweight women over the past 20 years. The accuracy in weight assessment is influenced by a number of social-demographic and economic factors; many of them have opposite effects and cancel out each other. This paper examines changes in misperception of body weight among overweight women in the United States, using data from the 1988–1994 and 1999–2004 National Health and Nutrition Examination Survey. Changes in characteristics of the population, such as the increased share of Hispanics in the US population, between these two time periods explain only a small portion of the changes in the accuracy of body weight assessment. Most of the differences come from changes in the association between population characteristics and the likelihood an overweight woman underestimates her weight status. Results also indicate that overweight women who receive benefits from the Supplemental Nutrition Assistance Program (formerly Food Stamp Program) are consistently more likely to misperceive themselves as healthy weight or underweight than higher income overweight women.

Efficacy of a Meal-Replacement Program for Promoting Blood Lipid Changes and Weight and Body Fat Loss in US Army Soldiers

Excess weight is associated with negative health outcomes. Meal replacements are effective in promoting favorable body composition changes in civilian populations; however, their efficacy with military service members who have unique lifestyles is unknown. The objective of this randomized controlled trial was to determine the efficacy of the Army's education-based weight-management program, “Weigh to Stay,” with and without meal replacements for improving blood lipids, and to promote weight and body fat loss in overweight US Army soldiers. Soldiers (n=113; 76 males/37 females) attending Weigh to Stay at Fort Bragg, NC, in 2006/2007 were randomized to Weigh to Stay only or a commercially available meal-replacement program (two meal replacements per day) in conjunction with Weigh to Stay, and followed until Army body fat standards were met or for 6 months if standards were not met. Study completers (n=46) in both treatment groups lost weight (Weigh to Stay: −2.7±4.3 kg; meal replacers: −3.8±3.5 kg) and fat mass (Weigh to Stay, −2.7±3.2 kg; meal replacers: −2.9±2.5 kg), and improved high-density lipoprotein cholesterol concentrations (Weigh to Stay: 13±9 mg/dL [0.34±0.23 mmol/L]; meal replacers: 8±7 mg/dL [0.21±0.18 mmol/L]; P<0.05); however, no between-group differences were observed. Attrition was lower ( P=0.009) and success in meeting body fat standards tended to be higher ( P=0.06) for the meal replacers vs Weigh to Stay participants. Intent-to-treat analysis demonstrated that meal replacers lost more weight (1.2±0.5 kg), percent body fat (1.0%±0.4%), and fat mass (0.8±0.4 kg) compared to Weigh to Stay volunteers ( P<0.05). Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay.

Mortality, Health Outcomes, and Body Mass Index in the Overweight Range

Health hazards of obesity have been recognized for centuries, appearing, for example, in writings attributed to Hippocrates. From the later decades of the 20th century through the present, there have been numerous epidemiological studies of the relationship between excess weight and the total, or all-cause, mortality rate,1 a critical cumulative measure of the public health impact of any health condition. Using body mass index (BMI), an indicator of relative weight for height (weight [kg]/height [m]2) and a frequently used surrogate for assessment of excess body fat, these studies have found linear, U-shaped, or J-shaped relationships between total mortality and BMI. That is, in some studies, both the thin and the obese were more likely to die than those in between. There is, however, always a point at which increasing BMI is associated with increasing mortality risk, but the BMI at which this occurs varies across studies and populations.2 Currently,3 overweight in adults is defined as a BMI of 25.0 to <30.0 kg/m2 and obesity as a BMI of ≥30.0 kg/m2 (Table 1). A number of studies have found no significant relationship between BMI in the overweight range and mortality rate4 and have shown the nadir of mortality risk to be in the overweight range. In particular, commentaries in both the lay press5–7 and scientific literature2,8,9 subsequent to recent reports from National Health and Nutrition Examination Surveys (NHANES)10,11 have highlighted the confusion and controversy regarding this issue. Some have interpreted the recent data to mean that overweight is not detrimental to health and is not in itself a public health concern and that drawing attention to the need for weight loss in this range will have negative effects on the health and well-being of the general population.8 Others have argued …

Effect of Dietary Antioxidants on the Lipid and Anthropometric Profile of at Risk Coronary Heart Subjects

Sixty male patients in age group of 30-50 years belonging to upper middle class and who were at risk of CHD were selected. Information regarding dietary antioxidant intake, anthropometric measurements, blood pressure and blood glucose was recorded. Blood samples were drawn to analysis the lipid profile. Nutrition education was imparted with special reference to intake of dietary antioxidants. Results indicated the improvement in intake of antioxidants and its positive impact on lipid profile and anthropometric parameters but the intake did not come up to standards set by heart health organisation. Significant (P 0.01) and negative correlation was also observed between intake of dietary antioxidants and lipid and anthropometric profile of the subjects. REFERENCES Broekmans, W.M.R., Varhagen, H., Berg, H.V., Kok, F.J. and Popper, G.V.: Fruit and vegetable increase plasma carotenoids and vitamins and decrease homocysteine in humans. J Nutr., 130: 1578-83 (2000). Chandrasekhar, V., Koushalya and Eapen, D.: Retention of b-carotene from selected greens and absorption of b- carotene from pumpkin leaves in adults. Ind. J. Nutr. Diet., 37: 233 (2000). Duell, P.B.: Prevention of atherosclerosis with dietary antioxidants: Fact or Fiction? J Nutr., 126: 1067-71S (1996). Feki, M., Soussi, M., Mokhtar, E., Hsairi, M., Kaabachi, N., Anteki, H., Alcindor, L.G., Mechmeche, R. and Mebazoa, A.: Vitamin E and coronary heart disease in Tusisians. Clin. Chem., 46: 1401-05 (2000) Ghafoorunissa and Krishnamurthy, K.: Fatty acid composition of food items. In: Diet and Heart Disease. pp 40-51. National Institute of Nutrition, Hyderabad (1994). Haidari, M., Javadi, E., Kodkhodaer, M. and Sanati, A.: Enhanced susceptibility to oxidation and diminished content of LDL from patients with stable coronary artery disease. Clin. Chem., 47: 1234-40 (2001). Jelliffee, B.B.: The Assessment of Nutritional Status of the Community. Monograph Series. World Health Organisation, Geneva. (1966). Loria, C.M., Klag, M.J., Caulfield, L.E. and Whelton, P.K.: Vitamin C status and mortality in US adults. Am. J. Clin. Nutr., 72: 139-45 (2000). Nayar, A.: Heart matters. Sunday Tribune, Spectrum, p 1 (2002). NCHS : Anthropometric reference data and prevalence of overweight US. Vital and Health Statistics Series, 111: No. 238 (1985). Pauling, L.: Health is determined by the nutrients you happen not to get, Heart Health Organisation http://www.heart health org./vitamins.htm. (2002). Song, W.O., Hoerrs, Bond J., Kakaral, M., Mann, S.K., Sihgal, S., Pande, U., Singh, U., Mehta, U. and Rohinidevi: A Nutrient Analysis Computer Program. Michigan State University, America (1992) Wallstrom, P., Wirfalt, E., Lahmann, P.N., Gullberg, B., Janson, L. and Berglund, G.: Serum concentrations of b-carotene and a-tocopherol are associatd with diet, smoking and general central adiposity. Am. J. Clin. Nutr., 73: 777-85 (Abstr) (2001). Authors’ Address: J.K. Sangha and Navjot Kaur, Department of Foods and Nutrition, Punjab Agricultural University, Ludhiana 141 004, Punjab, India

Glycemic status and soluble tumor necrosis factor receptor levels in relation to plasma leptin concentrations among normal weight and overweight US men.

Leptin, an adipocyte-derived protein product of the obesity (ob) gene, is a multifunctional polypeptide associated with the development of obesity-related disorders in humans. There is considerable inter-individual variation in plasma leptin even among subjects with comparable obesity levels, which suggests that factors other than adipose mass may be involved in the regulation of leptin expression and/or production. The purpose of this study was to evaluate the potential role of glycemic status and adipose-derived cytokines in regulating plasma leptin levels among normal and overweight men. Cross-sectional study. We measured plasma leptin, insulin, c-peptide and plasma soluble tumor necrosis factor receptor (sTNF-R) concentrations in 178 men. The subjects were selected from the Health Professionals Follow-up Study (HPFS), and aged 47-64 y in 1994, were free of cardiovascular disease, diabetes mellitus, malignant neoplasms, and had provided a fasting blood sample and a detailed lifestyle questionnaire. Men in the highest quintile of plasma leptin (mean = 12.7 ng/ml) weighed more, were less physically active and had higher circulating insulin, c-peptide, sTNF-R1 and sTNF-R2 concentrations than men in the lowest quintile (mean = 2.8 ng/ml). We found a significant correlation between plasma insulin, c-peptide, glycosylated hemoglobin (HbA1c), and sTNF-R1 on leptin concentrations (with Spearman correlation coefficients ranging from 0.17 to 0.48 and all P < 0.05). Only HbA1c and sTNF-R1 were independently and positively associated with plasma leptin after further adjusting for body mass index and other metabolic parameters of interest. Interestingly, these observed associations were limited to men with a BMI > or = 25 kg/m2. Our results suggest that glucose homeostasis and the activity of the TNF system may modulate leptin secretion and production among overweight men. Glucose homeostasis and TNF-alpha is important in metabolic disorders related to hyperleptinemia.

Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40-64 years.

Although 40% of US women indicate they are currently trying to lose weight, the association between intentional weight loss and longevity is unknown. The authors analyzed prospective data from 43,457 overweight, never-smoking US white women aged 40-64 years who in 1959-1960 completed a questionnaire that included questions on weight change direction, amount, time interval, and intentionality. Vital status was determined in 1972. Proportional hazards regression was used to estimate mortality rate ratios for women who intentionally lost weight compared with women who had no change in weight. Women who died within the first 3 years of follow-up were excluded. Analyses were stratified by preexisting illness and adjusted for age, beginning body mass index, alcohol intake, education, physical activity, and health conditions. In women with obesity-related health conditions (n = 15,069), intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality, primarily due to a 40-50% reduction in mortality from obesity-related cancers; diabetes-associated mortality was also reduced by 30-40% in those who intentionally lost weight. In women with no preexisting illness (n = 28,388), intentional weight loss of > or = 20 lb (> or = 9.1 kg) that occurred within the previous year was associated with about a 25% reduction in all-cause, cardiovascular, and cancer mortality; however, loss of < 20 lb (< 9.1 kg) or loss that occurred over an interval of > or = 1 year was generally associated with small to modest increases in mortality. The association between intentional weight loss and longevity in middle-aged overweight women appears to depend on their health status. Intentional weight loss among women with obesity-related conditions is generally associated with decreased premature mortality, whereas among women with no preexisting illness, the association is equivocal.

Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991

To examine trends in overweight prevalence and body mass index of the US adult population. Nationally representative cross-sectional surveys with an in-person interview and a medical examination, including measurement of height and weight. Between 6000 and 13,000 adults aged 20 through 74 years examined in each of four separate national surveys during 1960 to 1962 (the first National Health Examination Survey [NHES I]), 1971 to 1974 (the first National Health and Nutrition Examination Survey [NHANES I]), 1976 to 1980 (NHANES II), and 1988 to 1991 (NHANES III phase 1). In the period 1988 to 1991, 33.4% of US adults 20 years of age or older were estimated to be overweight. Comparisons of the 1988 to 1991 overweight prevalence estimates with data from earlier surveys indicate dramatic increases in all race/sex groups. Overweight prevalence increased 8% between the 1976 to 1980 and 1988 to 1991 surveys. During this period, for adult men and women aged 20 through 74 years, mean body mass index increased from 25.3 to 26.3; mean body weight increased 3.6 kg. These nationally representative data document a substantial increase in overweight among US adults and support the findings of other investigations that show notable increases in overweight during the past decade. These observations suggest that the Healthy People 2000 objective of reducing the prevalence of overweight US adults to no more than 20% may not be met by the year 2000. Understanding the reasons underlying the increase in the prevalence of overweight in the United States and elucidating the potential consequences in terms of morbidity and mortality present a challenge to our understanding of the etiology, treatment, and prevention of overweight.