Adult Weight Status Research Articles

Eat, Sleep, Work, Play: Associations of Weight Status and Health-Related Behaviors among Young Adult College Students

To examine relationships of sleep, eating, and exercise behaviors; work time pressures; and sociodemographic characteristics by weight status (healthy weight [body mass index or BMI < 25] vs. overweight [BMI ≥ 25]) of young adults. Cross-sectional. Nine U.S. universities. Enrolled college students (N = 1252; 18-24 years; 80% white; 59% female). Survey included the Pittsburgh Sleep Quality Index (PSQI), Three-Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory (ecSI), National Cancer Institute Fruit/Vegetable Screener, International Physical Activity Questionnaire, Work Time Pressure items, and sociodemographic characteristics. Chi-square and t-tests determined significant bivariate associations of sociodemographics, sleep behaviors, eating behaviors, physical activity behavior, and work time pressures with weight status (i.e., healthy vs. overweight/obese). Statistically significant bivariate associations with weight status were then entered into a multivariate logistic regression model that estimated associations with being overweight/obese. Sex (female), race (nonwhite), older age, higher Global PSQI score, lower ecSI total score, and higher TFEQ Emotional Eating Scale score were significantly (p < .05) associated with overweight/obesity in bivariate analyses. Multivariate logistic regression analysis showed that sex (female; odds ratio [OR] = 2.05, confidence interval [CI] = 1.54-2.74), older age (OR = 1.35, CI = 1.21-1.50), higher Global PSQI score (OR = 1.07, CI = 1.01-1.13), and lower ecSI score (OR = .96, CI = .94-.98), were significantly (p < .05) associated with overweight/obesity. Findings suggest that obesity prevention interventions for college students should include an education component to emphasize the importance of overall sleep quality and improving eating competence.

Influence of sleep timing behavior on weight status and activity patterns in adults with intellectual disabilities.

The aim was to explore the relationship between sleep habits and overweight/obesity, physical activity and sedentary behaviors in French adults with intellectual disabilities. This observational study was conducted on 570 French adults with intellectual deficiency. Sleep habits were analyzed and related to anthropometric measures, physical activity and sedentary behaviors. The study was conducted using a self-administered questionnaire. Participants completed the questionnaire during an interview with the principal investigator. Sleep timing behavior was classified into 4 sleep patterns: Early-bed/Early-rise, Early-bed/Late-rise, Late-bed/Late-rise, and Late-bed/Early-rise. Of 570 eligible participants, 61 were excluded because of missing data on age, weight or height. The number of participants identified in each of the four sleep patterns was as follows: Early-bed/Early-rise, N = 119 (23%), Early-bed/Late-rise, N = 171 (34%), Late-bed/Early-rise, N = 100 (20%), Late-bed/Late-rise N = 119 (23%). Participants who wake up earlier are more active than those who rise late (p < 0.02). Participants who slept later spent more time in sedentary activities than those in the Early rise groups (p < 0.01). The number of obese/overweight participants was also higher in Late-bed/Late rise group. Sleep behavior was associated with overweight/obesity, physical activity and sedentary behavior in adults with intellectual deficiency, independently the sleep duration. Implementing intervention or promotion programs on sleep behaviors should be considered in order to meet the objectives of promoting health on anthropometric characteristics and increased physical activity among these disabled adults.

Prevalence of overweight and obesity in adults from North Africa.

The share of North African immigrants in Europe is growing continuously. In this review, we aimed to systematically analyse and describe the literature on weight status and physical activity in North African adults, both in their home country and after immigration to Europe. Existing data on North African residents and on North African immigrants in Europe were analysed by a systematic search on PUBMED. There is a wide variation among countries in the prevalence of overweight/obesity, with immigrants showing higher values. The overall results revealed a higher prevalence of overweight and obesity in females than in males in North African residents. Females also show higher levels of obesity among immigrants. In particular, literature reports indicate that 1.3-47.8% of North African residents and 3.6-49.4% of North African immigrants in adult age are overweight or obese. Physical inactivity is higher than 20% in males and 40% in females in North African residents. The highest frequency of physically inactive or lightly active people among immigrants was observed in first-generation Sudanese and Moroccans in Amsterdam (males: 57.1%; females: 74.2%), with increasing rates in second-generation females. The results underline a higher health risk in North African immigrants than in residents. Specific public health strategies should be adopted in various populations of North African origin to control the obesity epidemic.

Establishing a method to estimate the cost-effectiveness of a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study.

Overweight and obesity in children are recognized as a major health problem. The ToyBox-intervention was developed with the aim of preventing obesity in pre-schoolers. Because it is increasingly important to inform policy makers not only on the effects of prevention interventions, but also on their costs and cost-effectiveness, our purpose was to establish a method to estimate the cost-effectiveness of the ToyBox-intervention. In order to estimate the long-term impact of the ToyBox-intervention on health and societal costs, extrapolations of the intervention effect will be conducted to predict children's weight status (based on the body mass index) at adult age. Effects of the adult weight status on the prevalence of obesity-related complications will be modelled through a Markov model, with a total time horizon of 70 years and a cycle length of 1 year. The model will be conducted in six European countries participating in the ToyBox-intervention, based on country-specific economic and epidemiological data. This study describes the methodological rationale and implementation of an analytic model to examine the cost-effectiveness of the ToyBox-intervention for six European countries, in order to inform decision-makers on the value for money of this intervention in the prevention of obesity in pre-schoolers.

Prospective cohort study on change in weight status and occurrence of habitual snoring in children.

To determine the association between the change in weight status and newly developed snoring in children. This was a prospective cohort study. Structured interviews were conducted at participants' homes, and physical examinations were performed at The-pa Community Hospital in Southern Thailand. Cohort subjects (n=1076) were recruited from children born over a 1-year period between November 2000 and October 2001 in The-pa District of Songkhla Province, Southern Thailand. Data collection was performed when the child was 5 and 8.5years old. The child's snoring, weight, height and tonsillar size were examined. The change in weight status was categorised into four groups: not obese, became not obese, became obese and persistently obese. Of 1076, 983 subjects (91.4%) completed both surveys. The overall prevalence of habitual snoring decreased from 13% at age 5 to 10.9% at age 8.5years. Of the 855 children who reported not snoring in the first survey, 61 (7.1%) had become habitual snorers. After adjusting for tonsillar size, children who had become obese or were persistently obese had a significant association with becoming a new snorer with an odds ratio of 5.8 (Confidence interval, CI, 1.3-25.8) and 11.7 (CI, 2.5-54.9), respectively. Children with newly developed obesity at 8.5years old were strongly associated with new snoring occurrence, which is similar to the findings of long-term follow-up studies in adults. Our findings support the idea that the patterns of changes in weight status and snoring development in adults begin as early as the primary school years.

Body weight status reflects the attitudes and behaviors related to vegetable consumption among Kentucky adults (640.3)

Vegetables are good sources of many important nutrients, including potassium, vitamin C, folate, fiber, and numerous phytochemicals. A diet rich in vegetables is low in energy density. Thus, vegetable consumption can play an important role in reducing incidence of overweight and obesity. The objective of this study was to assess the attitudes and behaviors related to vegetable consumption and body weight status of adults in Kentucky. A total of 280 visitors to the 2008 Kentucky State Fair were recruited to fill out a questionnaire before they were given a free analysis of their body composition (body fat %) with a Tanita TBF‐521 body composition analyzer. Frequency of vegetable consumption was negatively correlated with current body mass index and body fat percent of the subjects. The proportion of people within the normal weight range was higher among people who grew up eating vegetables and those who considered vegetables taste good. People who thought vegetables were expensive and troublesome to prepare, or only eat lettuce raw with dressings were more likely to be overweight or obese. Our results suggest that effective educational programs are needed to improve people's attitudes toward vegetables so they may increase their vegetable consumption to reduce the risk of obesity.

Obesogenic environments: a systematic review of the association between the physical environment and adult weight status, the SPOTLIGHT project

BackgroundUnderstanding which physical environmental factors affect adult obesity, and how best to influence them, is important for public health and urban planning. Previous attempts to summarise the literature have not systematically assessed the methodological quality of included studies, or accounted for environmental differences between continents or the ways in which environmental characteristics were measured.MethodsWe have conducted an updated review of the scientific literature on associations of physical environmental factors with adult weight status, stratified by continent and mode of measurement, accompanied by a detailed risk-of-bias assessment. Five databases were systematically searched for studies published between 1995 and 2013.ResultsTwo factors, urban sprawl and land use mix, were found consistently associated with weight status, although only in North America.ConclusionsWith the exception of urban sprawl and land use mix in the US the results of the current review confirm that the available research does not allow robust identification of ways in which that physical environment influences adult weight status, even after taking into account methodological quality.

Body mass index, self-esteem and weight contentment from adolescence to young adulthood and women's risk for sexually transmitted disease.

Background Women's risk for sexually transmitted diseases (STDs) were examined in terms of adolescent and young adult weight status, self-esteem trajectories and weight contentment using two waves of a nationally representative dataset. Using Waves 1 and 3 of the National Longitudinal Study of Adolescent Health, body mass index (BMI), self-esteem and weight contentment were examined during adolescence and young adulthood to assess the likelihood of STDs among 4000 young adult single women. Change in BMI, specifically weight loss between adolescence and young adulthood, significantly increased women's risk for STDs. Continuously low self-esteem during adolescence and young adulthood significantly increased women's risk for STDs. When women's contentment with their weight decreased from adolescence to young adulthood, women's risk for STDs was greater. Regardless of other variables, Black women were more likely to have an STD. RESULTS suggest that women's self-perception is important in reducing sexual risk; specifically, patterns of self-esteem, BMI and weight contentment across developmental periods should be a critical focus of research and practice related to adolescent and young adult sexual health. There are many known benefits to fostering self-esteem during adolescence and findings from this study add STD prevention among young women to this list. RESULTS emphasise the needed prevention during adolescence to address self-perspective and self-esteem for the long-term sexual well-being of young women.

The emergence of cardiometabolic disease risk in Chinese children and adults: consequences of changes in diet, physical activity and obesity.

Strong secular declines in physical activity, increased fat and salt intake, and increased obesity, especially abdominal obesity, mark China's recent nutrition transition. The China Health and Nutrition 2009 Survey collected anthropometry, blood pressure and fasting blood samples from more than 9,000 individuals ≥ 7 years of age. We focus on elevated blood pressure and plasma markers of diabetes, inflammation and dyslipidemia. We used international definitions of cardiometabolic risk and estimated age- and sex-specific prevalence ratios for each outcome for high waist circumference or overweight. We used logistic regression to assess each risk factor's association with diet, physical activity, overweight and abdominal obesity. Cardiometabolic risk prevalence was high in all age groups Prevalence ratios for most risk factors were nearly doubled for overweight or high waist circumference groups. Prevalence ratios were higher in younger than older adults. Low physical activity consistently predicted higher cardiometabolic risk across most outcomes and age-sex groups. The co-occurrence of overweight and high waist circumference was highly predictive of dyslipidemia, elevated glycated haemoglobin and diabetes. High prevalence of cardiometabolic risk factors and their strong association with weight status and abdominal obesity in young adults portend increases in cardiometabolic morbidity and mortality. Early interventions will be required to reverse trends.

Influence of neighbourhood ethnic density, diet and physical activity on ethnic differences in weight status: A study of 214,807 adults in Australia

We investigated whether ethnic and country of birth differences in adult Body Mass Index (BMI) were associated with differences in diet, physical activity and ethnic density (the percentage of an ethnic group within the neighbourhood environment).A sample of 214,807 adults living in Australia was extracted from the 45 and Up Study. Analyses comprised multilevel modelling of BMI for 38 ethnic and country of birth groups. Physical activity was ascertained using the Active Australia Survey. Dietary measures included self-reported consumption of fruit, vegetables, meat and cheese. Ethnic density was objectively measured using 2006 Australian Census data. Possible confounders included age, gender, household income, educational qualifications, economic status, couple status, language, duration of residence, neighbourhood affluence and remoteness.Compared to Australian-born Australians (age-gender adjusted mean BMI = 27.1, 95%CI 27.1, 27.2), overseas-born groups often had lower mean BMI, especially the Chinese born in China (23.2, 23.0, 23.4). Exceptions included the Italians (BMI = 28.1), Greeks (28.5), Maltese (27.6), Lebanese (28.4) and Croatians (27.8) born in their ethnic-country of origin. Regardless of birthplace, BMI was lower for the English, Scottish, and Chinese, but higher for Italians and Greeks. Some ethnic differences reflected the ‘healthy migrant’ hypothesis, whereas others did not. These differences were only partially attenuated by controls for portions of fruit and vegetables, meat and cheese, frequency of participation in physical activity, and other explanatory variables. Ethnic density was associated with lower BMI for the English and Irish (p < 0.05), regardless of whether they were born in the UK, Ireland, or Australia.Ethnic differences in adult weight status in Australia do not appear to be fully explained by conventional risk factors. For some groups, but not all, living among others of the same ethnic group may proxy unmeasured health-promoting factors and these contexts, along with other factors that harm health (e.g. racial discrimination) warrant further investigation.

Body weight status and cardiovascular risk factors in adults by frequency of candy consumption

BackgroundLimited information is available regarding the impact of candy consumption on health. The purpose of this study was to investigate associations between typical frequency of candy consumption and body weight status and select cardiovascular risk factors among adults in the United States.MethodsUsing data collected in the 2003–2006 National Health and Nutrition Examination Surveys (NHANES), adults were categorized as infrequent (≤ 3 eating occasions [EO]/month), moderate (> 3 EO/month and ≤ 3.5 EO/week), or frequent (> 3.5 EO/week) candy consumers based on the combined frequency of chocolate and other candy consumption over the previous 12 months. Weight and adiposity status were analyzed using logistic regression models, and blood pressure, lipids, and insulin sensitivity were analyzed using linear regression models. Models were adjusted for age, sex and race/ethnicity, and also for additional covariates with potential associations with the outcomes. Appropriate statistical weights were used to yield results generalizable to the US population.ResultsFrequency of candy consumption was not associated with the risk of obesity, overweight/obesity, elevated waist circumference, elevated skinfold thickness, blood pressure, low density lipoprotein (LDL) or high density lipoprotein (HDL) cholesterol, triglycerides, or insulin resistance. Increased frequency of candy consumption was associated with higher energy intakes and higher energy adjusted intakes of carbohydrates, total sugars and added sugars, total fat, saturated fatty acids and monounsaturated fatty acids (p < 0.05), and lower adjusted intakes of protein and cholesterol (p < 0.001).ConclusionsIncreased frequency of candy consumption among adults in the United States was not associated with objective measures of adiposity or select cardiovascular risk factors, despite associated dietary differences. Given the cross-sectional study design, however, it cannot be concluded that candy consumption does not cause obesity or untoward levels of cardiovascular risk markers. The lack of an association between frequency of candy consumption and cardiovascular risk factors could be due to reduced intake of candy among the overweight due to dieting or a health professional’s recommendations. Additionally, it is important to note that the analysis was based on frequency of candy consumption and not amount of candy consumed. Longitudinal studies are needed to confirm the lack of associations between frequency of candy consumption and cardiovascular risk factors.

Influence of weight status on muscle quality in older adults

The aim of this study was to investigate the impact of weight status on muscle quality in older adults. Community‐dwelling older adults (n=139) were assessed for body composition via dual‐energy X‐ray absorptiometry scanning and muscle power using the Nottingham Power Rig. MQ (watts/kg) was defined as leg muscle power (watts) normalized for mineral‐free lean mass of the lower body (kg). The sample was divided into four groups: normal weight males (n=12, 74.1±5.3 y, 23.6±1.3 kg/m2), normal weight females (n=36, 74.5±6.4 y, 22.7±1.5 kg/m2), overweight/obese males (n=29, 77.9±7.3 y, 28.8±3.3 kg/m2), and overweight/obese females (n=62, 73.7±5.3 y, 29.4±3.5 kg/m2). Analysis of covariance adjusted for age and number of medical conditions was conducted to examine the effect of weight status on MQ. Normal weight males (12.8 watts/kg) had significantly greater MQ relative to normal weight females (9.6 watts/kg) and overweight/obese females (8.4 watts/kg) (both p&lt;.01). In addition, MQ was significantly greater in overweight/obese males compared to overweight/obese females (10.5 vs. 8.4 watts/kg, respectively, p&lt;.01). These findings suggest that both weight status and sex influence MQ in older adults. Additional research is necessary to elucidate how weight‐related differences in MQ contribute to varying levels of functional performance in older men and women.

Cardiovascular disease in childhood: the role of obesity

In recent years, childhood obesity is becoming an epidemic health problem. It is now evident from many studies that childhood obesity is correlated with adult excess weight status and the development of risk factors for cardiovascular diseases in adulthood, including hypertension, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome. The exposure to obesity and to the above risk factors during childhood subsequently lead to atherosclerotic development, such as altered vascular structure and function, although the mechanisms are still unclear. Several non-invasive, and thus easy-to-obtain measures of arterial structure and function, have been shown to be clinically useful in providing information about vasculature early in the course of atherosclerosis, including measurement of endothelial function, carotid intima media thickness, and arterial stiffness. The early detection of cardiovascular abnormalities is essential because the control of the atherogenic process is more effective during its early stages. The present review focuses on the cardiovascular consequences of obesity, on the mechanisms and the methods of measurement of endothelial dysfunction in obese children and adolescents, and on the ways of intervention for the improvement of vascular health.

Physical activity and sitting time as mediators of the association between neighborhood environmental perceptions and weight status in African adults

Introduction: Growing evidence suggests the importance of environmental interventions for increasing physical activity and controlling obesity, but it remained unclear to what extent physical activity and sedentary behaviors mediate the association between neighborhood environmental factors and higher risk of overweight/obesity. This study aimed to investigate the mediating effects of physical activity and sedentary behaviors on the associations of neighborhood environmental factors and body mass index (BMI) among African adults.

Modelling of future outcomes to estimate the cost effectiveness of interventions related to child and adolescent overweight and obesity

BackgroundChildhood overweight and obesity is a major public health priority. Overweight or obese children are likely to become overweight or obese adults, are likely to be at increased risk of a wide range of chronic diseases (eg, type 2 diabetes, cardiovascular disease, and some cancers), and can have broader effects on lifestyle, health, and wellbeing compared with their peers. A clear need exists for cost-effective interventions or programmes that can help with the problems associated with childhood obesity. However, the conduct of cost-effectiveness analyses (and health technology assessment more broadly) in childhood obesity presents challenges. Translation of measures of effectiveness, for example body-mass index, into the potential effects of interventions on future health outcomes, such as prevention of diabetes, is one such challenge. The current methods available to model future outcomes in this way are limited. We aimed to develop a decision-analytic model to estimate the effect of interventions aimed at childhood overweight and obesity, for use in cost-effectiveness analyses in a public health context. MethodsWe developed a decision-analytic modelling framework using a simple model structure (in the first instance) consisting of three stages: prediction of adult weight status (healthy, overweight, or obese) from childhood weight status; prediction of obesity-related disease or events in adult years (type 2 diabetes, coronary heart disease, stroke, and colorectal cancer); and estimation of the effects of interventions for childhood obesity on prevention of these future events. The model was developed with longitudinal data for the 1958 UK birth cohort in which participants were followed up between ages 11 and 33 years, applying UK90 growth reference standards. Incidence rates for obesity-related health events were calculated on the basis of a 2009 systematic review and meta-analysis. The model was applied to a case study with data from an exploratory trial of a novel, drama-based, school-located obesity intervention, the Healthy Lifestyles Programme (HeLP), to present an example of the potential use of the model in a public health setting. HeLP was delivered to children aged 9–10 years during three school terms, and aimed to deliver a general healthy lifestyle message, seeking to change behaviours in the family, at school, and individually. Three key behaviours were emphasised: decrease in consumption of sweetened fizzy drinks, increase in proportion of healthy snacks to unhealthy snacks, and a reduction in television viewing and other screen-based activities. The empirical or mechanistic element of the model, prediction of adult weight status, was a major challenge, and sensitivity analyses explore the effect of the use of different sources of longitudinal data for prediction of adult weight status. FindingsIn a base-case scenario with a typical control cohort of 1000 children aged 11 years, the model predicted adult weight status at age 33 years, and thereafter an expected minimum of 274 health events (mainly coronary heart disease and type 2 diabetes) in this cohort between age 33 and 63 years (30 year time horizon). The model was used to estimate the expected effect of the HeLP intervention (a change in the distribution of weight status at age 11 years) on the expected number of health events over time, compared with standard practice and applying a third party payer (National Health Service or Personal Social Services) perspective. Outputs from the model can be used to estimate cost-effectiveness based on various input measures and assumptions. The sensitivity of judgments on cost effectiveness to different structural and data inputs were considered. InterpretationFindings suggest a reduction in future obesity-related health effects even when interventions are used in a broad public health context, and when average population effects are small. The model developed for use in cost-effectiveness analyses is a simple first stage, and the parsimonious nature of the model is subject to obvious limitations, but its potential usefulness in a public health decision making context is promising. FundingNIHR Research for Patient Benefit Programme; PenCLAHRC, the NIHR CLAHRC for the Southwest Peninsula.

Food Insecurity and Increased BMI in Young Adult Women

Food insecurity has been associated with weight status in children and adults although results have been mixed. We aimed to identify whether food insecurity was associated with BMI in young adults and whether this association differed by gender and was modified by food stamp use and the presence of children in the home. Cross-sectional data from wave 4 (2007-2008) of the National Longitudinal Study of Adolescent Health were analyzed. Multiple linear regression was used to investigate the association between food insecurity and BMI in gender stratified models of young adult women (n = 7,116) and men (n = 6,604) controlling for age, race/ethnicity, income, education, physical activity, smoking, alcohol use, the presence of children in the home, and food stamp use in young adulthood and/or adolescence. Food insecurity was more common in young adult women (14%) than young adult men (9%). After controlling for a variety of individual variables, food insecure women had a BMI that was on average 0.9 kg/m(2) units higher than women who were food secure. This difference in BMI persisted after controlling for recent or past food stamp use and was not different among women with or without children in the household. No relationship was found between food insecurity and BMI in young adult men. Providers should inquire about food insecurity, especially when treating obesity, and policy initiatives should address the role of access to healthy food in those facing food insecurity.

The Hunger–Obesity Paradox: Obesity in the Homeless

Despite stereotypes of the homeless population as underweight, the literature lacks a rigorous analysis of weight status in homeless adults. The purpose of this study is to present the body mass index (BMI) distribution in a large adult homeless population and to compare this distribution to the non-homeless population in the United States. Demographic, BMI, and socioeconomic variables from patients seen in 2007-2008 were collected from the Boston Health Care for the Homeless Program (BHCHP). This population was compared to non-homeless adults from the National Health and Nutrition Examination Survey (NHANES). Among 5,632 homeless adults, the mean BMI was 28.4 kg/m(2) and the prevalence of obesity was 32.3 %. Only 1.6 % of homeless adults were underweight. Compared to mean BMI in NHANES (28.6 kg/m(2)), the difference was not significant in unadjusted analysis (p = 0.14). Adjusted analyses predicting BMI or likelihood of obesity also showed that the homeless had a weight distribution not statistically different from the general population. Although underweight has been traditionally associated with homelessness, this study suggests that obesity may be the new malnutrition of the homeless in the United States.

Identifying built environmental patterns using cluster analysis and GIS: Relationships with walking, cycling and body mass index in French adults

BackgroundSocio-ecological models suggest that both individual and neighborhood characteristics contribute to facilitating health-enhancing behaviors such as physical activity. Few European studies have explored relationships between local built environmental characteristics, recreational walking and cycling and weight status in adults. The aim of this study was to identify built environmental patterns in a French urban context and to assess associations with recreational walking and cycling behaviors as performed by middle-aged adult residents.MethodsWe used a two-step procedure based on cluster analysis to identify built environmental patterns in the region surrounding Paris, France, using measures derived from Geographic Information Systems databases on green spaces, proximity facilities (destinations) and cycle paths. Individual data were obtained from participants in the SU.VI.MAX cohort; 1,309 participants residing in the Ile-de-France in 2007 were included in this analysis. Associations between built environment patterns, leisure walking/cycling data (h/week) and measured weight status were assessed using multinomial logistic regression with adjustment for individual and neighborhood characteristics.ResultsBased on accessibility to green spaces, proximity facilities and availability of cycle paths, seven built environmental patterns were identified. The geographic distribution of built environmental patterns in the Ile-de-France showed that a pattern characterized by poor spatial accessibility to green spaces and proximity facilities and an absence of cycle paths was found only in neighborhoods in the outer suburbs, whereas patterns characterized by better spatial accessibility to green spaces, proximity facilities and cycle paths were more evenly distributed across the region. Compared to the reference pattern (poor accessibility to green areas and facilities, absence of cycle paths), subjects residing in neighborhoods characterized by high accessibility to green areas and local facilities and by a high density of cycle paths were more likely to walk/cycle, after adjustment for individual and neighborhood sociodemographic characteristics (OR = 2.5 95%CI 1.4-4.6). Body mass index did not differ across patterns.ConclusionsBuilt environmental patterns were associated with walking and cycling among French adults. These analyses may be useful in determining urban and public health policies aimed at promoting a healthy lifestyle.

Comparison of prevalence of inadequate nutrient intake based on body weight status of adults in the US: An analysis of NHANES 2001–2008

Using total nutrient intake (foods and supplements) from the National Health and Nutrition Examination Survey 2001–2008, we determined usual intake for vitamins A, C, D, E, B6, folate and Ca, Mg, and Zn using the National Cancer Institute methodology in adults (n=18,995). Only subjects with reliable dietary records were included and pregnant and lactating females were excluded. Subjects were categorized by body weight status as either normal weight (&lt; 25 BMI), overweight (≥ 25 BMI &lt; 30), or obese (≥ 30 BMI). Normal weight subjects had lower (p &lt;0.01) levels of inadequate intake as compared to those overweight or obese for vitamin A (33.3 ± 1.4 vs 45.3 ± 2.3 vs 54.5 ± 2.7), D (77.4 ± 1.2 vs 84.0 ± 1.5, vs 87.8 ± 1.6), E (72.8 ± 1.1 vs 80.3 ± 1.1 vs 84.4 ± 2.0), Ca (55.7 ± 1.4 vs 65.9 ± 2.4 vs 68.5 ± 3.0), and Mg (50.7 ± 1.2 vs 62.7 ± 2.3 vs 72.1 ± 2.3). Obese subjects had higher inadequacy as compared to those overweight for vitamin A, Mg and Fe. We conclude that while large percentages of US adults have inadequate intake of vitamins A, C, D, E and Ca and Mg, body weight status influences inadequate intake in US adults with overweight and obese adults having even greater inadequacy for many of these nutrients. (Supported by Pharmavite, LLC.)

Relationship between Whole-Grain Intake, Chronic Disease Risk Indicators, and Weight Status among Adolescents in the National Health and Nutrition Examination Survey, 1999-2004

Background Although whole-grain intake has been associated with improved chronic disease risk factors and weight status in adults, similar studies are limited among adolescents. Objective To determine the relationship among chronic disease risk factors, weight status, and whole-grain intake among adolescents (aged 12 to 19 years) by sex. Design Analysis of the relationship between dietary, anthropometric, and chronic disease risk factors/laboratory measures and whole-grain intake groups (none, low [>0 to ≤0.5 oz equivalents/day], high [>0.5 oz equivalents/day]) among US adolescents (based on cross-sectional data from the National Health and Nutrition Examination Survey, 1999-2004). Participants/setting Data from 4,928 adolescents (2,495 boys, 2,433 girls) collected in person at home and mobile examination centers. Main outcome variables Adjusted least-squares means for dietary, anthropometric, and chronic disease risk factors/laboratory measures by whole-grain intake groups. Statistical analyses performed Outcome variables were examined in separate multiple linear regression models with categories of whole-grain intake as the independent variable, adjusted for demographic characteristics, smoking, physical activity, and food group/energy intake. Results Fewer than one third consumed >0.5 whole grain ounce equivalents per day. Higher whole-grain intake was associated with lower refined-grain and higher carbohydrate, fiber, folate, and energy intakes. Higher whole-grain intake was associated with lower body mass index and waist, thigh, and arm circumferences among boys only but not on further adjustment for food group intake. In models adjusted for food group intake, higher whole-grain intake was associated with lower fasting insulin levels and higher serum and red blood cell folate levels for boys and girls, with lower C-peptide concentrations for girls and lower homocysteine concentrations for boys. Conclusions Whole-grain intake was not associated with body mass index after adjusting for food group intake but was related to positive nutrient profiles and chronic disease risk factors, which supports current recommendations to promote greater intake of whole grains among adolescents.