ResearchPad - epidemiology-genetics https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Maternal Glucose Concentrations in Early Pregnancy and Cardiometabolic Risk Factors in Childhood]]> https://www.researchpad.co/article/elastic_article_6707 This study aimed to examine the associations of maternal early‐pregnancy glucose and insulin concentrations with offspring cardiometabolic risk factors and fat distribution.MethodsIn a population‐based prospective cohort study among 3,737 mothers and their children, random maternal glucose and insulin concentrations were measured at a median gestational age of 13.2 (95% range 10.5‐17.1) weeks. Childhood fat, blood pressure, and blood concentrations of lipids, glucose, and insulin at the age of 10 years were measured.ResultsHigher maternal early‐pregnancy glucose and insulin concentrations were associated with a higher risk of childhood overweight, and higher maternal early‐pregnancy insulin concentrations were associated with an increased childhood risk of clustering of cardiometabolic risk factors (all P < 0.05). These associations were explained by maternal prepregnancy BMI. Independent of maternal prepregnancy BMI, one SD score (SDS) higher maternal early‐pregnancy glucose and insulin concentrations were associated with higher childhood glucose (0.08 SDS, 95% CI: 0.04‐0.11) and insulin concentrations (0.07 SDS, 95% CI: 0.03‐0.10), but not with childhood blood pressure, lipids, and fat measures.ConclusionsThese results suggest that maternal early‐pregnancy random glucose and insulin concentrations are associated with childhood glucose and insulin concentrations but not with other childhood cardiometabolic risk factors. ]]> <![CDATA[The Societal Value of Broader Access to Antiobesity Medications]]> https://www.researchpad.co/article/Ne89726ed-d30a-49ef-b220-89de5ae2ef77

Objective

Obesity and its complications place an enormous burden on society. Yet antiobesity medications (AOM) are prescribed to only 2% of the eligible population, even though few individuals can sustain weight loss using other strategies alone. This study estimated the societal value of greater access to AOM.

Methods

By using a well‐established simulation model (The Health Economics Medical Innovation Simulation), the societal value of AOM for the cohort of Americans aged ≥ 25 years in 2019 was quantified. Four scenarios with differential uptake among the eligible population (15% and 30%) were modeled, with efficacy from current and next‐generation AOM. Societal value was measured as monetized quality of life, productivity gains, and savings in medical spending, subtracting the costs of AOM.

Results

For the 217 million Americans aged ≥ 25 years, AOM generated $1.2 trillion in lifetime societal value under a conservative scenario (15% annual uptake using currently available AOM). The introduction of next‐generation AOM increased societal value to $1.9 to $2.5 trillion, depending on uptake. Finally, societal value was higher for younger individuals and Black and Hispanic individuals compared with White individuals.

Conclusions

This study suggests that AOM provide substantial gains to patients and society. Policies promoting broader clinical access to and use of AOM warrant consideration to reach national goals to reduce obesity.

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<![CDATA[Behavioral and Psychological Strategies of Long‐Term Weight Loss Maintainers in a Widely Available Weight Management Program]]> https://www.researchpad.co/article/N36fc5b87-8597-4782-937c-0d2de52e338f

Objective

The study’s purpose was to use validated questionnaires to identify novel behavioral and psychological strategies among weight loss maintainers (WLMs) in a commercial weight management program.

Methods

Participants were 4,786 WLMs in WW (formerly Weight Watchers, New York, New York) who had maintained weight loss  ≥ 9.1 kg (24.7 kg/23.8% weight loss on average) for 3.3 years and had a current mean BMI of 27.6 kg/m2. A control group of 528 weight‐stable individuals with obesity had a mean BMI of 38.9 kg/m2 and weight change  < 2.3 kg over the previous 5 years.

Results

WLMs versus Controls practiced more frequent healthy dietary choices (3.3 vs. 1.9; ηp2 = 0.37), self‐monitoring (2.6 vs. 0.7; ηp2 = 0.30), and psychological coping (2.5 vs. 1.1; ηp2 = 0.25) strategies. WLMs also reported more willingness to ignore food cravings (4.4 vs. 3.5; ηp2 = 0.16) and had greater habit strength for healthy eating (5.3 vs. 3.2; ηp2 = 0.21). Standard canonical coefficients indicated that dietary (0.52), self‐monitoring (0.40), and psychological (0.14) strategies as well as habit strength for healthy eating (0.15) contributed independently and most (49.5% of variance) to discriminating groups.

Conclusions

In a widely available weight management program, more frequent practice of healthy dietary, self‐monitoring, and psychological coping strategies as well as development of greater habit strength for healthy eating differentiated long‐term WLMs from weight‐stable individuals with obesity.

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<![CDATA[Exposure to sewage water and the development of allergic manifestations in Finnish children]]> https://www.researchpad.co/article/N02b1f3bc-c501-489f-9934-e0d2a14d463a

Abstract

Background

The hygiene hypothesis suggests that a decreased microbial load contributes to an increased risk of allergies. In the Finnish municipality of Nokia, sewage water was accidentally mixed with drinking water for 2 days. We studied the association between exposure and the emergence of allergies in children.

Methods

Children aged 2‐5 years living in the accident area and an age‐matched cohort from the control municipality were recruited. Based on the questionnaires, we identified 139 children exposed to the contaminated water and selected age‐ and sex‐matched controls for them (mean age 16.59 months at the time of the accident). Allergic symptoms and diseases were recorded by ISAAC questionnaires and skin prick tests (SPTs) performed 2 and 5 years after the accident.

Results

SPT positivity at 5 years of follow‐up was decreased in the children exposed to the sewage water below 1 year of age (OR 0.311, 95% CI 0.118‐0.820; P = 0.019), particularly in children who did not develop gastroenteritis at exposure. In contrast, the children over 1 year of age at the exposure tended more likely to be SPT‐positive at 5 years of follow‐up (OR 1.997, 95% CI 0.963‐4.143; P = 0.070).

Conclusions

Sewage water exposure during the first year of life, but not later, decreased the risk of IgE sensitization emphasizing the importance of age as a modulator. The modulation of IgE sensitization by the presence of clinical gastroenteritis at the exposure suggests that the nature of microbial load may have importance or alternatively shared host defense mechanisms protect from infection and atopic sensitization.

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<![CDATA[Obesity, perceived weight discrimination, and psychological well‐being in older adults in England]]> https://www.researchpad.co/article/5bc71a9540307c07c9a42707

Objective

To examine whether the adverse effect of obesity on psychological well‐being can be explained by weight discrimination.

Methods

The study sample included 5056 older (≥50 y) men and women living in England and participating in the English Longitudinal Study of Ageing. Participants reported experiences of weight discrimination in everyday life and completed measures of quality of life (CASP‐19 scale), life satisfaction (Satisfaction With Life Scale), and depressive symptoms (eight‐item CES‐D scale). Height and weight were objectively measured, with obesity defined as BMI ≥30 kg/m2. Mediation analyses were used to test the role of perceived weight discrimination in the relationship between obesity and each psychological factor.

Results

Obesity, weight discrimination, and psychological well‐being were all significantly inter‐related. Mediation models revealed significant indirect effects of obesity through perceived weight discrimination on quality of life (β = −0.072, SE = 0.008), life satisfaction (β = −0.038, SE = 0.008), and depressive symptoms (β = 0.057, SE = 0.008), with perceived weight discrimination explaining approximately 40% (range: 39.5‐44.1%) of the total association between obesity and psychological well‐being.

Conclusions

Perceived weight discrimination explains a substantial proportion of the association between obesity and psychological well‐being in English older adults. Efforts to reduce weight stigma in society could help to reduce the psychological burden of obesity.

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<![CDATA[Normalization of Plus Size and the Danger of Unseen Overweight and Obesity in England]]> https://www.researchpad.co/article/5c060785d5eed0c484aedb83

Objective

This study aimed to investigate trends and sociodemographic factors underlying weight misperception in adults with overweight and obesity in England.

Methods

This study used descriptive and logistic regression analyses based on a pooled nationally representative cross‐sectional survey, Health Survey for England, for the years 1997, 1998, 2002, 2014, and 2015 of individuals with BMI ≥ 25 (n = 23,459). The main outcomes were (1) weight misperception and (2) weight‐loss attempts as well as the associations with demographic and socioeconomic characteristics and health status.

Results

The proportion of individuals with overweight and obesity misperceiving their weight status increased over time between 1997 and 2015 (37% to 40% in men; 17% to 19% in women). There were socioeconomic disparities in the misperception of weight status, with lower‐educated individuals from poorer‐income households and members of minority ethnic groups being more likely to underestimate their weight. Those underestimating their overweight and obesity status were 85% less likely to try to lose weight compared with people who accurately identified their weight status.

Conclusions

The upward trend in underassessment of overweight and obesity status in England is possibly a result of the normalization of overweight and obesity. Obesity prevention programs need to consider differential sociodemographic characteristics associated with underassessment of weight status.

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