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Sørensen TIA. Forecasting the global obesity epidemic through 2050. Lancet 2025; 405:756-757. [PMID: 40049184 DOI: 10.1016/s0140-6736(25)00260-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2025] [Accepted: 02/05/2025] [Indexed: 03/10/2025]
Affiliation(s)
- Thorkild I A Sørensen
- Department of Public Health and the Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark; Centre for Childhood Health, DK2300 Copenhagen, Denmark.
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Fraiman J, Baver S, Henneberg M. Microevolutionary hypothesis of the obesity epidemic. PLoS One 2024; 19:e0305255. [PMID: 39110707 PMCID: PMC11305523 DOI: 10.1371/journal.pone.0305255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/27/2024] [Indexed: 08/10/2024] Open
Abstract
The obesity epidemic represents potentially the largest phenotypic change in Homo sapiens since the origin of the species. Despite obesity's high heritability, it is generally presumed a change in the gene pool could not have caused the obesity epidemic. Here we advance the hypothesis that a rapid change in the obesogenic gene pool has occurred second to the introduction of modern obstetrics dramatically altering evolutionary pressures on obesity-the microevolutionary hypothesis of the obesity epidemic. Obesity is known to increase childbirth-related mortality several fold. Prior to modern obstetrics, childbirth-related mortality occurred in over 10% of women in their lifetime. After modern obstetrics, this mortality reduced to a fraction of a percent, thereby lifting a strong negative selection pressure. Regression analysis of data for ~ 190 countries was carried out to examine associations between 1990 lifetime maternal death rates (LMDR) and current obesity rates. Multivariate regression showed LMDR correlated more strongly with national obesity rates than GDP, calorie intake and physical inactivity. Analyses controlling for confounders via partial correlation show that LMDR explains approximately 11% of the variability of obesity rate between nations. For nations with LMDR above the median (>0.45%), LMDR explains 33% of obesity variance, while calorie intake, GDP and physical inactivity show no association with obesity in these nations. The microevolutionary hypothesis offers a parsimonious explanation of the global nature of the obesity epidemic.
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Affiliation(s)
- Joseph Fraiman
- Department of Graduate Education, Geisinger Commonwealth School of Medicine, Scranton, PA, United States of America
| | - Scott Baver
- Hanmol LLC, Sudbury, MA, United States of America
| | - Maciej Henneberg
- Biological Anthropology and Comparative Anatomy Unit, The University of Adelaide, Adelaide, Australia
- The Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- The Unit for Biocultural Variation in Obesity, University of Oxford, Oxford, United Kingdom
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Pedersen MM, Ekstrøm CT, Sørensen TI. Emergence of the obesity epidemic preceding the presumed obesogenic transformation of the society. SCIENCE ADVANCES 2023; 9:eadg6237. [PMID: 37703366 PMCID: PMC10499309 DOI: 10.1126/sciadv.adg6237] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/04/2023] [Indexed: 09/15/2023]
Abstract
The obesity epidemic, evolving in many countries since the 1970s, has been attributed to the widespread contemporary so-called obesogenic transformation of the societies, but what preceded the epidemic? Using quantile regression, we studied the trends by year of birth in the percentile distribution of body mass index (BMI = weight/height2) of 320,962 Danish school children, born from 1930 to 1976, and of 205,153 Danish young conscripts, born from 1939 to 1959. The overall trend of the percentiles of the BMI distributions were found to be linear across the years of birth. While the percentiles below the 75th were almost stable, those above showed a steadily steeper rise the more extreme the percentile among both school children and young men is. These changes, indicating the emergence of the obesity epidemic, preceded the presumed obesogenic transformation of the society by several decades and imply that other, so far unknown, factors have been involved.
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Affiliation(s)
- Mads Møller Pedersen
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- H. Lundbeck A/S, Copenhagen, Denmark
| | - Claus Thorn Ekstrøm
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I.A. Sørensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
Obesity is in theory defined on the basis of the excess health risk caused by adiposity exceeding the size normally found in the population, but for practical reasons, the World Health Organization (WHO) has defined obesity as a body mass index (weight (kg)/height (m)2) of 30 or above for adults. WHO considers the steep increases in prevalence of obesity in all age groups, especially since the 1970s as a global obesity epidemic. Today, approximately 650 million adult people and approximately 340 million children and adolescence (5-19 years) suffer from obesity. It is generally more prevalent among women and older age groups than among men and younger age groups. Beyond the necessity of availability of food, evidence about causes of obesity is still very limited. However, studies have shown that obesity 'runs in families', where both genetics and environmental, and especially social, factors play important roles. Obesity is associated with an increased risk of many adverse medical, mental and social consequences, including a strong relation to type 2 diabetes. Type 2 diabetes and related metabolic syndrome and diseases are major contributors to the excess morbidity and mortality associated with obesity.
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Apalasamy YD, Awang H, Mansor N, AbRashid N, Kamarulzaman ND, Lih Yoong T. Factors Associated With Obesity and Abdominal Obesity Among Malaysian Older Adults. Asia Pac J Public Health 2021; 33:547-554. [PMID: 34013778 DOI: 10.1177/10105395211014634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obesity is a rising concern globally. This study investigated the prevalence and factors associated with obesity and abdominal obesity (AO) among 5613 Malaysians aged 40 years and older via computer-assisted personal interviewing and anthropometric measurements. Obesity and AO prevalence were 37.8% and 63.1%, respectively. Significant associations were observed between: obesity with higher risk in patients aged between 40 and 49 years, Indians, females, income ≥RM 2000, and health status, and AO with higher risk in patients aged between 50 and 59 years, Indians, females, never married, income ≥RM 2000, and vigorous physical activity. Hence, age, sex, income, and ethnicity are associated with both obesity and AO. Promoting healthy body mass index and waist circumference is essential for healthy ageing.
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Josefson JL, Catalano PM, Lowe WL, Scholtens DM, Kuang A, Dyer AR, Lowe LP, Metzger BE. The Joint Associations of Maternal BMI and Glycemia with Childhood Adiposity. J Clin Endocrinol Metab 2020; 105:dgaa180. [PMID: 32271383 PMCID: PMC7229988 DOI: 10.1210/clinem/dgaa180] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/07/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT An obesogenic perinatal environment contributes to adverse offspring metabolic health. Previous studies have been limited by lack of direct adiposity measurements and failure to account for potential confounders. OBJECTIVE Examine the joint associations of maternal midpregnancy body mass index (BMI) and glycemia with direct adiposity measures in 10-14 year old offspring. DESIGN AND SETTING International, epidemiological study: Hyperglycemia and Adverse Pregnancy Outcome (HAPO) and HAPO Follow-up Study, conducted between 2000-2006 and 2013-2016, respectively. PARTICIPANTS AND MAIN OUTCOME MEASURES In 4832 children, adiposity measures for body mass index (BMI), body fat with air displacement plethysmography, skinfold thickness, and waist circumference were obtained at mean age 11.4 years. RESULTS Maternal BMI and glucose, as continuous and categorical variables, were the primary predictors. In fully adjusted models controlling for child age, sex, field center, and maternal characteristics, maternal BMI had significant, positive associations with all childhood adiposity outcomes, while maternal glycemia had significant, positive associations with childhood adiposity outcomes except BMI. In joint analyses, and compared with a nonobese, nongestational diabetes mellitus (GDM) reference group, maternal obesity and GDM were associated with higher odds (maternal obesity odds ratio; OR [95% confidence interval; CI], GDM OR [95% CI]; combined OR [95% CI]) of childhood overweight/obese BMI (3.00 [2.42-3.74], 1.39 [1.14-1.71], 3.55 [2.49-5.05]), obese BMI (3.54 [2.70-4.64], 1.73 [1.29-2.30], 6.10 [4.14-8.99]), percent body fat >85th percentile (2.15 [1.68-2.75], 1.33 [1.03-1.72], 3.88 [2.72-5.55]), sum of skinfolds >85th percentile (2.35 [1.83-3.00], 1.75 [1.37-2.24], 3.66 [2.55-5.27]), and waist circumference >85th percentile (2.52 [1.99-3.21], 1.39 [1.07-1.80], 4.18 [2.93-5.96]). CONCLUSIONS Midpregnancy maternal BMI and glycemia are independently and additively associated with direct adiposity measures in 10-14 year old children. The combination of maternal obesity and GDM is associated with the highest odds of childhood adiposity.
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Affiliation(s)
- Jami L Josefson
- Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Patrick M Catalano
- Mother Infant Research Institute, Tufts University School of Medicine, Boston, Massachusetts
| | - William L Lowe
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Denise M Scholtens
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alan Kuang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alan R Dyer
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lynn P Lowe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Boyd E Metzger
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Scribner RA, Radix RL, Gilliland AE, Leonardi C, Ferguson TF, Noel TP, Andall RG, Andall NR, Radix C, Frank R, Benjamin J, James J, Benjamin R, Waechter RL, Sothern MS. Absence of Adolescent Obesity in Grenada: Is This a Generational Effect? Front Public Health 2018; 6:204. [PMID: 30123791 PMCID: PMC6086203 DOI: 10.3389/fpubh.2018.00204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/03/2018] [Indexed: 01/15/2023] Open
Abstract
Background: Low- and middle-income countries are affected disproportionately by the ongoing global obesity pandemic. Representing a middle income country, the high prevalence of obesity among Grenadian adults as compared to US adults is expected as part of global obesity trends. The objective of this study was to determine if Grenadian adolescents have a higher prevalence of overweight compared to their US counterparts, and if a disparity exists between urban and rural adolescents. Methods: Using a subcohort of participants in the Grenadian Nutrition Student Survey, diet quality and anthropometric measures were collected from 55% of the classrooms of first year secondary students in Grenada (n = 639). Rural or urban designations were given to each school. Body Mass Index (BMI) was calculated and categorized as overweight or obese for each student following CDC classification cutoffs. A standardized BMI (BMIz) was calculated for each school. Sex-specific BMI and overall BMIz were compared to a 1980s US cohort. Multilevel models, overall and stratified by sex, of students nested within schools were conducted to determine if BMIz differed by rural or urban locality, gender, and diet quality. Results: The mean age of this cohort was 12.7 (SD = 0.8) years with 83.8% of the cohort identifying as Afro-Caribbean. Females had nearly twice the prevalence of overweight when compared to males (22.7 vs. 12.2%) but a similar prevalence of obesity (8.2 vs. 6.8%). Grenadian adolescents had lower prevalence of overweight (females: 22.7 vs. 44.7%; males: 12.2 vs. 38.8%, respectively) as compared to US counterparts. Eating a traditional diet was negatively associated with BMIz score among females ( β ^ = -0.395; SE = 0.123) in a stratified, multilevel analysis. BMIz scores did not differ significantly by rural or urban school designation. Conclusions: Among Grenadian adolescents, this study identified a lower overweight prevalence compared to US counterparts and no difference in overweight prevalence by urban or rural location. We hypothesize that the late introduction of processed foods to Grenada protected this cohort from obesogenic promoters due to a lack of fetal overnutrition. However, further research in subsequent birth cohorts is needed to determine if adolescent obesity will increase due to a generational effect.
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Affiliation(s)
- Richard A. Scribner
- Epidemiology Department, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, United States
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, United States
| | - Roger L. Radix
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Aubrey E. Gilliland
- Epidemiology Department, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, United States
| | - Claudia Leonardi
- Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, United States
| | - Tekeda F. Ferguson
- Epidemiology Department, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, United States
| | - Trevor P. Noel
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Rebecca G. Andall
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Naomi R. Andall
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Christal Radix
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Rhoda Frank
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Jonell Benjamin
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Jenifer James
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Romero Benjamin
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Randall L. Waechter
- Windward Islands Research and Education Foundation, St. George's University, St. George's, Grenada
| | - Melinda S. Sothern
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, United States
- Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, United States
- Department of Pediatrics, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, United States
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Wüst M, Mortensen EL, Osler M, Sørensen TIA. Universal infant health interventions and young adult outcomes. HEALTH ECONOMICS 2018; 27:1319-1324. [PMID: 29766619 DOI: 10.1002/hec.3771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/07/2018] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Abstract
Three recent studies have documented short- and long-run benefits of early-infancy health interventions in Norway, Sweden, and Denmark: Universal nurse home visiting (NHV) and well-baby center care decreased infant mortality and positively impacted long-run survival (DK, S), morbidity (DK, N), and educational and labor market outcomes (N). Using Danish conscription data, this paper examines intermediate outcomes to assess both potential mechanisms and the importance of selective survival for the long-run health effects of NHV. We do not find strong effects of NHV for young adult's height or obesity status, but we find that NHV increases treated individuals' probability of emigration. As emigrants in our sample are positively selected and as they are not part of the samples used in long-run analyses, this finding suggests that the established long-run health benefits of NHV may be lower bounds.
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Affiliation(s)
- Miriam Wüst
- The Danish Center for Applied Social Science, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Institute of Public Health and Center for Healthy Aging, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Merete Osler
- Research Center for Prevention and Health, Rigshopitalet-Glostrup, Glostrup, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research (Section of Metabolic Genetics), and Department of Public Health (Section of Epidemiology), Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark
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Affiliation(s)
- Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark. .,Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Graversen L, Howe LD, Sørensen TIA, Sovio U, Hohwü L, Tilling K, Laitinen J, Taanila A, Pouta A, Järvelin M, Obel C. Body mass index trajectories from 2 to 18 years - exploring differences between European cohorts. Pediatr Obes 2017; 12:102-109. [PMID: 26918667 PMCID: PMC5347959 DOI: 10.1111/ijpo.12115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 10/26/2015] [Accepted: 11/28/2015] [Indexed: 12/03/2022]
Abstract
BACKGROUND In recent decades, there has been an increase in the prevalence of childhood overweight in most high-income countries. Within northern Europe, prevalence tends to be higher in the UK compared with the Scandinavian countries. We aimed to study differences in body mass index (BMI) trajectories between large cohorts of children from UK and Scandinavian populations. METHODS We compared BMI trajectories in participants from the English Avon Longitudinal Study of Parents and Children born in 1991-1993 (ALSPAC) (N = 6517), the Northern Finland Birth Cohorts born in 1966 (NFBC1966) (N = 3321) and 1986 (NFBC1986) (N = 4764), and the Danish Aarhus Birth Cohort born in 1990-1992 (ABC) (N = 1920). We used multilevel models to estimate BMI trajectories from 2 to 18 years. We explored whether cohort differences were explained by maternal BMI, height, education or smoking during pregnancy and whether differences were attributable to changes in the degree of skew in the BMI distribution. RESULTS Differences in mean BMI between the cohorts were small but emerged early and persisted in most cases across childhood. Girls in ALSPAC had a higher BMI than all other cohorts throughout childhood, e.g. compared with the NFBC1986 BMI was 2.2-3.5% higher. For boys, the difference emerging over time (comparing the two NFBC's) exceeded the differences across populations (comparing NFBC1986, ABC and ALSPAC). BMI distribution demonstrated increasing right skew with age. CONCLUSION Population-level differences between cohorts were small, tended to emerge very early, persisted across childhood, and demonstrated an increase in the right-hand tail of the BMI distribution.
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Affiliation(s)
- L. Graversen
- Section for General Medical Practice, Department of Public HealthAarhus UniversityAarhusDenmark
| | - L. D. Howe
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK,School of Social and Community MedicineUniversity of BristolBristolUK
| | - T. I. A. Sørensen
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK,Institute of Preventive MedicineBispebjerg and Frederiksberg HospitalsCopenhagenDenmark,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - U. Sovio
- Department of Obstetrics and GynaecologyUniversity of CambridgeCambridgeUK,Department of Epidemiology and BiostatisticsImperial CollegeLondonUK
| | - L. Hohwü
- Section for General Medical Practice, Department of Public HealthAarhus UniversityAarhusDenmark
| | - K. Tilling
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK,School of Social and Community MedicineUniversity of BristolBristolUK
| | - J. Laitinen
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - A. Taanila
- Institute of Health SciencesUniversity of OuluOuluFinland,Unit of Primary CareUniversity Hospital of OuluOuluFinland
| | - A. Pouta
- National Institute of Health and WelfareOuluFinland,Department of Obstetrics and GynecologyUniversity of Oulu and Oulu University HospitalOuluFinland
| | - M‐R. Järvelin
- Department of Epidemiology and BiostatisticsImperial CollegeLondonUK,Unit of Primary CareUniversity Hospital of OuluOuluFinland,Biocenter OuluUniversity of OuluOuluFinland,Center for Life Course EpidemiologyUniversity of OuluOuluFinland
| | - C. Obel
- Section for General Medical Practice, Department of Public HealthAarhus UniversityAarhusDenmark
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Blundell JE, Baker JL, Boyland E, Blaak E, Charzewska J, de Henauw S, Frühbeck G, Gonzalez-Gross M, Hebebrand J, Holm L, Kriaucioniene V, Lissner L, Oppert JM, Schindler K, Silva AM, Woodward E. Variations in the Prevalence of Obesity Among European Countries, and a Consideration of Possible Causes. Obes Facts 2017; 10:25-37. [PMID: 28190010 PMCID: PMC5644946 DOI: 10.1159/000455952] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/06/2017] [Accepted: 01/06/2017] [Indexed: 01/07/2023] Open
Abstract
Over the last 10 years the prevalence of obesity across the European continent has in general been rising. With the exception of a few countries where a levelling-off can be perceived, albeit at a high level, this upward trend seems likely to continue. However, considerable country to country variation is noticeable, with the proportion of people with obesity varying by 10% or more. This variation is intriguing and suggests the existence of different profiles of risk or protection factors operating in different countries. The identification of such protection factors could indicate suitable targets for interventions to help manage the obesity epidemic in Europe. This report is the output of a 2-day workshop on the 'Diversity of Obesity in Europe'. The workshop included 14 delegates from 12 different European countries. This report contains the contributions and discussions of the materials and viewpoints provided by these 14 experts; it is not the output of a single mind. However, such is the nature of scientific analysis regarding obesity that it is possible that a different set of 14 experts may have come to a different set of conclusions. Therefore the report should not be seen as a definitive statement of a stable situation. Rather it is a focus for discussion and comment, and a vehicle to drive forward further understanding and management of obesity in Europe.
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Affiliation(s)
- John E. Blundell
- Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | - Emma Boyland
- Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Ellen Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | - Jadwiga Charzewska
- Department Nutritiona Epidemiology and DRI, National Food and Nutrition Institute, Warszawa, Poland
| | | | - Gema Frühbeck
- Metabolic Research Laboratory, Obesity Area, Department of Endocrinology & Nutrition, Clinica Univ. de Navarra, University of Navarra, Pamplona, Spain
| | - Marcela Gonzalez-Gross
- Department of Health and Human Performance, Facultad de CC de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, LVR-Klinikum, University Duisburg-Essen, Essen, Germany
| | - Lotte Holm
- Department of Food and Resource Economics, Consumption, Bioethics and Governance, University of Copenhagen, Frederiksberg C, Denmark
| | - Vilma Kriaucioniene
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), Gothenburg, Sweden
| | | | - Karin Schindler
- Abteilung für Endokrinologie und Stoffwechsel, Klinik für Innere Medizin III, Wien, Austria
| | - Analiza Mónica Silva
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, University of Lisbon, Portugal
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12
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The rise and the recent decline of childhood obesity in Swedish boys: the BEST cohort. Int J Obes (Lond) 2017; 41:807-812. [PMID: 28119533 DOI: 10.1038/ijo.2017.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/12/2016] [Accepted: 01/11/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Childhood obesity increases the risk for adult obesity and diseases. The aim of this study was to investigate secular changes of childhood body mass index (BMI), overweight and obesity in boys born during 1946-2006, using the population-based BMI Epidemiology STudy (BEST) cohort in Gothenburg, Sweden. SUBJECTS/METHODS We collected height and weight from archived school health records for boys born every 5 years 1946-2006 (birth cohort 1946 n=1584, each birth cohort 1951-2006 n=425). Childhood BMI at 8 years of age was obtained for all the participants. RESULTS Childhood BMI increased 0.18 kg m-2 (95% confidence interval: 0.16-0.20) per decade increase in birth year, during 1946-2006. The increase was significant from birth year 1971, peaked 1991 and was then followed by a stabilization or tendency to a reduction. Next, we aimed to thoroughly explore the trend after birth year 1991 and therefore expanded birth cohorts 1991 (n=1566), 2001 (n=6478) and 2006 (n=6515). Importantly, decreases in mean BMI (P<0.01), prevalences of overweight (P<0.01) and obesity (P<0.05) were observed after birth year 1991. For boys born in Sweden and with parents born in Sweden, a substantial reduction in the prevalences of overweight (-28.6%, P<0.001) and obesity (-44.3%, P<0.001) were observed between birth year 1991 and birth year 2006. CONCLUSIONS This long-term study captures both the rise and the recent decline of childhood obesity. As childhood obesity is strongly associated with subsequent adult obesity, we anticipate a similar reduction in adult obesity during the coming decades in Swedish men.
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Age-period-cohort analyses of obesity prevalence in US adults. Public Health 2016; 141:163-169. [PMID: 27931993 DOI: 10.1016/j.puhe.2016.09.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Age-period-cohort analysis is a stream of methodologies that decompose the temporal trends for disease risk into three time scales-age, calendar year (period) and year of birth (cohort). This study conducted age-period-cohort analyses of obesity prevalence in US adults. STUDY DESIGN Retrospective data analysis. METHODS We constructed regression models based on anthropometric data from the 1999-2012 National Health and Nutrition Examination Survey to correct for the self-reported height/weight in the 1984-2014 Behavioral Risk Factor Surveillance System (BRFSS). We estimated fixed-effects age-period-cohort models based on the BRFSS data for the overall adult sample (n = 6,093,293) and by sex and race/ethnicity, adjusting for individual characteristics and the BRFSS survey design. RESULTS An inverted U-shaped age effect on obesity and a positive period effect characterized by over-time increase in obesity risk independent of age and cohort influences were identified in the overall sample and subgroups by sex and race/ethnicity. From 1984 to 2014, the adjusted obesity prevalence increased by 21.1 percentage points among US adults, and 20.9, 21.6, 21.0, 26.4 and 20.1 percentage points in men, women, non-Hispanic whites, African Americans and Hispanics, respectively. In contrast, no consistent evidence was found in support of the cohort effect-the adjusted obesity risk was comparable across birth cohorts after accounting for the age and period effects. CONCLUSIONS Shifts in the age distribution and nationwide secular changes may have fuelled the obesity epidemic in the USA over the past decades. Reversing the obesity epidemic may require understanding of the nationwide changes over time that affect weight gain across all population subgroups and promoting universal changes to diet, physical activity and the obesogenic environment.
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Zimmermann E, Berentzen TL, Gamborg M, Sørensen TIA, Baker JL. Sex-specific associations between birth weight and adult primary liver cancer in a large cohort of Danish children. Int J Cancer 2015; 138:1410-5. [DOI: 10.1002/ijc.29900] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/09/2015] [Accepted: 10/21/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Esther Zimmermann
- Bispebjerg and Frederiksberg Hospital; Institute of Preventive Medicine, The Capital Region; Copenhagen Denmark
| | - Tina L. Berentzen
- Bispebjerg and Frederiksberg Hospital; Institute of Preventive Medicine, The Capital Region; Copenhagen Denmark
| | - Michael Gamborg
- Bispebjerg and Frederiksberg Hospital; Institute of Preventive Medicine, The Capital Region; Copenhagen Denmark
| | - Thorkild I. A. Sørensen
- Bispebjerg and Frederiksberg Hospital; Institute of Preventive Medicine, The Capital Region; Copenhagen Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
- MRC Integrative Epidemiology Unit; Bristol University; Bristol United Kingdom
| | - Jennifer L. Baker
- Bispebjerg and Frederiksberg Hospital; Institute of Preventive Medicine, The Capital Region; Copenhagen Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health Sciences; University of Copenhagen; Copenhagen Denmark
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15
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Ajslev TA, Ängquist L, Silventoinen K, Baker JL, Sørensen TIA. Stable intergenerational associations of childhood overweight during the development of the obesity epidemic. Obesity (Silver Spring) 2015; 23:1279-87. [PMID: 25959297 DOI: 10.1002/oby.21060] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 01/25/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The obesity epidemic may have developed as a response to the obesogenic environment among the genetically predisposed. This investigation examined whether the intergenerational resemblances in childhood overweight changed across the development of the obesity epidemic in groups of children born to parents with and without childhood overweight. METHODS The study population was from the Copenhagen School Health Records Register, which includes age- and sex-specific body mass index (BMI; kg/m(2) ) of children. This study used BMI values from 7-year-old children born 1952-1989 and from their parents at ages 7 and 13 years. The available number of parent-child pairs ranged from 17,926 through 42,184. The odds ratios of childhood overweight (BMI z-score >90th percentile) were calculated using logistic regression by parental BMI groups (BMI > or ≤90th percentile) and child birth year intervals. RESULTS Stable levels in parent-child overweight associations were observed across child BMI groups born to parents with and without childhood overweight. A slight upward odds ratio trend was observed across time in children born to two overweight parents at age 13, but not at age 7 years. CONCLUSIONS Parent-child resemblance in childhood overweight showed small changes during the development of the obesity epidemic, suggesting that the obesogenic environment inducing the epidemic in Denmark influenced children irrespective of their familial predisposition.
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Affiliation(s)
- Teresa A Ajslev
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospital, The Capital Region, Copenhagen, Denmark
| | - Lars Ängquist
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospital, The Capital Region, Copenhagen, Denmark
| | - Karri Silventoinen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Jennifer L Baker
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospital, The Capital Region, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- MRC Integrative Epidemiology Unit, Bristol University, Bristol, UK
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16
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Richmond RC, Timpson NJ, Sørensen TIA. Exploring possible epigenetic mediation of early-life environmental exposures on adiposity and obesity development. Int J Epidemiol 2015; 44:1191-8. [PMID: 25953782 DOI: 10.1093/ije/dyv066] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 12/17/2022] Open
Affiliation(s)
| | | | - Thorkild I A Sørensen
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark and Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark
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17
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Badiel M, Cepeda M, Ochoa J, Loaiza JH, Velásquez JG. [Birth cohort effect on prevalence of cardiovascular risk factors in coronary artery disease. Experience in a Latin-american country]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2015; 85:9-15. [PMID: 25660087 DOI: 10.1016/j.acmx.2014.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 10/05/2014] [Accepted: 10/13/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The prevalence of major risk factors associated to coronary artery disease has changed over time. Today, the frequency of dyslipidemia, hypertension and diabetes mellitus has increased, while smoking has decreased. The birth cohort effect for coronary artery disease in subjects as an approximation of the true prevalence over time has not been studied in Latin-America. OBJECTIVE To determine the trends in the prevalence of major risk factors for coronary artery disease by birth cohort effect in a high risk population. METHODS We estimate the prevalence of diabetes mellitus, smoking, hypertension and dyslipidemia from a prospective institutional registry (DREST registry) of patients who underwent percutaneous coronary intervention for acute coronary event. Birth cohort effect was defined as a statistical, epidemiological and sociological methodology to identify the influence of the environment in the lifetime from birth by each decade. Univariate and multivariate analyses were performed adjusted by gender. RESULTS Out of 3,056 subjects who were enrolled, 72% were male, with a median age of 61 years (interquartile range=53-69). Hypertension prevalence was 62.3%, for diabetes mellitus it was 48.8%, for smoking it was 18.8% and for dyslipidemia it was 48.8%. We observed an increase in prevalence for diabetes mellitus and dyslipidemia in each cohort according to birth decade, while there was a reduction in prevalence for hypertension in the same decades. CONCLUSIONS The prevalence of major cardiovascular risk factors has changed in time and the presence of time at birth effect is evident, possibly influenced by the environment's social conditions in each decade of life.
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Affiliation(s)
- Marisol Badiel
- Unidad de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia.
| | - Magda Cepeda
- Unidad de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Julián Ochoa
- Laboratorio de cateterismo cardiaco, Unidad cardiovascular, Fundación Valle del Lili, Cali, Colombia
| | - John H Loaiza
- Unidad de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Jorge G Velásquez
- Laboratorio de cateterismo cardiaco, Unidad cardiovascular, Fundación Valle del Lili, Cali, Colombia
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18
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Should age-period-cohort analysts accept innovation without scrutiny? A response to Reither, Masters, Yang, Powers, Zheng and Land. Soc Sci Med 2015; 128:331-3. [PMID: 25641207 DOI: 10.1016/j.socscimed.2015.01.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This commentary clarifies our original commentary (Bell and Jones, 2014c) and illustrates some concerns we have regarding the response article in this issue (Reither et al., 2015). In particular, we argue that (a) linear effects do not have to be produced by exact linear mathematical functions to behave as if they were linear, (b) linear effects by this wider definition are extremely common in real life social processes, and (c) in the presence of these effects, the Hierarchical Age Period Cohort (HAPC) model will often not work. Although Reither et al. do not define what a 'non-linear monotonic trend' is (instead, only stating that it isn't a linear effect) we show that the model often doesn't work in the presence of such effects, by using data generated as a 'non-linear monotonic trend' by Reither et al. themselves. We then question their discussion of fixed and random effects before finishing with a discussion of how we argue that theory should be used, in the context of the obesity epidemic.
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19
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Abstract
A substantial body of research has explored the relative roles of genetic and environmental factors on phenotype expression in humans. Recent research has also sought to identify gene-environment (or g-by-e) interactions, with mixed success. One potential reason for these mixed results may relate to the fact that genetic effects might be modified by changes in the environment over time. For example, the noted rise of obesity in the United States in the latter part of the 20th century might reflect an interaction between genetic variation and changing environmental conditions that together affect the penetrance of genetic influences. To evaluate this hypothesis, we use longitudinal data from the Framingham Heart Study collected over 30 y from a geographically relatively localized sample to test whether the well-documented association between the rs993609 variant of the FTO (fat mass and obesity associated) gene and body mass index (BMI) varies across birth cohorts, time period, and the lifecycle. Such cohort and period effects integrate many potential environmental factors, and this gene-by-environment analysis examines interactions with both time-varying contemporaneous and historical environmental influences. Using constrained linear age-period-cohort models that include family controls, we find that there is a robust relationship between birth cohort and the genotype-phenotype correlation between the FTO risk allele and BMI, with an observed inflection point for those born after 1942. These results suggest genetic influences on complex traits like obesity can vary over time, presumably because of global environmental changes that modify allelic penetrance.
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20
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Ajslev TA, Ängquist L, Silventoinen K, Baker JL, Sørensen TIA. Trends in parent-child correlations of childhood body mass index during the development of the obesity epidemic. PLoS One 2014; 9:e109932. [PMID: 25329656 PMCID: PMC4201474 DOI: 10.1371/journal.pone.0109932] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/12/2014] [Indexed: 01/19/2023] Open
Abstract
Background The intergenerational resemblance in body mass index may have increased during the development of the obesity epidemic due to changes in environment and/or expression of genetic predisposition. Objectives This study investigates trends in intergenerational correlations of childhood body mass index (BMI; kg/m2) during the emergence of the obesity epidemic. Methods The study population was derived from the Copenhagen School Health Records Register, which includes height and weight measurements since birth year 1930. Mothers and fathers with BMIs available at ages 7 (n = 25,923 and n = 20,972) or 13 years (n = 26,750 and n = 21,397), respectively, were linked through the civil registration system introduced in 1968 to their children with BMIs available at age 7 years. Age- and sex-specific BMI z-scores were calculated. Correlations were estimated across eight intervals of child birth years (1952–1989) separately by sex. Trends in these correlations were examined. Whereas the mother-child correlations reflected the biological relationship, a likely decline in the assignment of non-biological fathers through the registration system across time must be considered when interpreting the father-child correlations. Results The BMI correlations between mothers and sons ranged from 0.29–0.36 and they decreased marginally, albeit significantly across time at ages 7–7 years (−0.002/year, p = 0.006), whereas those at 13–7 years remained stable (<0.0004/year, p = 0.96). Mother-daughter correlations ranged from 0.30–0.34, and they were stable at ages 7–7 years (0.0001/year, p = 0.84) and at 13–7 years (0.0004/year, p = 0.56). In contrast, father-son correlations increased significantly during this period, both at ages 7–7 (0.002/year, p = 0.007) and at ages 13–7 years (0.003/year, p<0.001), whereas the increase in father-daughter correlations were insignificant both at ages 7–7 (0.001/year, p = 0.37) and at ages 13–7 years (0.001/year, p = 0.18). Conclusion During the obesity epidemics development, the intergenerational resemblance with mothers remained stable, whereas the father-child BMI resemblance increased, possibly reflecting changes in family relationships, and unlikely to have influenced the epidemic.
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Affiliation(s)
- Teresa A. Ajslev
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- * E-mail:
| | - Lars Ängquist
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
| | - Karri Silventoinen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Jennifer L. Baker
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I. A. Sørensen
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg Hospital, Frederiksberg, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
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21
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Delahaye F, Wijetunga NA, Heo HJ, Tozour JN, Zhao YM, Greally JM, Einstein FH. Sexual dimorphism in epigenomic responses of stem cells to extreme fetal growth. Nat Commun 2014; 5:5187. [PMID: 25300954 PMCID: PMC4197137 DOI: 10.1038/ncomms6187] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 09/08/2014] [Indexed: 12/17/2022] Open
Abstract
Extreme fetal growth is associated with increased susceptibility to a range of adult diseases through an unknown mechanism of cellular memory. We tested whether heritable epigenetic processes in long-lived CD34+ hematopoietic stem/progenitor cells (HSPCs) showed evidence for re-programming associated with the extremes of fetal growth. Here we show that both fetal growth restriction and over-growth are associated with global shifts towards DNA hypermethylation, targeting cis-regulatory elements in proximity to genes involved in glucose homeostasis and stem cell function. We find a sexually dimorphic response; intrauterine growth restriction (IUGR) is associated with substantially greater epigenetic dysregulation in males, whereas large for gestational age (LGA) growth predominantly affects females. The findings are consistent with extreme fetal growth interacting with variable fetal susceptibility to influence cellular aging and metabolic characteristics through epigenetic mechanisms, potentially generating biomarkers that could identify infants at higher risk for chronic disease later in life.
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Affiliation(s)
- Fabien Delahaye
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block Building, Room 631, Bronx, New York 10461, USA
| | - N Ari Wijetunga
- Department of Genetics, Albert Einstein College of Medicine, 1301 Morris Park Avenue, Price Building, Room 322, Bronx, New York 10461, USA
| | - Hye J Heo
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block Building, Room 631, Bronx, New York 10461, USA
| | - Jessica N Tozour
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block Building, Room 631, Bronx, New York 10461, USA
| | - Yong Mei Zhao
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block Building, Room 631, Bronx, New York 10461, USA
| | - John M Greally
- Department of Genetics, Albert Einstein College of Medicine, 1301 Morris Park Avenue, Price Building, Room 322, Bronx, New York 10461, USA
| | - Francine H Einstein
- Department of Obstetrics &Gynecology and Women's Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Block Building, Room 631, Bronx, New York 10461, USA
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Abstract
A new report provides compelling evidence of the high prevalence of overweight and obesity throughout the world. The prevalence has increased since 1980, but at different rates across ages, times and locations. Studies exploring the causes of these differences could aid development of effective prevention strategies.
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Affiliation(s)
- Camilla Schmidt Morgen
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Nordre Fasanvej 57, DK2000 Frederiksberg, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 1, DK2100 Copenhagen, Denmark
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23
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Krueger PM, Coleman-Minahan K, Rooks RN. Race/ethnicity, nativity and trends in BMI among U.S. adults. Obesity (Silver Spring) 2014; 22:1739-46. [PMID: 24634406 PMCID: PMC4545289 DOI: 10.1002/oby.20744] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 02/25/2014] [Accepted: 03/11/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The average BMI is rising even as the U.S. population grows increasingly diverse. Prior research by examining BMI trends in diverse groups including whites, blacks, Chinese, Filipinos, Asian Indians, Mexicans, Puerto Ricans, and Cubans who are U.S. born, recent immigrants, or long-term immigrants was extended. METHODS Cross-sectional data from the 1989 to 2011 waves of the National Health Interview Survey (N = 989,273) have been pooled and linear regression models to examine trends in BMI among U.S. adults have been used. RESULTS Annual increases in BMI are greatest among U.S.-born Puerto Ricans and Mexicans and slowest among foreign born Chinese. Among the U.S. born in 2011, Chinese adults have an average BMI below the threshold for overweight, whereas blacks, Mexicans, and Puerto Ricans have average BMIs in the obese range. Foreign-born adults average lower BMIs than U.S. born adults in most race/ethnic groups, and nativity disparities generally widen over time. BMI increases across calendar periods rather than birth cohorts. CONCLUSION Our results suggest that calendar period interventions may be particularly useful in reversing rising BMIs in the United States. However, interventions must be tailored to different race/ethnic and nativity groups in order to reduce disparities in body mass.
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Affiliation(s)
- Patrick M Krueger
- Department of Health & Behavioral Sciences, University of Colorado Denver, Denver, CO, USA
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Visscher TLS, Heitmann BL, Rissanen A, Lahti-Koski M, Lissner L. A break in the obesity epidemic? Explained by biases or misinterpretation of the data? Int J Obes (Lond) 2014; 39:189-98. [PMID: 24909829 DOI: 10.1038/ijo.2014.98] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 03/14/2014] [Accepted: 04/01/2014] [Indexed: 12/24/2022]
Abstract
Recent epidemiologic papers are presenting prevalence data suggesting breaks and decreases in obesity rates. However, before concluding that the obesity epidemic is not increasing anymore, the validity of the presented data should be discussed more thoroughly. We had a closer look into the literature presented in recent reviews to address the major potential biases and distortions, and to develop insights about how to interpret the presented suggestions for a potential break in the obesity epidemic. Decreasing participation rates, the use of reported rather than measured data and small sample sizes, or lack of representativeness, did not seem to explain presented breaks in the obesity epidemic. Further, available evidence does not suggest that stabilization of obesity rates is seen in higher socioeconomic groups only, or that urbanization could explain a potential break in the obesity epidemic. However, follow-ups of short duration may, in part, explain the apparent break or decrease in the obesity epidemic. On the other hand, a single focus on body mass index (BMI) ⩾25 or ⩾30 kg m(-)(2) is likely to mask a real increase in the obesity epidemic. And, in both children and adults, trends in waist circumferences were generally suggesting an increase, and were stronger than those reported for trends in BMI. Studies concluding that there is a recent break in the obesity epidemic need to be interpreted with caution. Reported studies presenting a break were mostly of short duration. Further, focusing on trends in waist circumference rather than BMI leads to a less optimistic conclusion: the public health problem of obesity is still increasing.
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Affiliation(s)
- T L S Visscher
- 1] Research Centre for the Prevention of Overweight (Zwolle), Windesheim University of Applied Sciences and VU University, Zwolle, The Netherlands [2] Institute of Health Sciences, VU University, Amsterdam, The Netherlands [3] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK
| | - B L Heitmann
- 1] Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals, The Capital Region, Copenhagen, Denmark [2] National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark [3] The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, New South Wales, Australia
| | - A Rissanen
- 1] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK [2] Helsinki University Central Hospital, Helsinki, Finland
| | - M Lahti-Koski
- 1] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK [2] Finnish Heart Association, Helsinki, Finland
| | - L Lissner
- 1] Prevention and Public Health Taskforce, European Association for the Study of Obesity, London, UK [2] Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
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Zhou SS, Zhou Y. Excess vitamin intake: An unrecognized risk factor for obesity. World J Diabetes 2014; 5:1-13. [PMID: 24567797 PMCID: PMC3932423 DOI: 10.4239/wjd.v5.i1.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/07/2013] [Accepted: 12/17/2013] [Indexed: 02/05/2023] Open
Abstract
Over the past few decades, food fortification and infant formula supplementation with high levels of vitamins have led to a sharp increase in vitamin intake among infants, children and adults. This is followed by a sharp increase in the prevalence of obesity and related diseases, with significant disparities among countries and different groups within a country. It has long been known that B vitamins at doses below their toxicity threshold strongly promote body fat gain. Studies have demonstrated that formulas, which have very high levels of vitamins, significantly promote infant weight gain, especially fat mass gain, a known risk factor for children developing obesity. Furthermore, ecological studies have shown that increased B vitamin consumption is strongly correlated with the prevalence of obesity and diabetes. We therefore hypothesize that excess vitamins may play a causal role in the increased prevalence of obesity. This review will discuss: (1) the causes of increased vitamin intake; (2) the non-monotonic effect of excess vitamin intake on weight and fat gain; and (3) the role of vitamin fortification in obesity disparities among countries and different groups within a country.
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26
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Predictors of change in weight and waist circumference: 15-year longitudinal study in Australian adults. Eur J Clin Nutr 2014; 68:309-15. [PMID: 24398635 DOI: 10.1038/ejcn.2013.260] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 10/17/2013] [Accepted: 10/18/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES This study examines which socio-demographic and lifestyle characteristics are associated with weight and waist circumference (WC) change in a cohort of Australian adults over a 15-year period (1992-2007). Further, it tests the effect of period of birth (birth cohort) on mean weight and WC at two time points, 15 years apart. SUBJECTS/METHODS Up to three repeated measures of weight (n=1437) and WC (n=1317) were used. Self-reported data on socio-demographic and lifestyle characteristics were derived from repeated questionnaires. Multivariable models, stratified by sex, were adjusted for potential confounders. RESULTS Participants born more recently were heavier, on average, than those in the same age group 15 years earlier, but there was no such secular trend in WC. Age at baseline was associated with change in weight and WC, but the pattern was different: participants gained weight up to age 55 years, while WC gain continued to 65 years. In women, higher level of recreational physical activity was associated with lower WC gain (P<0.05). Parity was also associated with WC change in women (P<0.05), but there was no linear trend. CONCLUSIONS Age was the most important factor associated with change in weight and WC in both sexes, apparently reducing the influence of all potential covariates. Among women, physical activity and parity were also associated with change in weight and WC. This study provides longitudinal evidence to support public health efforts that address the continuous increases in average weight and WC of many populations around the world.
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27
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Don't birth cohorts matter? A commentary and simulation exercise on Reither, Hauser, and Yang's (2009) age–period–cohort study of obesity. Soc Sci Med 2014; 101:176-80. [DOI: 10.1016/j.socscimed.2013.09.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 11/21/2022]
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Schmidt Morgen C, Rokholm B, Sjöberg Brixval C, Schou Andersen C, Geisler Andersen L, Rasmussen M, Nybo Andersen AM, Due P, Sørensen TIA. Trends in prevalence of overweight and obesity in danish infants, children and adolescents--are we still on a plateau? PLoS One 2013; 8:e69860. [PMID: 23894553 PMCID: PMC3722196 DOI: 10.1371/journal.pone.0069860] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 06/12/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND After the worldwide steep increase in child and adolescent overweight and obesity during the last decades, there is now evidence of a levelling off in the prevalence in many countries in the Western world. AIM To examine whether there still is a plateau in the prevalence of overweight and obesity in Danish children and adolescents, or whether the prevalence is decreasing or rising again. METHODS THE TRENDS IN THE PREVALENCE RATES WERE BASED ON THREE DATA SETS PROVIDING COMPARABLE REPEATED ESTIMATES: 1) the Danish Health Visitors Child Health Database (DHVCHD) with measurements on infant and childhood height and weight from 2002 to 2011 (n up to 39,984), 2) the Danish National Birth Cohort (DNBC) with maternal reports of measured infant and childhood height and weight from 1998 to 2010 (n up to 56,826) and 3) the Danish part of the Health Behaviour in School-aged Children survey (HBSC) with self-reported information on adolescent height and weight from the years 2002 to 2010 (n = 16,557). Overweight and obesity were categorized according to WHO growth standards. Trends were assessed by repeated point estimates and linear regression analyses providing regression coefficients for changes in per cent per year with 95% confidence intervals (CI). RESULTS The prevalence rates of overweight and obesity for infants, children and adolescents showed a mixed pattern of decline, stability and increase (ranging from -1.10 through 0.29 per cent per year with CI's from -3.10 through 2.37). Overall, there were no consistent statistically significant trends upwards or downwards, although some significant downward trends in childhood and adolescence were observed. CONCLUSION This study, based on data from 1998 through 2011, showed that the prevalence rates of overweight and obesity among Danish infants, children and adolescents were largely still on a plateau with tendencies for a decline among children and adolescents.
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Affiliation(s)
- Camilla Schmidt Morgen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
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29
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Haugaard LK, Ajslev TA, Zimmermann E, Ängquist L, Sørensen TIA. Being an only or last-born child increases later risk of obesity. PLoS One 2013; 8:e56357. [PMID: 23437116 PMCID: PMC3577826 DOI: 10.1371/journal.pone.0056357] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 01/14/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies have suggested that number of siblings and birth order is associated with obesity. However, studies combining these exposures are needed. This study aimed at investigating obesity in children and young adults in regard to different combinations of family size and birth order. METHODS Two cohorts selected from the general population were investigated: The Copenhagen School Health Records Register (CSHRR) and a Draft Board (DB) sample with measured heights and weights in childhood (age 13 years) and young adulthood (age 19 years), respectively. Information on birth order, number of siblings, and relevant covariates were available on 29 327 children, as well as on 323 obese young men and 575 randomly selected controls of young men representing approximately 58 000. The relation between number of siblings and birth order, respectively, and having a Body Mass Index (BMI) z-score above or equal to the 95(th) percentile in childhood or having a BMI of at least 31.00 kg/m(2) in young adulthood was analysed using logistic regression analyses adjusted for relevant confounders. RESULTS Only children had significantly higher odds of obesity both in childhood and in young adulthood compared with children with siblings, odds ratio (OR) =1.44 (95% Confidence Interval (CI): 1.26-1.66) and OR=1.76 (95% CI: 1.18-2.61), respectively. No association between first-born status and obesity was found. The OR of last-born children being obese was also significantly increased in childhood, e.g. OR=1.93 (95% CI: 1.09-3.43) of obesity if last-born in a family of four children. This was not found in young adulthood. Additionally, higher spacing to previous sibling (average 1872 vs. 1303 days; p=0.026 in four children families) was observed in obese last-born compared to non-obese last-born children. CONCLUSION Being an only or last-born child is associated with obesity. These associations may provide leads to targeted prevention of obesity in children.
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Affiliation(s)
- Line K. Haugaard
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospitals, Frederiksberg, Denmark
| | - Teresa A. Ajslev
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospitals, Frederiksberg, Denmark
| | - Esther Zimmermann
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospitals, Frederiksberg, Denmark
| | - Lars Ängquist
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospitals, Frederiksberg, Denmark
| | - Thorkild I. A. Sørensen
- Institute of Preventive Medicine, Frederiksberg and Bispebjerg University Hospitals, Frederiksberg, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Andersen LG, Baker JL, Sørensen TIA. Contributions of incidence and persistence to the prevalence of childhood obesity during the emerging epidemic in Denmark. PLoS One 2012; 7:e42521. [PMID: 22900026 PMCID: PMC3416857 DOI: 10.1371/journal.pone.0042521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 07/10/2012] [Indexed: 11/29/2022] Open
Abstract
Background Prevalence of obesity is the result of preceding incidence of newly developed obesity and persistence of obesity. We investigated whether increasing incidence and/or persistence during childhood drove the prevalence of childhood obesity during the emerging epidemic. Methods Height and weight were measured at ages 7 and 13 years in 192,992 Danish school children born 1930–1969. Trends in the incidence (proportion obese at 13 years among those not obese at 7 years) and persistence (proportion obese at 13 years among those obese at 7 years) across birth cohort periods (1930–41 with low stable prevalence of obesity, 1942–51 with increasing prevalence, 1952–69 with the higher, but stable prevalence) were investigated. Logistic regression was used to examine the associations between BMI at 7 years as a continuous trait, allowing interactions with the birth cohorts, and occurrence of obesity at 13 years. Results The prevalence of obesity was similar at 7 and 13 years and increased across birth cohorts in boys from around 0.1% to 0.5% and in girls from around 0.3% to 0.7%. The incidence of obesity between ages 7 and 13 years increased from 0.15% to 0.35% in boys and from 0.20% to 0.44% in girls. The persistence increased from 28.6% to 41.4% in boys and from 16.4% to 31.0% in girls. Despite a decrease over time, the remission of obesity occurred in >60% of obese children in the last birth cohort. However, the odds ratios of obesity at age 13 years in relation to the full range of BMI at 7 years remained unchanged across the birth cohort periods. Conclusions/Significance The development of the obesity epidemic in children was due to an increase in both incidence and persistence of obesity. Contrary to prevailing expectations, a large, although declining, proportion of children obese at an early age underwent remission during childhood.
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Affiliation(s)
- Lise Geisler Andersen
- Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
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Ajslev TA, Angquist L, Silventoinen K, Gamborg M, Allison DB, Baker JL, Sørensen TIA. Assortative marriages by body mass index have increased simultaneously with the obesity epidemic. Front Genet 2012; 3:125. [PMID: 23056005 PMCID: PMC3458436 DOI: 10.3389/fgene.2012.00125] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 06/21/2012] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The genetic predisposition to obesity may have contributed to the obesity epidemic through assortative mating. We investigated whether spouses were positively assorted by body mass index (BMI; = kg/m(2)) in late childhood, and whether changes in assorted marriage by upper BMI-percentiles occurred during the obesity epidemic. METHODS In the Copenhagen School Health Records Register (CSHRR) boys and girls with measures of BMI at age 13 years later became 37,792 spousal-pairs who married between 1945 and 2010. Trends in the spousal BMI correlations using sex-, age-, and birth cohort-specific BMI z-scores across time were investigated. Odds ratios (ORs) of marriage among spouses both with BMI z-scores >90th or >95th percentile compared with marriage among spouses ≤90th percentile were analyzed for marriages entered during the years prior to (1945-1970), and during the obesity epidemic (1971-2010). FINDINGS Spousal BMI correlations were around 0.05 and stayed similar across time. ORs of marriage among spouses with BMIs >90th percentile at age 13 were 1.21, 1.05-1.39, in 1945-1970, and increased to 1.63, 1.40-1.91, in 1971-2010 (p = 0.006). ORs of marriage among spouses both >95th BMI percentile were higher and increased more; from 1.39, 1.10-1.81, to 2.39, 1.85-3.09 (p = 0.004). INTERPRETATION Spousal correlations by pre-marital BMIs were small and stable during the past 65 years. Yet, there were assorted marriages between spouses with high BMI at age 13 years and the tendency increased alongside with the obesity epidemic which may increase the offsprings' predisposition to obesity.
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Affiliation(s)
- Teresa A Ajslev
- Institute of Preventive Medicine, Copenhagen University Hospital Copenhagen, Denmark
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Aetiological factors behind adipose tissue inflammation: an unexplored research area. Public Health Nutr 2012; 16:27-35. [PMID: 22464010 DOI: 10.1017/s1368980012000894] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite extensive research into the biological mechanisms behind obesity-related inflammation, knowledge of environmental and genetic factors triggering such mechanisms is limited. In the present narrative review we present potential determinants of adipose tissue inflammation and suggest ways ahead for future research in the field. DESIGN We searched the literature for potential determinants of obesity with inflammation through MEDLINE by applying the MeSH headings 'obesity' and 'inflammation' in combination with specific terms for a series of environmental and genetic factors. RESULTS Numerous articles reported on the association between environmental or genetic factors and respectively obesity and inflammation, whereas only a few studies assessed obesity and inflammation as a combined outcome. Among suggested determinants for obesity with inflammation were Adenovirus-36, the gut microbiota, trans-fatty acids, and the four genes FTO, MC4R, TNF-α and LEPR. CONCLUSIONS We present a limited number of factors potentially contributing to the development of obesity with inflammation, while concluding that overall the area is indeed sparsely investigated. We present ideas for future studies that can identify relevant aetiological factors. This identification is essential for targeted prevention of obesity with inflammation and the clinical consequences thereof.
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Baker JL, Sørensen TIA. Obesity research based on the Copenhagen School Health Records Register. Scand J Public Health 2011; 39:196-200. [PMID: 21775383 DOI: 10.1177/1403494811399955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION To summarise key findings from research performed using data from the Copenhagen School Health Records Register over the last 30 years with a main focus on obesity-related research. The register contains computerised anthropometric information on 372,636 schoolchildren from the capital city of Denmark. Additional information on the cohort members has been obtained via linkages with population studies and national registers. RESEARCH TOPICS Studies using data from the register have made important contributions in the areas of the aetiology of obesity, the development of the obesity epidemic, and the long-term health consequences of birth weight as well as body size and growth in childhood. CONCLUSION Research using this unique register is ongoing, and its contributions to the study of obesity as well as other topics will continue for years to come.
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Affiliation(s)
- Jennifer L Baker
- Institute of Preventive Medicine, Øster Søgade 18, 1357 Copenhagen K, Denmark.
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Rokholm B, Silventoinen K, Ängquist L, Skytthe A, Kyvik KO, Sørensen TIA. Increased genetic variance of BMI with a higher prevalence of obesity. PLoS One 2011; 6:e20816. [PMID: 21738588 PMCID: PMC3126806 DOI: 10.1371/journal.pone.0020816] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 05/10/2011] [Indexed: 12/03/2022] Open
Abstract
Background and objectives There is no doubt that the dramatic worldwide increase in obesity prevalence is due to changes in environmental factors. However, twin studies suggest that genetic differences are responsible for the major part of the variation in body mass index (BMI) and other measures of body fatness within populations. Several recent studies suggest that the genetic effects on adiposity may be stronger when combined with presumed risk factors for obesity. We tested the hypothesis that a higher prevalence of obesity and overweight and a higher BMI mean is associated with a larger genetic variation in BMI. Methods The data consisted of self-reported height and weight from two Danish twin surveys in 1994 and 2002. A total of 15,017 monozygotic and dizygotic twin pairs were divided into subgroups by year of birth (from 1931 through 1982) and sex. The genetic and environmental variance components of BMI were calculated for each subgroup using the classical twin design. Likewise, the prevalence of obesity, prevalence of overweight and the mean of the BMI distribution was calculated for each subgroup and tested as explanatory variables in a random effects meta-regression model with the square root of the additive genetic variance (equal to the standard deviation) as the dependent variable. Results The size of additive genetic variation was positively and significantly associated with obesity prevalence (p = 0.001) and the mean of the BMI distribution (p = 0.015). The association with prevalence of overweight was positive but not statistically significant (p = 0.177). Conclusion The results suggest that the genetic variation in BMI increases as the prevalence of obesity, prevalence of overweight and the BMI mean increases. The findings suggest that the genes related to body fatness are expressed more aggressively under the influence of an obesity-promoting environment.
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Affiliation(s)
- Benjamin Rokholm
- Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, Copenhagen, Denmark.
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Rokholm B, Baker JL, Sørensen TIA. The levelling off of the obesity epidemic since the year 1999--a review of evidence and perspectives. Obes Rev 2010; 11:835-46. [PMID: 20973911 DOI: 10.1111/j.1467-789x.2010.00810.x] [Citation(s) in RCA: 409] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose was to investigate a possible levelling off in the obesity epidemic, by systematically reviewing literature and web-based sources. Eligible studies and data sources were required to have at least two measures of obesity prevalence since 1999. A literature and Internet search resulted in 52 studies from 25 different countries. The findings supported an overall levelling off of the epidemic in children and adolescents from Australia, Europe, Japan and the USA. In adults, stability was found in the USA, while increases were still observed in some European and Asian countries. Some evidence for heterogeneity in the obesity trends across socioeconomic status (SES) groups was found. The levelling off was less evident in the lower-SES groups. No obvious differences between genders were identified. We discussed potential explanations for a levelling off and the utility of investigating obesity trends to identify the driving forces behind the epidemic. It is important to emphasize that the levelling off is not tantamount to calling off the epidemic. Additionally, it is worthwhile to keep in mind that previous stable phases have been followed by further increases in the prevalence of obesity. Therefore, research into the causes, prevention and treatment of obesity should remain a priority.
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Affiliation(s)
- B Rokholm
- Institute of Preventive Medicine, Copenhagen University Hospital, Denmark.
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Pearson S, Hansen B, Sørensen TIA, Baker JL. Overweight and obesity trends in Copenhagen schoolchildren from 2002 to 2007. Acta Paediatr 2010; 99:1675-8. [PMID: 20528793 DOI: 10.1111/j.1651-2227.2010.01897.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this study is to monitor the prevalence trend in overweight and obesity among Copenhagen schoolchildren from the school years 2002 to 2007. METHODS Copenhagen community health service doctors conducted routine examinations at school entry (ages 5-8 years) and exit (ages 14-16 years). Body mass index (kg/m²) of 33,245 schoolchildren was calculated. The prevalence of overweight (including obesity) and obesity was classified using the International Obesity Task Force definitions. RESULTS From 2002 to 2007, although the prevalence of overweight (including obesity) in young girls decreased from 17.8 to 15.9%, the trend was non-significant. In young boys, the trend slightly decreased, and the prevalence fell from 14.0 to 11.6%. In adolescent girls, the prevalence varied considerably and increased from 22.7 to 25.4% without a discernable trend. In adolescent boys, the trend slightly increased, and the prevalence rose from 15.8 to 18.9%. There were no significant changes in the prevalence of obesity. CONCLUSION In contrast to the preceding decades, we identified a potential stagnation in the obesity epidemic among children but a continuing increase among adolescents. It remains critical to continue monitoring and to increase preventive measures to reduce the prevalence of overweight and obesity.
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Affiliation(s)
- Seija Pearson
- Copenhagen Community Health Service, Copenhagen NV, Denmark.
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Abstract
BACKGROUND A rapid increase in the prevalence of obesity has been reported in France since 1990. We investigated the impact of birth cohort on the changes in obesity prevalence after taking into account age and survey period. METHODS We analyzed data from 4 national surveys in 1997, 2000, 2003, and 2006. For each survey, self-reported data on weight and height were recorded on mailed questionnaires sent to a sample of 20,000 households, representative of the French population. Obesity was defined according to World Health Organization criteria as body mass index >or=30 kg/m. We modeled the prevalence of obesity using logistic regression with age, cohort, and period as explanatory variables. As these variables are linearly dependent, only nonlinear effects can be estimated uniquely and interpreted, after including specific chosen constraints in the models. RESULTS There was a progressive increase in the prevalence of obesity between 1997 and 2006, attributable either to a period effect or to a cohort effect. There was a substantial departure from a linear trend for the cohort effect only, which seemed to be stronger in women: there was an acceleration in the prevalence of obesity with birth cohort for individuals born after the mid-1960s, in both sexes. CONCLUSIONS Our results are consistent with previous studies in other countries. Compared with older generations, men and women born in the late 1960s may have been subject to early exposures that increased their lifelong susceptibility to obesity.
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Vallgårda S. Why did the stillbirth rate decline in Denmark after 1940? Population Studies 2010; 64:117-30. [DOI: 10.1080/00324721003746484] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Faeh D, Bopp M. Increase in the prevalence of obesity in Switzerland 1982-2007: birth cohort analysis puts recent slowdown into perspective. Obesity (Silver Spring) 2010; 18:644-6. [PMID: 19779475 DOI: 10.1038/oby.2009.310] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although the prevalence of obesity continues to increase in Switzerland, the latest figures suggest a slowdown in the rate of increase. In order to elucidate whether this could be the onset of a trend reversal, we analyzed cross-sectional data by birth cohort. We assessed the prevalence of overweight+ (BMI > or =25 kg/m(2)) and obesity (BMI > or =30 kg/m(2)) in six population surveys with self-reported height and weight values (Switzerland, N = 68,829, 1982-2007, men (45%) and women (55%), aged 20-84 years) by 10-year birth cohorts (from the decade 1910-1919 through to 1970-1979). We found that increases in the prevalence of overweight+ and obesity occurred mainly in the cohort born 1930 to 1939, and again in the cohorts born 1960 to 1979. The accelerated increase in the prevalence of overweight+ in the youngest birth cohort and the lower prevalence in the oldest birth cohorts suggest that the current slowdown seen in Switzerland may not herald the onset of a trend reversal. As this example shows, simple comparisons of prevalence rates over time could provide a misleading picture of actual trends. Birth cohort analysis may offer a valuable alternative.
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Affiliation(s)
- David Faeh
- Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland
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Schack-Nielsen L, Sørensen TI, Mortensen EL, Michaelsen KF. Late introduction of complementary feeding, rather than duration of breastfeeding, may protect against adult overweight. Am J Clin Nutr 2010; 91:619-27. [PMID: 20032492 PMCID: PMC2824155 DOI: 10.3945/ajcn.2008.27078] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Accepted: 12/02/2009] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Early nutrition may affect the risk of overweight in later life. OBJECTIVE The objective was to explore the effect of the duration of breastfeeding (BF) and age at introduction of complementary feeding (CF) on body mass index (BMI) during childhood through adulthood. DESIGN The study was based on a subsample of the Copenhagen Perinatal Cohort established in 1959-1961 (n = 5068). Information on BF and available information on CF (age of introduction of "spoon-feeding," "vegetables," "egg," "meat," and "firm food") and several covariates were collected in infancy and linked with information on BMI from follow-up examinations in childhood and adulthood at age 42 y. RESULTS The median (10th, 90th percentiles) durations of any BF and age at introduction of spoon-feeding were 2.50 (0.23, 6.50) and 3.50 (2.00, 6.00) mo, respectively. After 1 y of age and throughout childhood and adolescence, no association between BF and BMI was found in regression models also adjusted for age at introduction of spoon-feeding and covariates. The risk of overweight at age 42 y decreased or tended to decrease with increasing age (in mo) at introduction of spoon-feeding [odds ratio (OR): 0.94; 95% CI: 0.86, 1.02], vegetables (OR: 0.90; 95% CI: 0.81, 0.98), meat (OR: 0.93; 95% CI: 0.87, 1.00), and firm food (OR: 0.92; 95% CI: 0.86, 0.98) but not egg (OR: 0.98; 95% CI: 0.91, 1.05). CONCLUSION The findings of this study suggest that introduction of CF at a later age (within the range of 2 to 6 mo) is protective against overweight in adulthood but do not support a protective effect of a longer duration of BF.
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Affiliation(s)
- Lene Schack-Nielsen
- Department of Human Nutrition, University of Copenhagen, Copenhagen, Denmark
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Conference on "Multidisciplinary approaches to nutritional problems". Symposium on "Diabetes and health". Challenges in the study of causation of obesity. Proc Nutr Soc 2008; 68:43-54. [PMID: 19079823 DOI: 10.1017/s0029665108008847] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Use of the energy balance equation for understanding the causation of obesity is discussed. Its basis on the thermodynamic laws is expressed in mathematical models for body-weight changes. Only a very small net energy surplus per time unit constitutes the energy deposition during weight gain, making measurements of its components difficult. The physical laws provide exact quantitative relationships between energy intake, energy expenditure and deposition of energy, but cannot disentangle the initiating and driving forces of the energy imbalance, which may also be an active storage of fat in adipose tissue. These and various other limitations of the energy balance model warrant cautiousness in using the model in studies of obesity causation. Weight gain may be self-promoting and mathematical feedback models allowing estimation of such effects show that they are realistic. Predisposition and susceptibility should be distinguished, and susceptibility as a modifiable predisposition, the genetic and environmental contribution to predisposition and its usefulness as targets for prevention and treatment are discussed. Current progress in unravelling genetic predisposition, the complex genetically-determined mechanisms, the slower progress in unravelling the environmental influences, the different nature of genetic and environmental influences, the possible pathways of environmental influences and the environmental influences as mediators of genetic effects are addressed. The evidence behind the prevailing concept of the 'obesogenic' environment is critically analysed. Finally, particular opportunities for the identification of the causes of the obesity epidemic by detailed analysis of an observed irregular development of the epidemic over long time periods are presented, and evidence for predisposition as a result of postnatal environmental influences is inferred from these studies.
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Grammatikopoulou MG, Manai A, Tsigga M, Tsiligiroglou-Fachantidou A, Galli-Tsinopoulou A, Zakas A. Nutrient intake and anthropometry in children and adolescents with Down syndrome--a preliminary study. Dev Neurorehabil 2008; 11:260-7. [PMID: 19031198 DOI: 10.1080/17518420802525526] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess nutrient intake and anthropometrical characteristics of children and adolescents with DS, in Northern Greece. STUDY DESIGN Cross-sectional study of 34 youngsters with DS. The sample was divided into two age groups, children aged 2-9 years and adolescents aged 10-18 years old. A 3-day food record was used to assess dietary intake. Body weight, height, WHR,% body fat, BMI, FMI, FFMI and z-scores were recorded for each participant. RESULTS All participants exhibited a high CHO and low fat diet. More than half of the participants reported having five meals daily and the majority exercised twice a week. A great majority was stunted and overweight according to general population growth charts and 22% of the adolescents were also obese. %Body fat, BMI, FMI and FFMI was higher in adolescents. Generally, younger participants presented lower overweight rates and consumed a diet more sufficient in micronutrients; however, WHR was similar in both age-groups, indicating a constant trend in weight distribution of DS patients. CONCLUSIONS Although children with DS are born with a genetic predisposition to become overweight, obesity is actually nurtured throughout childhood when they develop food choices and become more independent.
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Affiliation(s)
- Maria G Grammatikopoulou
- Department of Human Nutrition & Dietetics, Alexander Technological Educational Institute, Thessaloniki, Greece
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Funatogawa I, Funatogawa T, Nakao M, Karita K, Yano E. Changes in body mass index by birth cohort in Japanese adults: results from the National Nutrition Survey of Japan 1956-2005. Int J Epidemiol 2008; 38:83-92. [PMID: 18782894 PMCID: PMC2639362 DOI: 10.1093/ije/dyn182] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The National Nutrition Survey, Japan (NNS-J) provides annual anthropometric information for a whole nation over 50 years. Based on this survey, the mean body mass index (BMI) of Japanese men and elderly women has increased in recent decades, but that of young women has decreased. We examined the effect of birth cohort on this phenomenon. Methods We analysed data from the NNS-J for subjects aged 20–69 years. BMI during 1956–2005 and the prevalence of overweight and obesity (BMI ≥ 25 kg/m2) during 1976–2005 were estimated. Results The BMI increased with age in every birth cohort, with similar increments, and did not peak until 60–69 years of age. However, with cross-sectional age, the BMI usually peaked before 60–69 years of age. The differences among cohorts already existed at 20–29 years of age, and slightly increased in men between 20–29 and 30–39 years of age. The BMI in all male age groups increased from the 1891–1900 through 1971–80 cohorts. However, in women, the figure increased until the 1931–40 cohorts, but later decreased. Changes in prevalence were generally consistent with changes in BMI. The recent increase (decrease in young women) in the mean BMI is attributable to birth cohort, indicating that thinner (fatter) and less recent birth cohorts have been replaced by fatter (thinner) ones. Conclusions A cohort effect was quantitatively demonstrated based on a repeated annual survey. In Japan, the differences in BMI among cohorts were already established by young adulthood.
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Affiliation(s)
- Ikuko Funatogawa
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo 173-8605, Japan.
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Baker JL, Olsen LW, Andersen I, Pearson S, Hansen B, Sørensen TI. Cohort profile: the Copenhagen School Health Records Register. Int J Epidemiol 2008; 38:656-62. [PMID: 18719090 DOI: 10.1093/ije/dyn164] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Jennifer L Baker
- Institute of Preventive Medicine, Centre for Health and Society, Øster Søgade 18, 1st Floor, 1357 Copenhagen K, Denmark.
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Funatogawa I, Funatogawa T, Yano E. Do overweight children necessarily make overweight adults? Repeated cross sectional annual nationwide survey of Japanese girls and women over nearly six decades. BMJ 2008; 337:a802. [PMID: 18719011 PMCID: PMC2518696 DOI: 10.1136/bmj.a802] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare growth curves of body mass index from children to adolescents, and then to young adults, in Japanese girls and women in birth cohorts born from 1930 to 1999. DESIGN Retrospective repeated cross sectional annual nationwide surveys (national nutrition survey, Japan) carried out from 1948 to 2005. SETTING Japan. PARTICIPANTS 76,635 females from 1 to 25 years of age. MAIN OUTCOME MEASURE Body mass index. RESULTS Generally, body mass index decreased in preschool children (2-5 years), increased in children (6-12 years) and adolescents (13-18 years), and slightly decreased in young adults (19-25 years) in these Japanese females. However, the curves differed among birth cohorts. More recent cohorts were more overweight as children but thinner as young women. The increments in body mass index in early childhood were larger in more recent cohorts than in older cohorts. However, the increments in body mass index in adolescents were smaller and the decrease in body mass index in young adults started earlier, with lower peak values in more recent cohorts than in older cohorts. The decrements in body mass index in young adults were similar in all birth cohorts. CONCLUSIONS An overweight birth cohort in childhood does not necessarily continue to be overweight in young adulthood. Not only secular trends in body mass index at fixed ages but also growth curves for wide age ranges by birth cohorts should be considered to study obesity and thinness. Growth curves by birth cohorts were produced by a repeated cross sectional annual survey over nearly six decades.
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Affiliation(s)
- Ikuko Funatogawa
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo 173-8605, Japan.
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Jess T, Zimmermann E, Kring SII, Berentzen T, Holst C, Toubro S, Astrup A, Hansen T, Pedersen O, Sørensen TIA. Impact on weight dynamics and general growth of the common FTO rs9939609: a longitudinal Danish cohort study. Int J Obes (Lond) 2008; 32:1388-94. [PMID: 18663371 DOI: 10.1038/ijo.2008.110] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE AND DESIGN We investigated the impact of the fatness-related FTO rs9939609 A-allele on cross-sectional and longitudinal measures of body mass index (BMI), height and lean body mass (LBM) in a unique cohort representing a broad range of BMI. SUBJECTS AND MEASUREMENTS A random sample of all men attending the Danish draft boards during 1943-1977 plus all men with a BMI>or=31.0 kg/m(2) (assuring representation of the right end of the distribution) was taken. Anthropometric measures were available at up to eight points in time from birth to adulthood in 1629 genotyped men. The odds ratio (OR) for being a carrier of FTO rs9939609 according to (1) one unit alteration in z-scores for BMI, height and LBM at given ages and (2) longitudinal changes in BMI and height z-scores were assessed by logistic regression. RESULTS Except at birth, the AA genotype was associated with increased BMI z-scores at all point during the monitored lifespan, starting at the age of 7 years. This effect remained stable until early adulthood, where further weight gain occurred. The AA genotype was also--mainly through the effect on fatness--associated with accelerated linear growth in childhood (age 7 years; OR, 1.36; 95% confidence interval (CI), 1.06-1.74) and increased LBM in adulthood (OR, 1.24; 95% CI, 1.14-1.35). CONCLUSION Fatness induced by FTO rs9939609 in early childhood is sustained until early adulthood, where further weight gain may occur. FTO rs9939609 may, however, also be associated with linear growth and LBM mainly through the effect on fat mass.
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Affiliation(s)
- T Jess
- Institute of Preventive Medicine, Copenhagen University Hospitals, Centre for Health and Society, Copenhagen, Denmark.
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Alves JGB, Galé CR, Souza E, Batty GD. [Effect of physical exercise on bodyweight in overweight children: a randomized controlled trial in a Brazilian slum]. CAD SAUDE PUBLICA 2008; 24 Suppl 2:S353-9. [PMID: 18670715 DOI: 10.1590/s0102-311x2008001400020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 01/28/2008] [Indexed: 11/22/2022] Open
Abstract
Given the increase in obesity in developed and developing countries and its concomitant morbidity, successful treatment approaches are needed. We examined the effect of a structured exercise intervention in overweight children in a slum in Recife, Pernambuco State, Brazil. This was a randomized, controlled efficacy trial. Seventy-eight children were randomized. Exercise was supervised, consisting of three 50' group aerobics sessions per week for six months. All participants maintained ad libitum diets. Based on intention-to-treat analyses, children in both groups had a significant increase in weight at follow-up (p-value for within-group increase < or = 0.01). The increase in weight was significantly lower in the exercise group (mean difference between groups; -1.37; 95%CI: -2.00; -0.74). A significant difference (p = 0.049) between the exercise and control groups at six-month follow-up was also found for BMI (mean difference between groups; -0.53; 95%CI: -1.06; -0.002). When we restricted the analyses to children who completed the trial (intervention = 30 and control = 38), the results were the same. An exercise program for children, sustained for six months, was effective for reducing weight gain in overweight children living in a very poor neighborhood.
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Abstract
BACKGROUND The worldwide epidemic of childhood obesity is progressing at an alarming rate. Risk factors for coronary heart disease (CHD) are already identifiable in overweight children. The severity of the long-term effects of excess childhood weight on CHD, however, remains unknown. METHODS We investigated the association between body-mass index (BMI) in childhood (7 through 13 years of age) and CHD in adulthood (25 years of age or older), with and without adjustment for birth weight. The subjects were a cohort of 276,835 Danish schoolchildren for whom measurements of height and weight were available. CHD events were ascertained by linkage to national registers. Cox regression analyses were performed. RESULTS In 5,063,622 person-years of follow-up, 10,235 men and 4318 women for whom childhood BMI data were available received a diagnosis of CHD or died of CHD as adults. The risk of any CHD event, a nonfatal event, and a fatal event among adults was positively associated with BMI at 7 to 13 years of age for boys and 10 to 13 years of age for girls. The associations were linear for each age, and the risk increased across the entire BMI distribution. Furthermore, the risk increased as the age of the child increased. Adjustment for birth weight strengthened the results. CONCLUSIONS Higher BMI during childhood is associated with an increased risk of CHD in adulthood. The associations are stronger in boys than in girls and increase with the age of the child in both sexes. Our findings suggest that as children are becoming heavier worldwide, greater numbers of them are at risk of having CHD in adulthood.
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Affiliation(s)
- Jennifer L Baker
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen, Denmark.
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Silventoinen K, Pietiläinen KH, Tynelius P, Sørensen TIA, Kaprio J, Rasmussen F. Genetic and environmental factors in relative weight from birth to age 18: the Swedish young male twins study. Int J Obes (Lond) 2007; 31:615-21. [PMID: 17384662 DOI: 10.1038/sj.ijo.0803577] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To investigate the contributions of genetic and environmental factors to the development of relative weight during the growth period. DESIGN Longitudinal twin study. SUBJECTS Two-hundred and thirty-one monozygotic and 144 dizygotic complete male twin pairs born between 1973 and 1979 were measured annually from birth to 18 years of age. RESULTS Body mass index (BMI, kg/m(2)) at age 18 correlated with BMI at age 1 (r=0.32, 95% confidence intervals (CI) 0.21-0.42), and this correlation increased steadily up to age 17 (r=0.91, 95% CI 0.89-0.93). Major part (81-95%) of these trait correlations was attributable to correlate additive genetic factors, but also unique environmental correlations were present during the whole-growth period. The correlation between ponderal index (kg/m(3)) at birth and BMI at age 18 was small (r=0.09, 95% CI 0.02-0.15) and totally because of correlated unique environmental factors. CONCLUSIONS Our results suggest persistent genetic regulation of BMI from age 1 to 18. However, environmental factors, not shared by siblings, also affected the correlations of BMI. A small specific environmental correlation was found between ponderal index at birth and BMI at age 18, which may reflect the effect of neonatal environmental factors on adult BMI. A challenge to the future research is to identify chromosome regions and specific genes regulating the development of BMI as well as environmental factors affecting BMI through the growth period independently or interacting with genetic factors.
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Affiliation(s)
- K Silventoinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
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Abstract
There has been a pronounced, distinctive increase of the prevalence of obesity within almost all age groups of the Danish population, during the last 25-30 years. The largest increase has been documented in studies based on objective data from total populations and the latest data show the increase will continue. The Danish studies show heterogeneity in the development of the obesity epidemic. A close association with birth cohorts indicates a need for further aetiological research, not only into behavioural factors, but also into early life factors that may explain some of this developmental pattern.
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Affiliation(s)
- P Due
- Department of Social Medicine, Institute of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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