Obesity and breastfeeding: The strength of association

Obesity and attendant co-morbidities are an emergent problem in public health. Much attention has focused on prevention, especially during the perinatal period. Breastfeeding is considered a possible protective factor for obesity in childhood, influencing gene–neuroendocrine–environment–lifestyle interaction. Therefore, breastfeeding and its longer duration are probably associated with lower development of childhood obesity. Through human milk, but not formula, the child assumes greater bioactive factors contributing to immunological, endocrine, development, neural and psychological benefits. Contrarily, other studies did not confirm a critical role of breast milk. Confounding factors, especially maternal pre-pregnancy overweight, may influence breastfeeding effects. This review summarises what is known about the possible relationship between breastfeeding and prevention of obesity development.ConclusionBreastfeeding appears to represent a protective factor for obesity in childhood, although evidence is still controversial and underlying mechanisms unclear. Further research is needed to improve knowledge on overweight/obesity and breastfeeding.     

A gender-based approach to developing a healthy lifestyle and healthy weight intervention for diverse Utah women

Utah women from some cultural minority groups have higher overweight/obesity rates than the overall population. We utilized a gender-based mixed methods approach to learn about the underlying social, cultural and gender issues that contribute to the increased obesity risk among these women and to inform intervention development. A literature review and analysis of Utah's Behavioral Risk Factor Surveillance System data informed the development of a focus group guide. Focus groups were conducted with five groups of women: African immigrants from Burundi and Rwanda, African Americans, American Indians/Alaskan Natives, Hispanics/Latinas, and Pacific Islanders. Six common themes emerged: (1) health is multidimensional and interventions must address health in this manner; (2) limited resources and time influence health behaviors; (3) norms about healthy weight vary, with certain communities showing more preference to heavier women; (4) women and men have important but different influences on healthy lifestyle practices within households; (5) women have an influential role on the health of families; and (6) opportunities exist within each group to improve health. Seeking insights from these five groups of women helped to identify common and distinct cultural and gender themes related to obesity, which can be used to help elucidate core obesity determinants.     

Neighborhood disadvantage and obesity across childhood and adolescence: Evidence from the NLSY children and young adults cohort (1986–2010)

Previous research suggests that youth who grow up in socioeconomically disadvantaged neighborhoods face higher odds of becoming obese. Neighborhood effects scholars, meanwhile, have suggested that contextual influences may increase in strength as children age. This is the first study to examine whether developmental epochs moderate the effect of neighborhood disadvantage on obesity over time. I use thirteen waves of new restricted and geo-coded data on children ages 2–18 from the National Longitudinal Survey of Youth, Children and Young Adults. Bivariate and pooled logistic regression results suggest that neighborhood disadvantage has a stronger impact on adolescents' likelihood of becoming obese. Fixed effects models reveal that after adjusting for observed and unobserved confounders, adolescents continue to face higher odds of becoming obese due to the conditions associated with living in disadvantaged neighborhoods. Moreover, as research on adults suggests, girls experience larger impacts of neighborhood disadvantage than boys.     

Adult obesity prevalence and state policymaking in the United States: Is problem severity associated with more policies?

This study explores the relationship between adult obesity prevalence and obesity-related state policymaking in the United States. We examine whether 2009 obesity prevalence and the change in prevalence between 2000 and 2009 are associated with obesity-related state laws and regulations introduced or enacted between 2009 and 2011. Policies that exclusively target youth are eliminated from our analysis. Adult obesity prevalence increased in all 50 states over the decade studied, with a slight decrease in Washington, DC. Increases in prevalence are significantly associated with fewer policies in the South and Midwest Census regions and the East North Central and South Atlantic Census divisions. Findings suggest the need for greater advocacy and an opportunity for obesity to rise on state policy agendas.     

The views and attitudes of health professionals providing antenatal care to women with a high BMI: A qualitative research study

BackgroundThe prevalence of overweight and obesity is increasing amongst women of child bearing age. The objective of this study was to investigate the views and attitudes of providers of antenatal care for women who have a body mass index (BMI) of 30 kg/m² and over.MethodsA qualitative study using focus groups was undertaken within the department of obstetrics and gynaecology at a large teaching hospital in south-eastern Australia. Three focus group discussions were held. One with hospital midwives (n = 10), one with continuity of care midwives (n = 18) and one with obstetricians (n = 5). Data were analysed using Interpretative Phenomenological Analysis (IPA).FindingsSix dominant themes emerged: (1) obesity puts the health of mothers, babies and health professionals at risk; (2) overweight and obesity has become the norm; (3) weighing women and advising about weight gain is out of fashion; (4) weight is a sensitive topic to discuss; (5) there are significant barriers to weight control in pregnancy; and (6) health professionals and women need to deal with maternal obesity. These themes are drawn together to form a model representing current health care issues for these women.ConclusionHealth professionals, who have a high BMI, can find it difficult to discuss obesity during antenatal visits with obese women. Specialist dietary interventions and evidence based guidelines for working with child-bearing women is seen as a public health priority by health care professionals.     

The Impact of Religiosity on Health Behaviors and Obesity among African Americans

Religion has been associated with good physical health and may represent a protective factor against overweight and obesity. This study explored dimensions of religiosity associated with health behaviors—eating habits and physical activity—and obesity in the African American population. Data from the National Longitudinal Study of Adolescent Health were analyzed for 3,620 African American adults ages 28 to 34. A structural equation model (path model) revealed that high levels of church attendance combined with religious practice encouraged healthy eating habits. However, increasing time spent in prayer while making religion more important in life was associated with poor eating habits. More frequent church attendance and prayer were implicated in heightened levels of obesity, suggesting that various dimensions of religiosity were constructed differently with health behaviors and obesity.     

Obesity-related behaviors in adolescent friendship networks

This study examines obesity-related behaviors within adolescent friendship networks, because adolescent peers have been identified as being important determinants of many health behaviors. We applied ERGM selection models for single network observations to determine if close adolescent friends engage in similar behaviors and to explore associations between behavior and popularity. Same-sex friends were found to be similar on measures of organized physical activity in two out of three school-based friendship networks. Female friends were found to engage in similar screen-based behaviors, and male friends tended to be similar in their consumption of high-calorie foods. Popularity (receiving ties) was also associated with some behaviors, although these effects were gender specific and differed across networks.     

肥胖与胰岛素抵抗的关系：社区人群心脑血管事件前瞻性研究系列之二

目的调查广西南宁市部分社区人群肥胖者和非肥胖者的基线数据,探讨肥胖者发生胰岛素抵抗的风险因素以及肥胖与胰岛素抵抗二者间的关系。方法在广西南宁市部分居民社区横断面随机调查建立的“广西干部群体重大慢性疾病发病基线数据库”人群,采用随机整群抽样,录入资料完整的南宁市两个社区1072入作为本次研究对象。按2004年中华医学会（CDS）身高体重指数BMI≥25kg／m^2为肥胖的诊断标准,其中肥胖组454人,非肥胖组618人,分别检测身高体重指数（BMI）、空腹血糖（FBG）、餐后血糖（PBG）和空腹胰岛素（FINS）以及用HOMA模型评价胰岛素抵抗（IR）,并进行对比分析。结果肥胖组较非肥胖组BMI、FINS、HOMAIR均显著升高（P〈0．0001）。结论BMI是肥胖者发生胰岛素抵抗的风险因素。肥胖者可能更容易发生严重的胰岛素抵抗。     

Your Money or Your Life: Managing Health,Managing Money

Using the Panel Study of Income Dynamics, this paper examines the relationship between non-collateralized debt (NCD) and health behaviors. The results reveal that households whose members tend to lead less healthy lifestyles are more likely to hold NCD. There are three possible underlying hypotheses that may explain these relationships: (a) common factors, such as preferences, shaping both debt and poorer health behaviors; (b) poorer health and health behaviors causing debt; and (c) debt causing poorer health behaviors. Our findings are not consistent with a causal relationship between health behaviors and NCD. It is likely that other factors, such as time preferences, risk aversion and self-control may underlie the observed correlation.