The effect of alcohol consumption on insulin sensitivity and glycemic status: a systematic review and meta-analysis of intervention studies
Schrieks, I.C. ; Heil, A.L.J. ; Hendriks, H.F.J. ; Mukamal, K.J. ; Beulens, J.W.J. - \ 2015
Diabetes Care 38 (2015). - ISSN 0149-5992 - p. 723 - 732.
randomized controlled-trial - high-density-lipoprotein - life-style intervention - red wine polyphenols - body-mass index - lipid-metabolism - glycated hemoglobin - diabetes-mellitus - white wine - moderate
OBJECTIVE Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes. This reduced risk might be explained by improved insulin sensitivity or improved glycemic status, but results of intervention studies on this relation are inconsistent. The purpose of this study was to conduct a systematic review and meta-analysis of intervention studies investigating the effect of alcohol consumption on insulin sensitivity and glycemic status. RESEARCH DESIGN AND METHODS PubMed and Embase were searched up to August 2014. Intervention studies on the effect of alcohol consumption on biological markers of insulin sensitivity or glycemic status of at least 2 weeks' duration were included. Investigators extracted data on study characteristics, outcome measures, and methodological quality. RESULTS Fourteen intervention studies were included in a meta-analysis of six glycemic end points. Alcohol consumption did not influence estimated insulin sensitivity (standardized mean difference [SMD] 0.08 [-0.09 to 0.24]) or fasting glucose (SMD 0.07 [-0.11 to 0.24]) but reduced HbA1c (SMD -0.62 [-1.01 to -0.23]) and fasting insulin concentrations (SMD -0.19 [-0.35 to -0.02]) compared with the control condition. Alcohol consumption among women reduced fasting insulin (SMD -0.23 [-0.41 to -0.04]) and tended to improve insulin sensitivity (SMD 0.16 [-0.04 to 0.37]) but not among men. Results were similar after excluding studies with high alcohol dosages (>40 g/day) and were not influenced by dosage and duration of the intervention. CONCLUSIONS Although the studies had small sample sizes and were of short duration, the current evidence suggests that moderate alcohol consumption may decrease fasting insulin and HbA1c concentrations among nondiabetic subjects. Alcohol consumption might improve insulin sensitivity among women but did not do so overall.
Effects of nutritional status and dietetic interventions on survival in Cystic Fibrosis patients before and after lung transplantation
Hollander, F.M. ; Pierre, D.D. van; Roos, N.M. de; Graaf, E.A. van de; Iestra, J.A. - \ 2014
Journal of Cystic Fibrosis 13 (2014)2. - ISSN 1569-1993 - p. 212 - 218.
body-mass index - fat-free mass - percutaneous endoscopic gastrostomy - weight-gain - adults - bioimpedance - candidates - overweight - recipients - impedance
Background: This study retrospectively investigated nutritional status, dietetic intervention and intake in Cystic Fibrosis (CF) patients before and after lung transplantation (LTX). Methods: Body Mass Index (BMI), Fat Free Mass Index (FFMI) and nutritional intake were retrieved from 75 out-patients aged 15-53 years. Patients were seen every 3-4 months during the waiting list time (range 0-81 months) and up to 116 months after LTX. Survival was measured in months. Results: The median BMI at baseline was 19.2 kg/m(2) (range: 15.3 to 28.4 kg/m(2)) with 29 patients (39%) below = 500 kcal less than recommended. Protein intake was 104 (range 60-187) g or 1.9 g/kg per day. Despite dietetic intervention with oral nutritional supplements (ONS) (36 patients), tube feeding (12 patients), or both (13 patients), HMI and FFMI hardly improved pre-LTX. LTX was performed in 51 patients (68%); 10 patients died during follow-up, median survival time was 41 months. A BMI 18.5 kg/m(2) was more prevalent in patients who died before LTX (6/9) or who died after LTX (4/10) than in patients who were still alive on the waiting list (5/15) or who survived LTX (14/41). Results for FFMI were comparable. From 6-12 months post-LTX, BMI and FFMI markedly improved, especially in underweight patients. Conclusion: A BMI
Cross-Sectional Associations of Objectively Measured Physical Activity, Cardiorespiratory Fitness and Anthropometry in European Adults
Wientzek, A. ; Diaz, M.J.T. ; Castano, J.M.H. ; Amiano, P. ; Arriola, L. ; Overvad, K. ; Ostergaard, J.N. ; Charles, M.A. ; Fagherazzi, G. ; Palli, D. ; Bendinelli, B. ; Skeie, G. ; Borch, K.B. ; Wendel-Vos, W. ; Hollander, E.L. de; May, A.M. ; Ouden, M.E.M. den; Trichopoulou, A. ; Valanou, E. ; Soderberg, S. ; Franks, P.W. ; Brage, S. ; Vigl, M. ; Boeing, H. ; Ekelund, U. - \ 2014
Obesity 22 (2014)5. - ISSN 1930-7381 - p. E127 - E134.
activity energy-expenditure - body-mass index - heart-rate - abdominal obesity - aerobic fitness - weight - accelerometry - indicators - behaviors - patterns
Objective: To quantify the independent associations between objectively measured physical activity (PA), cardiorespiratory fitness (CRF), and anthropometry in European men and women. Methods: 2,056 volunteers from 12 centers across Europe were fitted with a heart rate and movement sensor at 2 visits 4 months apart for a total of 8 days. CRF (ml/kg/min) was estimated from an 8 minute ramped step test. A cross-sectional analysis of the independent associations between objectively measured PA (m/s(2)/d), moderate and vigorous physical activity (MVPA) (% time/d), sedentary time (% time/d), CRF, and anthropometry using sex stratified multiple linear regression was performed. Results: In mutually adjusted models, CRF, PA, and MVPA were inversely associated with all anthropometric markers in women. In men, CRF, PA, and MVPA were inversely associated with BMI, whereas only CRF was significantly associated with the other anthropometric markers. Sedentary time was positively associated with all anthropometric markers, however, after adjustment for CRF significant in women only. Conclusion: CRF, PA, MVPA, and sedentary time are differently associated with anthropometric markers in men and women. CRF appears to attenuate associations between PA, MVPA, and sedentary time. These observations may have implications for prevention of obesity.
Dietary B vitamin and methionine intake and MTHFR C677T genotype on risk of colorectal tumors in Lynch syndrome: the GEOLynch cohort study
Jung, A.Y. ; Duijnhoven, F.J.B. van; Nagengast, F.M. ; Botma, A. ; Heine-Bröring, R.C. ; Kleibeuker, J.H. ; Vasen, H.F.A. ; Harryvan, J.L. ; Winkels, R.M. ; Kampman, E. - \ 2014
Cancer Causes and Control 25 (2014)9. - ISSN 0957-5243 - p. 1119 - 1129.
food-frequency questionnaire - nonpolyposis colon-cancer - folic-acid supplementation - biomarker-based validity - mismatch-repair genes - body-mass index - methylenetetrahydrofolate reductase - folate intake - plasma folate - cigarette-smoking
Purpose Dietary intake of B vitamins and methionine, essential components of DNA synthesis and methylation pathways, may influence colorectal tumor (CRT) development. The impact of B vitamins on colorectal carcinogenesis in individuals with Lynch syndrome (LS) is unknown but is important given their high lifetime risk of developing neoplasms. The role of MTHFR C677T genotype in modifying these relationships in LS individuals is also unclear. We investigated associations between dietary intakes of folate, vitamins B2, B6, B12, and methionine and CRT development in a prospective cohort study of 470 mismatch repair gene mutation carriers. Methods Dietary intakes were assessed by food frequency questionnaire. Cox regression models with robust sandwich covariance estimation, adjusted for age, sex, physical activity, number of colonoscopies during person-time, NSAID use, and mutual vitamins were used to calculate hazard ratios (HRs) and 95 % confidence intervals (95 % CIs). Analyses were also stratified by MTHFR C677T genotype. Results During a median person-time of 28.0 months, 131 persons developed a CRT. Fifty-one of these persons developed an incident colorectal adenoma, while there were four persons who developed an incident colorectal carcinoma. Compared to the lowest tertile of intake, adjusted HRs (95 % CIs) for CRT development in the highest tertile were 1.06 (0.59–1.91) for folate, 0.77 (0.39–1.51) for vitamin B2, 0.98 (0.59–1.62) for vitamin B6, 1.24 (0.77–2.00) for vitamin B12, and 1.36 (0.83–2.20) for methionine. Low vitamin B2 and low methionine intake were statistically significantly associated with an increased risk of CRT in MTHFR 677TT individuals compared to a combined reference of persons with low intake and CC genotype. Conclusions There was no suggestion that intake of any dietary B vitamin or methionine was associated with CRT development among those with LS.
Active video games as a tool to prevent excessive weight gain in adolescents: rationale, design and methods of a randomized controlled trial
Simons, M. ; Chinapaw, M.J.M. ; Bovenkamp, M. van de; Boer, M.R. de; Seidell, J.C. ; Brug, J. ; Vet, E. de - \ 2014
BMC Public Health 14 (2014). - ISSN 1471-2458 - 13 p.
promote physical-activity - sedentary screen time - body-mass index - intrinsic motivation - self-determination - economic burden - obesity - children - overweight - youth
Background Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games –i.e. active games- may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game intervention, incorporating several motivational elements, on anthropometrics and health behaviors in adolescents. Methods/Design The study is a randomized controlled trial (RCT), with non-active gaming adolescents aged 12 – 16 years old randomly allocated to a ten month intervention (receiving active games, as well as an encouragement to play) or a waiting-list control group (receiving active games after the intervention period). Primary outcomes are adolescents’ measured BMI-SDS (SDS =¿adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds. Secondary outcomes are adolescents’ self-reported time spent playing active and non-active games, other sedentary activities and consumption of sugar-sweetened beverages. In addition, a process evaluation is conducted, assessing the sustainability of the active games, enjoyment, perceived competence, perceived barriers for active game play, game context, injuries from active game play, activity replacement and intention to continue playing the active games. Discussion This is the first adequately powered RCT including normal weight adolescents, evaluating a reasonably long period of provision of and exposure to active games. Next, strong elements are the incorporating motivational elements for active game play and a comprehensive process evaluation. This trial will provide evidence regarding the potential contribution of active games in prevention of excessive weight gain in adolescents.
The COLON study: Colorectal cancer: Longitudinal, Observational study on Nutritional and lifestyle factors that may influence colorectal tumour recurrence, survival and quality of life
Winkels, R.M. ; Heine-Bröring, R.C. ; Zutphen, M. van; Harten-Gerritsen, A.S. van; Kok, D.E.G. ; Duijnhoven, F.J.B. van; Kampman, E. - \ 2014
BMC Cancer 14 (2014). - ISSN 1471-2407 - 8 p.
body-mass index - enhancing physical-activity - treatment-related toxicity - visceral obesity - short questionnaire - skeletal-muscle - clinical-trials - adipose-tissue - rectal-cancer - health
Background There is clear evidence that nutrition and lifestyle can modify colorectal cancer risk. However, it is not clear if those factors can affect colorectal cancer treatment, recurrence, survival and quality of life. This paper describes the background and design of the “COlorectal cancer: Longitudinal, Observational study on Nutritional and lifestyle factors that may influence colorectal tumour recurrence, survival and quality of life” – COLON – study. The main aim of this study is to assess associations of diet and other lifestyle factors, with colorectal cancer recurrence, survival and quality of life. We extensively investigate diet and lifestyle of colorectal cancer patients at diagnosis and during the following years; this design paper focusses on the initial exposures of interest: diet and dietary supplement use, body composition, nutrient status (e.g. vitamin D), and composition of the gut microbiota. Methods/Design The COLON study is a multi-centre prospective cohort study among at least 1,000 incident colorectal cancer patients recruited from 11 hospitals in the Netherlands. Patients with colorectal cancer are invited upon diagnosis. Upon recruitment, after 6 months, 2 years and 5 years, patients fill out food-frequency questionnaires; questionnaires about dietary supplement use, physical activity, weight, height, and quality of life; and donate blood samples. Diagnostic CT-scans are collected to assess cross-sectional areas of skeletal muscle, subcutaneous fat, visceral fat and intermuscular fat, and to assess muscle attenuation. Blood samples are biobanked to facilitate future analyse of biomarkers, nutrients, DNA etc. Analysis of serum 25-hydroxy vitamin D levels, and analysis of metabolomic profiles are scheduled. A subgroup of patients with colon cancer is asked to provide faecal samples before and at several time points after colon resection to study changes in gut microbiota during treatment. For all patients, information on vital status is retrieved by linkage with national registries. Information on clinical characteristics is gathered from linkage with the Netherlands Cancer Registry and with hospital databases. Hazards ratios will be calculated for dietary and lifestyle factors at diagnosis in relation to recurrence and survival. Repeated measures analyses will be performed to assess changes over time in dietary and other factors in relation to recurrence and survival.
Effective Interventions in Overweight or Obese Young Children: Systematic Review and Meta-Analysis
Hoek, E. van; Feskens, E.J.M. ; Bouwman, L.I. ; Janse, A.J. - \ 2014
Childhood Obesity 10 (2014)6. - ISSN 2153-2168 - p. 448 - 460.
randomized controlled-trial - body-mass index - life-style intervention - weight management interventions - primary-care - pediatric obesity - adolescent overweight - childhood obesity - age-children - program
Abstract Background: Treatment programs for overweight and obese young children are of variable effectiveness, and the characteristics of effective programs are unknown. In this systematic review with meta-analysis, the effectiveness of treatment programs for these children is summarized. Methods: PubMed, Embase, Web of Science, and PsycINFO databases were searched up to April 2012. Articles reporting the effect of treatment on the body weight of overweight or obese children with a mean age in the range of 3– <8 years are included. Studies reporting the change in BMI z-score with standard error were included in a meta-analysis. For this purpose, a random-effects model was used. Results: The search identified 11,250 articles, of which 27 were included in this review. Eleven studies, including 20 treatment programs with 1015 participants, were eligible for the meta-analysis. The pooled intervention effect showed high heterogeneity; therefore, subgroup analysis was performed. Subgroup analysis showed that program intensity and used components partly explained the heterogeneity. The subgroup with two studies using multicomponent treatment programs (combining dietary and physical activity education and behavioral therapy) of moderate or high intensity showed the largest pooled change in BMI z-score (–0.46; I2, 0%). Conclusion: Although the subgroup multicomponent treatment programs of moderate to high intensity contained only two studies, these treatment programs appeared to be most effective in treating overweight young children.
Screen time, adiposity and cardiometabolic markers: mediation by physical activity, not snacking, among 11-year-old children
Berendtzen, N.E. ; Smit, H.A. ; Rossem, L. van; Gehring, U. ; Kerkhof, M. van de; Postma, D.S. ; Boshuizen, H.C. - \ 2014
International Journal of Obesity 38 (2014). - ISSN 0307-0565 - p. 1317 - 1323.
body-mass index - sedentary behavior - risk-factors - computer use - television - obesity - health - youth - association - adolescents
Background:There is evidence for a relation of TV viewing with adiposity and increased cardiometabolic risk factors in children and adolescents. It is unclear to what extent this relation is mediated by snacking and lack of physical activity. We determined whether associations of screen time with adiposity and cardiometabolic markers were mediated by these behaviours.Methods:Children from a population-representative Dutch birth cohort (n=1447) reported screen time and other lifestyle factors by a questionnaire around the age of 11 years (range 10-14) and had anthropometry and cardiometabolic markers measured around the age of 12 years (range 12-14). Adjusted associations of screen time with snacking, physical activity, adiposity and cardiometabolic markers (total-to-high-density lipoprotein cholesterol (TC/HDLC) ratio, blood pressure, glycated haemoglobin) were assessed by using formal mediation analysis. We tested the hypothesized paths by structural equation modeling, which allows quantification of the indirect effects associated with potential mediators.Results:Children with ¿20¿h screen time per week consumed more snacks (1.9 vs 1.3 portions per day) and were less physically active (4.3 vs 4.8 days per week) than children with maximum 6¿h screen time. Screen time was directly associated with higher adiposity (standardized ß=0.10-0.12 depending on the outcome, P
Comined effects of smoking and alcohol on metabolic syndrome: the lifelines cohort study
Slagter, S.N. ; Vliet-Ostaptchouk, J.V. ; Vonk, J.M. ; Boezen, H.M. ; Dullaart, R.P.F. ; Muller Kobold, A.C. ; Feskens, E.J.M. ; Beek, A.P. van; Klauw, M.M. van der; Wolffenbuttel, B.H.R. - \ 2014
PLoS ONE 9 (2014)4. - ISSN 1932-6203 - 9 p.
genome-wide association - nutrition examination survey - coronary-heart-disease - body-mass index - blood-pressure - waist circumference - cigarette-smoking - physical-activity - national-health - dietary-intake
Introduction - The development of metabolic syndrome (MetS) is influenced by environmental factors such as smoking and alcohol consumption. We determined the combined effects of smoking and alcohol on MetS and its individual components. Methods - 64,046 participants aged 18–80 years from the LifeLines Cohort study were categorized into three body mass index (BMI) classes (BMI1 drink/day) and tobacco showed higher triglycerides levels. Up to 2 drinks/day was associated with a smaller waist circumference in overweight and obese individuals. Consumption of >2 drinks/day increased blood pressure, with the strongest associations found for heavy smokers. The overall metabolic profile of wine drinkers was better than that of non-drinkers or drinkers of beer or spirits/mixed drinks. Conclusion - Light alcohol consumption may moderate the negative associations of smoking with MetS. Our results suggest that the lifestyle advice that emphasizes smoking cessation and the restriction of alcohol consumption to a maximum of 1 drink/day, is a good approach to reduce the prevalence of MetS. Figures
Changes in weight and health-related quality of life. The Doetinchem Cohort Study
Milder, I.E.J. ; Hollander, E.L. de; Picavet, H.S.J. ; Verschuren, W.M.M. ; Groot, C.P.G.M. de; Bemelmans, W.J.E. - \ 2014
Journal of Epidemiology and Community Health 68 (2014). - ISSN 0143-005X - p. 471 - 477.
body-mass index - of-life - population - obesity - surgery - gender - women - sf-36
Background The cross-sectional association between obesity and a lower health-related quality of life (HRQL) is clear. However, less is known about the association between changes in weight and HRQL. We examined the association between weight changes and changes in HRQL in a population-based sample of 2005 men and 2130 women aged 26–70 years. Methods Weight was measured two or three times with 5-year intervals between 1995 and 2009, and was categorised as stable (change =2 kg, 40%), weight loss (19%), or weight gain 2.1–4.0 kg, 4.1–6.0 kg, or >6 kg (41%). Changes in HRQL (SF36 questionnaire, including physical and mental scales) per weight change category were compared with a stable weight using generalised estimating equations. Results Weight gain was associated with declines of up to 5 points on five mainly physical scales and holds for different age categories. Especially for women, a dose-response relationship was observed, that is, larger weight gain was associated with larger declines in HRQL. Changes in HRQL for those with weight loss were small, but particularly on the mental scales, changes were in the negative direction compared to a stable weight. Conclusions Weight gain and weight loss were associated with unfavourable changes in HRQL compared with a stable weight. For weight gain, this was most pronounced on the physical scales and for weight loss, although less consistent, on the mental scales.
Do lifestyle factors influence colorectal cancer risk in Lynch syndrome?
Duijnhoven, F.J.B. van; Botma, A. ; Winkels, R.M. ; Nagengast, F.M. ; Vasen, H.F. ; Kampman, E. - \ 2013
Familial Cancer 12 (2013). - ISSN 1389-9600 - p. 285 - 293.
body-mass index - revised bethesda guidelines - gene mutation carriers - mismatch repair - cigarette-smoking - microsatellite instability - dietary patterns - colon-cancer - endometrial cancer - geolynch cohort
Lynch syndrome (LS) is one of the inherited colorectal cancer (CRC) syndromes and is due to germline mutations in one of the mismatch repair (MMR) genes. Within LS affected-families the expression of the syndrome varies, which suggests that other factors, such as lifestyle factors, have an influence on the LS phenotype. This review gives an overview of studies that assessed the role of lifestyle factors in the development of CRC in LS. Several published studies investigated smoking habits or body fatness (BMI) in relation to colorectal tumours. Those studies fairly consistently suggest that smoking and a high BMI markedly increase the risk of CRC in persons with LS. Other lifestyle factors, such as physical activity, alcohol or diet have not or only scarcely been studied. Lifestyle factors may indeed affect CRC risk in LS. However, more prospective studies with only confirmed MMR gene mutation carriers should be done to further elucidate the role of all lifestyle factors in CRC and in other types of cancer in persons with LS. Information on the role of lifestyle factors in the development of LSassociated cancers may help in establishing lifestyle and dietary recommendations with the ultimate goal of decreasing cancer risk in persons with LS.
Richness of human gut microbiome correlates with metabolic markers
Chatelier, E. Le; Nielsen, T. ; Qin, J. ; Prifti, E. ; Hildebrand, F. ; Falony, G. ; Almeida, M. ; Arumugam, M. ; Batto, J.M. ; Kennedy, S. ; Leonard, P. ; Li, J. ; Burgdorf, K. ; Grarup, N. ; Jorgensen, T. ; Branslund, I. ; Nielsen, H.B. ; Juncker, A.S. ; Bertalan, M. ; Levenez, F. ; Pons, N. ; Rasmussen, S. ; Sunagawa, S. ; Tap, J. ; Tims, S. ; Zoetendal, E.G. ; Brunak, S. ; Clement, K. ; Dore, J. ; Kleerebezem, M. ; Kristiansen, K. ; Renault, P. ; Sicheritz-Ponten, T. ; Vos, W.M. de; Zucker, J.D. ; Raes, J. ; Hansen, T. ; Bork, P. ; Wang, J. ; Ehrlich, S.D. ; Pederson, O. ; Guedon, E. ; Delorme, C. ; Layec, S. ; Khaci, G. ; Guchte, M. van de; Vandemeulebrouck, G. ; Jamet, A. ; Dervyn, R. ; Sanchez, N. ; Maguin, E. ; Haimet, F. ; Winogradski, Y. ; Cultrone, A. ; Leclerc, M. ; Juste, C. ; Blottière, H. ; Pelletier, E. ; LePaslier, D. ; Artiguenave, F. ; Bruls, T. ; Weissenbach, J. ; Turner, K. ; Parkhill, J. ; Antolin, M. ; Manichanh, C. ; Casellas, F. ; Boruel, N. ; Varela, E. ; Torrejon, A. ; Guarner, F. ; Denariaz, G. ; Derrien, M. ; Hylckama Vlieg, J.E.T. van; Veiga, P. ; Oozeer, R. ; Knol, J. ; Rescigno, M. ; Brechot, C. ; M'Rini, C. ; Mérieux, A. ; Yamada, T. - \ 2013
Nature 500 (2013)7464. - ISSN 0028-0836 - p. 541 - 546.
body-mass index - diet-induced obesity - insulin-resistance - wide association - reared apart - weight-loss - inflammation - adiposity - disease - twins
We are facing a global metabolic health crisis provoked by an obesity epidemic. Here we report the human gut microbial composition in a population sample of 123 non-obese and 169 obese Danish individuals. We find two groups of individuals that differ by the number of gut microbial genes and thus gut bacterial richness. They contain known and previously unknown bacterial species at different proportions; individuals with a low bacterial richness (23% of the population) are characterized by more marked overall adiposity, insulin resistance and dyslipidaemia and a more pronounced inflammatory phenotype when compared with high bacterial richness individuals. The obese individuals among the lower bacterial richness group also gain more weight over time. Only a few bacterial species are sufficient to distinguish between individuals with high and low bacterial richness, and even between lean and obese participants. Our classifications based on variation in the gut microbiome identify subsets of individuals in the general white adult population who may be at increased risk of progressing to adiposity-associated co-morbidities.
Influence of calendar period on the association between BMI and coronary heart disease: a meta-analysis of 31 cohorts : Review
Hollander, E.L. de; Bogers, R.P. ; Boshuizen, H.C. ; Rosengren, A. ; Shipley, M.J. ; Knekt, P. ; Ducimetiere, P. ; Menotti, A. ; Groot, C.P.G.M. de; Bemelmans, W.J.E. - \ 2013
Obesity 21 (2013)5. - ISSN 1930-7381 - p. 865 - 880.
body-mass index - all-cause mortality - cardiovascular risk-factors - monica project populations - life-style factors - follow-up - physical-activity - blood-pressure - western-australia - abdominal obesity
Objective: The association between obesity and coronary heart disease (CHD) may have changed over time, for example due to improved pharmacological treatment of CHD risk factors. This meta-analysis of 31 prospective cohort studies explores the influence of calendar period on CHD risk associated with body mass index (BMI). Design and Methods: The relative risks (RRs) of CHD for a five-BMI-unit increment and BMI categories were pooled by means of random effects models. Meta-regression analysis was used to examine the influence of calendar period (>1985 v =1985) in univariate and multivariate analyses (including mean population age as a covariate). Results: The age, sex, and smoking adjusted RR (95% confidence intervals) of CHD for a five-BMI-unit increment was 1.28(1.22:1.34). For underweight, overweight and obesity, the RRs (compared to normal weight) were 1.11(0.91:1.36), 1.31(1.22:1.41), and 1.78(1.55:2.04), respectively. The univariate analysis indicated 31% (95%CI: -56:0) lower RR of CHD associated with a five-BMI-unit increment and a 51% (95%CI: -78: -14)) lower RR associated with obesity in studies starting after 1985 (n = 15 and 10, respectively) compared to studies starting in or before 1985 (n = 16 and 10). However, in the multivariate analysis, only mean population age was independently associated with the RRs for a five-BMI-unit increment and obesity (-29(95%CI: -55: -5)) and -31(95%CI: -66:3), respectively) per 10-year increment in mean age). Conclusion: This study provides no consistent evidence for a difference in the association between BMI and CHD by calendar period. The mean population age seems to be the most important factor that modifies the association between the risk of CHD and BMI, in which the RR decreases with increasing age.
Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis
Bendsen, N.T. ; Christensen, R. ; Bartels, E.M. ; Kok, F.J. ; Sierksma, A. ; Raben, A. ; Astrup, A. - \ 2013
Nutrition Reviews 71 (2013)2. - ISSN 0029-6643 - p. 67 - 87.
to-hip ratio - body-mass index - density-lipoprotein cholesterol - moderate alcohol-consumption - randomized controlled-trial - middle-aged men - blood-pressure - weight-gain - waist circumference - risk-factor
A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake¿>¿500¿mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21–126 days) results in weight gain (0.73¿kg; P¿
Associations between changes in anthropometric measures and mortality in old age: a role for mid-upper arm circumference?
Hollander, E.L. de; Bemelmans, W.J.E. ; Groot, C.P.G.M. de - \ 2013
Journal of the American Medical Directors Association 14 (2013)3. - ISSN 1525-8610 - p. 187 - 193.
body-mass index - waist circumference - weight change - cardiovascular events - muscle area - obesity - risk - health - adults - men
Objectives: In elderly individuals, little is known about changes in different anthropometric measures with respect to mortality. We examined the association between changes in eight anthropometric measures and mortality in an elderly population. Design: Longitudinal study including baseline measurements in 1988-1990 and repeated measures in 1993. Setting: European towns. Participants: A total of 1061 older adults born in 1913-1918 from the Survey in Europe on Nutrition and the Elderly, A Concerted Action study were included in this study. Measurements: Weight, body mass index, waist circumference, waist to hip ratio, waist to height ratio, mid-upper arm circumference (MUAC), triceps skinfold thickness, and corrected arm muscle area were taken during both measurements. Results: A Cox regression model was used to examine the association between anthropometric changes (divided into quintiles, smallest change - reference category) and all-cause and cardiovascular disease mortality over approximately 6 years of follow-up, adjusted for baseline measurement of application, age, sex, smoking, education, physical activity, and major chronic diseases. A decrease in weight (>= 3.2 kg), waist circumference (>= 3.1 cm), and MUAC (>= 1.6 cm and 0.6-1.6 cm) were (near) significantly associated with an all-cause mortality risk of 1.48 (95% CI: 0.99-2.20), 1.52 (95% CI: 1.01-2.31), 1.81 (95% CI: 1.17-2.79), and 1.66 (95% CI: 1.10-2.49), respectively. Also for MUAC, an increase (>= 1.3 cm) was significantly associated with an increased all-cause and cardiovascular disease mortality risk [hazard ratio, 1.52 (95% CI: 1.00-2.31) and 1.94 (95% CI: 1.00-3.75), respectively]. Conclusion: Associations were observed for decreases in only 3 of 8 anthropometric measures and all-cause mortality. Decreases in MUAC had the strongest association with mortality and was the only measure in which an increase also was associated with mortality. This suggests a role for MUAC in the prediction of mortality in elderly individuals. Published by Elsevier Inc. on behalf of the American Medical Directors Association, Inc.
Do obesity and parental history of myocardial infaction improve cardiovascular risk prediction?
Dis, I. van; Geleijnse, J.M. ; Kromhout, D. ; Boer, J.M. ; Boshuizen, H.C. ; Verschuren, W.M. - \ 2013
European Journal of Preventive Cardiology 20 (2013)5. - ISSN 2047-4873 - p. 793 - 799.
coronary-heart-disease - body-mass index - abdominal adiposity - clinical-practice - score - netherlands - prevention - guidelines - mortality - events
Background: In clinical practice, individuals at increased risk of cardiovascular diseases (CVD) are identified on the basis of age, sex, smoking, blood pressure, and serum total and high-density lipoprotein cholesterol. We examined whether CVD risk prediction improved when obesity (body mass index 30 kg/m2) and premature (
Food-induced brain responses and eating behaviour
Smeets, P.A.M. ; Charbonnier, L. ; Meer, F. van der; Laan, L.N. van der; Spetter, M.S. - \ 2012
Proceedings of the Nutrition Society 71 (2012)4. - ISSN 0029-6651 - p. 511 - 520.
body-mass index - human orbitofrontal cortex - sensory-specific satiety - central-nervous-system - neural responses - individual-differences - selective attention - gastric distension - obese adolescents - taste stimuli
The brain governs food intake behaviour by integrating many different internal and external state and trait-related signals. Understanding how the decisions to start and to stop eating are made is crucial to our understanding of (maladaptive patterns of) eating behaviour. Here, we aim to (1) review the current state of the field of 'nutritional neuroscience' with a focus on the interplay between food-induced brain responses and eating behaviour and (2) highlight research needs and techniques that could be used to address these. The brain responses associated with sensory stimulation (sight, olfaction and taste), gastric distension, gut hormone administration and food consumption are the subject of increasing investigation. Nevertheless, only few studies have examined relations between brain responses and eating behaviour. However, the neural circuits underlying eating behaviour are to a large extent generic, including reward, self-control, learning and decision-making circuitry. These limbic and prefrontal circuits interact with the hypothalamus, a key homeostatic area. Target areas for further elucidating the regulation of food intake are: (eating) habit and food preference formation and modification, the neural correlates of self-control, nutrient sensing and dietary learning, and the regulation of body adiposity. Moreover, to foster significant progress, data from multiple studies need to be integrated. This requires standardisation of (neuroimaging) measures, data sharing and the application and development of existing advanced analysis and modelling techniques to nutritional neuroscience data. In the next 20 years, nutritional neuroscience will have to prove its potential for providing insights that can be used to tackle detrimental eating behaviour.
A risk model for lung cancer incidence
Hoggart, C. ; Brennan, P. ; Tjonneland, A. ; Vogel, U. ; Overvad, K. ; Ostergaard, J.N. ; Kaaks, R. ; Canzian, F. ; Boeing, H. ; Steffen, A. ; Trichopoulou, A. ; Bamia, C. ; Trichopoulos, D. ; Johansson, M. ; Palli, D. ; Krogh, V. ; Tumino, R. ; Sacerdote, C. ; Panico, S. ; Boshuizen, H.C. ; Bueno-de-Mesquita, H.B. ; Peeters, P.H. ; Lund, E. ; Gram, I.T. ; Braaten, T. ; Rodrígues, L. ; Agudo, A. ; Sánchez-Cantalejo, E. ; Arriola, L. ; Chirlaque, M.D. ; Barricarte, A. ; Rasmuson, T. ; Khaw, K.T. ; Wareham, N. ; Allen, N.E. ; Riboli, E. ; Vineis, P. - \ 2012
Cancer Prevention Research / American Association for Cancer Research 5 (2012)6. - ISSN 1940-6207 - p. 834 - 846.
body-mass index - susceptibility locus - smoking-cessation - cigarette-smoking - prediction model - smokers - mortality - women - association - 5p15.33
Risk models for lung cancer incidence would be useful for prioritizing individuals for screening and participation in clinical trials of chemoprevention. We present a risk model for lung cancer built using prospective cohort data from a general population which predicts individual incidence in a given time period. We build separate risk models for current and former smokers using 169,035 ever smokers from the multicenter European Prospective Investigation into Cancer and Nutrition (EPIC) and considered a model for never smokers. The data set was split into independent training and test sets. Lung cancer incidence was modeled using survival analysis, stratifying by age started smoking, and for former smokers, also smoking duration. Other risk factors considered were smoking intensity, 10 occupational/environmental exposures previously implicated with lung cancer, and single-nucleotide polymorphisms at two loci identified by genome-wide association studies of lung cancer. Individual risk in the test set was measured by the predicted probability of lung cancer incidence in the year preceding last follow-up time, predictive accuracy was measured by the area under the receiver operator characteristic curve (AUC). Using smoking information alone gave good predictive accuracy: the AUC and 95% confidence interval in ever smokers was 0.843 (0.810-0.875), the Bach model applied to the same data gave an AUC of 0.775 (0.737-0.813). Other risk factors had negligible effect on the AUC, including never smokers for whom prediction was poor. Our model is generalizable and straightforward to implement. Its accuracy can be attributed to its modeling of lifetime exposure to smoking.
Physical activity reduces the risk of incident type 2 diabetes in general and in abdominally lean and obese men and women: the EPIC-InterAct Study
Ekelund, U. ; Feskens, E.J.M. - \ 2012
Diabetologia 55 (2012)7. - ISSN 0012-186X - p. 1944 - 1952.
10 european countries - body-mass index - life-style - insulin sensitivity - fat distribution - heart-rate - mellitus - adiposity - accelerometry - improves
Aims/hypothesis We examined the independent and combined associations of physical activity and obesity with incident type 2 diabetes in men and women. Methods The InterAct case–cohort study consists of 12,403 incident type 2 diabetes cases and a randomly selected subcohort of 16,154 individuals, drawn from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. Physical activity was assessed by a four-category index. Obesity was measured by BMI and waist circumference (WC). Associations between physical activity, obesity and case-ascertained incident type 2 diabetes were analysed by Cox regression after adjusting for educational level, smoking status, alcohol consumption and energy intake. In combined analyses, individuals were stratified according to physical activity level, BMI and WC. Results A one-category difference in physical activity (equivalent to approximately 460 and 365 kJ/day in men and women, respectively) was independently associated with a 13% (HR 0.87, 95% CI 0.80, 0.94) and 7% (HR 0.93, 95% CI 0.89, 0.98) relative reduction in the risk of type 2 diabetes in men and women, respectively. Lower levels of physical activity were associated with an increased risk of diabetes across all strata of BMI. Comparing inactive with active individuals, the HRs were 1.44 (95% CI 1.11, 1.87) and 1.38 (95% CI 1.17, 1.62) in abdominally lean and obese inactive men, respectively, and 1.57 (95% CI 1.19, 2.07) and 1.19 (95% CI 1.01, 1.39) in abdominally lean and obese inactive women, respectively. Conclusions/interpretation Physical activity is associated with a reduction in the risk of developing type 2 diabetes across BMI categories in men and women, as well as in abdominally lean and obese men and women.
Long-term risk of incident type 2 Diabetes and measures of overall and regional obesity: The EPIC-InterAct Case-Cohort Study
Langenberg, C. ; Feskens, E.J.M. - \ 2012
PLOS Medicine 9 (2012)6. - ISSN 1549-1676 - 16 p.
body-mass index - waist circumference - abdominal adiposity - primary-care - nutrition - mellitus - cancer - participants - association - prevention
Background - Waist circumference (WC) is a simple and reliable measure of fat distribution that may add to the prediction of type 2 diabetes (T2D), but previous studies have been too small to reliably quantify the relative and absolute risk of future diabetes by WC at different levels of body mass index (BMI). Methods and Findings - The prospective InterAct case-cohort study was conducted in 26 centres in eight European countries and consists of 12,403 incident T2D cases and a stratified subcohort of 16,154 individuals from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. We used Prentice-weighted Cox regression and random effects meta-analysis methods to estimate hazard ratios for T2D. Kaplan-Meier estimates of the cumulative incidence of T2D were calculated. BMI and WC were each independently associated with T2D, with WC being a stronger risk factor in women than in men. Risk increased across groups defined by BMI and WC; compared to low normal weight individuals (BMI 18.5–22.4 kg/m2) with a low WC (102/88 cm). Among the large group of overweight individuals, WC measurement was highly informative and facilitated the identification of a subgroup of overweight people with high WC whose 10-y T2D cumulative incidence (men, 70 per 1,000 person-years; women, 44 per 1,000 person-years) was comparable to that of the obese group (50–103 per 1,000 person-years in men and 28–74 per 1,000 person-years in women). Conclusions - WC is independently and strongly associated with T2D, particularly in women, and should be more widely measured for risk stratification. If targeted measurement is necessary for reasons of resource scarcity, measuring WC in overweight individuals may be an effective strategy, since it identifies a high-risk subgroup of individuals who could benefit from individualised preventive action.