The Role of School Environments in Explaining Racial-Ethnic Disparities in Body Mass Index Among U.S. Adolescents

Summary The study of racial/ethnic inequalities in health is important to reduce the uneven burden of disease. In the case of colorectal cancer (CRC), disparities in survival among non-Hispanic Whites and Blacks are well documented, and mechanisms leading to these disparities need to be studied formally. It has also been established that body mass index (BMI) is a risk factor for developing CRC, and recent literature shows BMI at diagnosis of CRC is associated with survival. Since BMI varies by racial/ethnic group, a question that arises is whether differences in BMI are partially responsible for observed racial/ethnic disparities in survival for CRC patients. This article presents new methodology to quantify the impact of the hypothetical intervention that matches the BMI distribution in the Black population to a potentially complex distributional form observed in the White population on racial/ethnic disparities in survival. Our density mediation approach can be utilized to estimate natural direct and indirect effects in the general causal mediation setting under stronger assumptions. We perform a simulation study that shows our proposed Bayesian density regression approach performs as well as or better than current methodology allowing for a shift in the mean of the distribution only, and that standard practice of categorizing BMI leads to large biases when BMI is a mediator variable. When applied to motivating data from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, our approach suggests the proposed intervention is potentially beneficial for elderly and low-income Black patients, yet harmful for young or high-income Black populations.

Download Full-text

Multimorbidity Accumulation among Middle-Aged Americans: Differences by Race/Ethnicity and Body-Mass Index

The Journals of Gerontology Series A ◽

10.1093/gerona/glab116 ◽

2021 ◽

Author(s):

Anda Botoseneanu ◽

Sheila Markwardt ◽

Corey L Nagel ◽

Heather G Allore ◽

Jason T Newsom ◽

...

Keyword(s):

Body Mass Index ◽

Chronic Diseases ◽

Body Mass ◽

Minority Groups ◽

Ethnic Disparities ◽

Later Life ◽

Overweight And Obesity ◽

Obese Class ◽

Class 1 ◽

Racial Ethnic

Abstract BACKGROUND Obesity and multimorbidity are more prevalent among U.S. racial/ethnic minority groups. Evaluating racial/ethnic disparities in disease accumulation according to body-mass index (BMI) may guide interventions to reduce multimorbidity burden in vulnerable racial/ethnic groups. METHODS We used data from the 1998-2016 Health & Retirement Study on 8,106 participants aged 51-55 at baseline. Disease burden and multimorbidity (≥2 co-occurring diseases) were assessed using seven chronic diseases: arthritis, cancer, heart disease, diabetes, hypertension, lung disease, and stroke. Four BMI categories were defined per convention: normal, overweight, obese class 1, and obese class 2/3. Generalized estimating equations models with inverse probability weights estimated the accumulation of chronic diseases. RESULTS Overweight and obesity were more prevalent in non-Hispanic Black (82.3%) and Hispanic (78.9%) than non-Hispanic White (70.9 %) participants at baseline. The baseline burden of disease was similar across BMI categories, but disease accumulation was faster in the obese class 2/3 and marginally in the obese class 1 categories compared with normal BMI. Black participants across BMI categories had a higher initial burden and faster accumulation of disease over time, while Hispanics had a lower initial burden and similar rate of accumulation, compared with Whites. Black participants, including those with normal BMI, reach the multimorbidity threshold 5-6 years earlier compared with White participants. CONCLUSIONS Controlling weight and reducing obesity early in the lifecourse may slow the progression of multimorbidity in later life. Further investigations are needed to identify the factors responsible for the early and progressing nature of multimorbidity in Blacks of non-obese weight.

Download Full-text

Racial-ethnic differences in childhood higher body mass index: insurance status explanatory model

International Journal of Human Rights in Healthcare ◽

10.1108/ijhrh-10-2013-0031 ◽

2015 ◽

Vol 8 (1) ◽

pp. 45-56 ◽

Cited By ~ 2

Author(s):

Laurens Holmes ◽

Sequoia Jackson ◽

Alexandra LaHurd ◽

Pat Oceanic ◽

Kelli Grant ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Race And Ethnicity ◽

Pediatric Population ◽

Insurance Coverage ◽

Ethnic Disparities ◽

Insurance Status ◽

Cross Sectional ◽

Content Type ◽

Racial Ethnic

Purpose – The purpose of this paper is to examine the prevalence of obesity/overweight using higher body mass index (BMI), assess racial/ethnic variance in overweight/obese prevalence, and to determine whether or not insurance status explains the variance. Design/methodology/approach – A cross-sectional design was used to assess medical records of children in Nemours Healthcare System during 2011. The authors reviewed the records and extracted information on normal BMI, BMI percent, higher BMI, prevalence of overweight/obese and other variables as well as race and ethnicity. χ2 statistic, Fischer's exact and logistic regression model were used to examine the data. Findings – Overall, the prevalence of higher BMI as overweight/obese was comparable to that of the US pediatric population, 33.4 percent. Compared to Caucasian/white, Asians were less likely to have higher BMI, prevalence odd ratio (POR)=0.79, 95 percent CI=0.70-0.90, but Blacks/African Americans (POR=1.22, 95 percent CI=1.18-1.27) and Some other Race were more likely to have higher BMI, POR=1.61, 95 percent CI=1.92-1.71. After controlling for insurance status, the racial disparities in higher BMI persisted; p<0.0001. Research limitations/implications – Racial/ethnic disparities exist in childhood higher BMI, which were not removed after controlling for insurance coverage as a surrogate for socioeconomic status. These findings are indicative of assessing sex, religious, dietary patterns, physical activities level, environmental resources, social media resources; and geographic locale as confounders in race/ethnicity and higher BMI association. Originality/value – Understanding the predisposing factors to obesity/overweight among diverse populations is essential in developing and implementing intervention programs in addressing this epidemic in our nation.

Download Full-text

STEROID RECEPTOR PHENOTYPE, EXPRESSION OF HER-2/NEU, PD-1, PD-L1 AND LYMPHOCYTIC-MACROPHAGAL INFILTRATION OF ENDOMETRIAL CARCINOMAS: COMPARISON OF MODERN MOLECULAR BIOLOGICAL TYPES OF THE DISEASE (THE ROLE OF BODY MASS INDEX)

Problems in oncology ◽

10.37469/0507-3758-2020-66-1-71-78 ◽

2020 ◽

Vol 66 (1) ◽

pp. 71-78

Author(s):

Lev Bershteyn ◽

Aleksandr Ivantsov ◽

Aglaya Ievleva ◽

A. Venina ◽

I. Berlev

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Tumor Tissue ◽

Immunohistochemical Analysis ◽

The Body ◽

Molecular Profile ◽

Total N ◽

Number Of Patients ◽

Her 2

The aim of this study was to evaluate steroid receptors’ status of tumor tissue in different molecular biological types of endometrial cancer (EC), subdivided according to the current classification, and their colonization by lymphocytic and macrophage cells, taking into account body mass index of the patients. Materials and methods: Material from treatment-naive patients with EC (total n = 229) was included; the number of sick persons varied depending on the method used. The average age of patients was close to 60 years, and about 90% of them were postmenopausal. It was possible to divide the results of the work into two main subgroups: a) depending on the molecular biological type of the tumor (determined on the basis of genetic and immunohistochemical analysis), and b) depending on the value of the body mass index (BMI). The latter approach was used in patients with EC type demonstrating a defective mismatch repair of the incorrectly paired nucleotides (MMR-D) and with a type without characteristic molecular profile signs (WCMP), but was not applied (due to the smaller number of patients) in EC types with a POLE gene mutation or with expression of the oncoprotein p53. According to the data obtained, when comparing various types of EC, the lowest values of Allred ER and PR scores were revealed for POLE-mutant and p53 types, while the “triple-negative” variant of the tumor (ER-, PR-, HER2/neu-) was most common in POLE-mutant (45.5% of cases) and WCMP (19.4%) types of EC. The p53+ type of EC is characterized by inclination to the higher expression of the macrophage marker CD68 and lymphocytic Foxp3, as well as mRNA of PD-1 and SALL4. In addition to the said above, for WCMP type of EC is peculiar, on the contrary, a decrease in the expression of lymphocytic markers CD8 (protein) and PD-L1 (mRNA). When assessing the role of BMI, its value of >30.0 (characteristic for obesity) was combined with an inclination to the increase of HER-2/neu expression in the case of MMR-D EC type and to the decrease of HER-2 /neu, FOXp3 and ER expression in WCMP type. Conclusions: The accumulated information (mainly describing here hormonal sensitivity of the tumor tissue and its lymphocytic-macrophage infiltration) additionally confirms our earlier expressed opinion that the differences between women with EC are determined by both the affiliation of the neoplasm to one or another molecular biological type (subdivided according to the contemporary classification), as well as by body mass value and (very likely) the associated hormonal and metabolic attributes.

Download Full-text

Combination of sleep duration, TV time and body mass index is associated with cardiometabolic risk moderated by age in youth

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0399 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Ana P. Sehn ◽

Anelise R. Gaya ◽

Caroline Brand ◽

Arieli F. Dias ◽

Roya Kelishadi ◽

...

Keyword(s):

Body Mass Index ◽

Risk Factor ◽

Sleep Duration ◽

Body Mass ◽

Cardiometabolic Risk ◽

High Systolic Blood Pressure ◽

Television Time ◽

The Relationship ◽

Moderating Role

AbstractObjectivesThe combination of sleep duration, television (TV) time and body mass index (BMI) may be related to the alteration of cardiometabolic risk. However, there are few studies that use these variables grouped, and showing the moderating role of age. This study aimed to verify if the combination of sleep duration, TV time and BMI is associated with cardiometabolic risk and the moderating role of age in this relationship in youth.MethodsCross-sectional study conducted with 1411 adolescents (611 male), aged 10–17 years. Sleep duration, TV time and BMI were assessed and grouped into eight categories. Cardiometabolic risk was assessed by a continuous metabolic risk score, including the following variables: low HDL-cholesterol, elevated triglycerides, dysglycemia, high systolic blood pressure, high waist circumference and low cardiorespiratory fitness. Generalized linear models were used to test moderation of age in the relationship between the eight categories of sleep duration/television time/BMI with cardiometabolic risk.ResultsCardiometabolic risk factor showed association with all overweight or obesity independent of sleep time and TV time. Age moderated the relationship between sleep duration/television time/BMI with cardiometabolic risk. This association was stronger in younger adolescents (11 and 13 years), indicating that individuals with inadequate sleep, prolonged TV time and overweight/obesity present higher cardiometabolic risk values when compared to 15-year-old adolescents.ConclusionOverweight/obesity, independently of sleep duration and TV time, is the main risk factor for cardiometabolic disorders in adolescence. When moderated by age, younger adolescents that presented the combination of risk factors had higher cardiometabolic risk.

Download Full-text