Increased Sodium Consumption Is Associated With Abdominal Obesity in Older Adults

Abstract Objectives Sodium intake has been widely studied for its role in cardiovascular disease (CVD) and blood pressure (BP) changes. Some studies have suggested that sodium intake is associated with an increased risk of obesity. Although BMI is a common measure of obesity, waist circumference (WC) may serve as a better predictor of increased obesity-related CVD risk. The objective of this study was to examine the association of measures of body fat distribution including body mass index (BMI), WC, waist to hip ratio (WHP), and waist to height ratio (WHT) with sodium intake and BP in older adults. Methods One hundred twenty-eight adults aged 65–80 were included in this cross-sectional study. Dietary data was collected through a food frequency questionnaire (110 food items). Anthropometric and BP measurements were also collected. Multiple linear regression analyses were conducted to examine the association of obesity measures with sodium intake and BP levels. One-way ANOVA was used to determine differences in sodium and BP readings between BMI categories (Normal: 18.5–24.9; Overweight: 25.0–29.9 and Obese: 30.0 and above). Results WC and WHT were both significantly associated with sodium intake after controlling for age, gender, physical activity, and total calorie intake. Obese individuals consumed significantly more sodium than individuals with normal weight (2834 ± 974 mg in obese individuals; 2172 ± 840 mg in normal weight individuals; P = 0.044). BMI, WC, WHP, and WHT were significantly associated with systolic and diastolic BP. Mean systolic BP was significantly different between individuals with normal BMI and obese BMI (126 ± 16.5 mmHg in normal BMI; 139.7 ± 22.9 mmHg in obese BMI; P = 0.047). The mean diastolic BP showed a statistically significant difference between the normal BMI and overweight individuals (70.9 ± 10.4 mmHg in normal BMI; 79.3 ± 15.2 mmHg in overweight; P = 0.036) but not in obese individuals. Conclusions Higher sodium consumption was significantly related with higher abdominal body fat mass as measured by WC and WHT in older adults. Higher BMI, WC, WHP, and WHT were also associated with systolic and diastolic BP levels. Our findings suggest that excessive sodium intake is an independent risk factor for obesity in older adults. Funding Sources None.

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Expanded normal weight obesity and blood pressure in Chinese adults: a community-based cross-sectional study

Australian Journal of Primary Health ◽

10.1071/py18166 ◽

2019 ◽

Vol 25 (3) ◽

pp. 256 ◽

Cited By ~ 2

Author(s):

Huijing He ◽

Li Pan ◽

Feng Liu ◽

Jingang Ma ◽

Zhiping Hu ◽

...

Keyword(s):

Blood Pressure ◽

Body Fat ◽

Normal Weight ◽

Shaanxi Province ◽

High Risk Population ◽

Body Fat Percentage ◽

Fat Percentage ◽

Cross Sectional ◽

Increased Risk ◽

Normal Weight Obesity

The study aimed to explore the independent association between expanded normal weight obesity categories and blood pressure among adults aged 20–80 years in China. By cross-sectional design, a total of 4279 adults living in Shaanxi Province, China, were selected from communities via multi-stage stratified cluster sampling in 2014. Information on anthropometric, body composition and blood pressure was collected and analysed. Expanded normal weight obesity (ENWO) categories were used to identify the level of bodyweight based on the combination of body mass index (BMI) and body fat percentage (BFP) categories. The age- and sex-standardised prevalence of hypertension increased within ENWO groups, from 10.12% in the underweight-low body fat group to 45.92% in the obesity-high body fat group. In under or normal weight participants, body fat percentage was found independently associated with hypertension in men, with an adjusted odds ratio of 3.69 in the fourth quartile of BFP compared with the first one. However, this effect was not observed in women. BFP was independently associated with increased risk of hypertension, especially in men. People with normal BMI should be re-identified as a high-risk population based on BFP level when it comes to hypertension prevention in primary healthcare settings.

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Abstract P353: Dietary Sodium Intake and Sodium Density in The United States: Estimates From Nhanes 2005-2006 and 2015-2016

Circulation ◽

10.1161/circ.141.suppl_1.p353 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Jiun-ruey Hu ◽

Shivani Sahni ◽

Kenneth J Mukamal ◽

Courtney Millar ◽

Yingfei Wu ◽

...

Keyword(s):

Older Adults ◽

Sodium Intake ◽

The United States ◽

Dietary Sodium ◽

Calorie Intake ◽

The Us ◽

Race Ethnicity ◽

The Difference ◽

Sodium Consumption ◽

Total Sodium

Introduction: Current guidelines for sodium reduction focus on total daily sodium consumption (<2300 mg/d) for an intake of 2100 kcal. However, calorie consumption varies substantially. Here, we quantify mean sodium intake, calorie intake, and sodium density across demographic groups in the US and over time. Hypothesis: We hypothesized that, compared to sodium density, total sodium may overestimate adherence to sodium recommendations, especially in older adults. Methods: In the National Health and Nutrition Examination Survey (NHANES), weighted mean sodium and energy intake was estimated in US adults as the average of two 24-hour dietary recalls. Sodium density was calculated as the mg of sodium per 1,000 kcal consumed. The prevalence of adherence to sodium intake (<2300 mg/d) and sodium density (<1.1 mg/kcal) limits was quantified by age group, self-reported sex, self-reported race/ethnicity, Calorie level (<2100 kcal, ≥2100 kcal), and self-reported high blood pressure. Adherence prevalence estimates were compared between 2005-2006 and 2015-2016 survey periods by logistic regression adjusted for age, sex, and race/ethnicity. Methods: In 2015-2016, 24.8% of the US population (mean age 38 yr, 51% female, 12% black) adhered to the recommended <2300 mg/d sodium intake, but only 5.6% achieved the recommended 1.1 mg/kcal sodium density (Table). In 2005-2006, these figures were 26.5% and 8.9%, respectively. While there was no change in adherence by total sodium consumption (P = 0.11), adherence by sodium density was significantly lower in 2015-2016 than 2005-2006 (P < 0.001). The difference in adherence between total sodium and sodium density goals was greater among older adults (≥70 years), women, Hispanic adults, and adults consuming <2100 kcal per day. Conclusions: In 2015-2016, <6% of US adults consumed sodium densities at recommended levels. The prevalence of those achieving these goals is lower compared to 10 years prior. Further efforts to regulate population sodium intake are urgently needed.

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Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018

BMJ Open ◽

10.1136/bmjopen-2020-039295 ◽

2020 ◽

Vol 10 (11) ◽

pp. e039295

Author(s):

Mary L. Greaney ◽

Steven A. Cohen ◽

Furong Xu ◽

Christie L Ward-Ritacco ◽

Deborah Riebe

Keyword(s):

Older Adults ◽

National Health ◽

Weight Status ◽

Calorie Intake ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Race Ethnicity ◽

Sectional Analysis ◽

Overweight Or Obesity

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.

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Are older adults with excessive sodium intake at increased risk of hypohydration?

Journal of Human Nutrition and Dietetics ◽

10.1111/jhn.12859 ◽

2021 ◽

Author(s):

Marta Gamba ◽

Pedro Moreira ◽

Nuno Borges ◽

Alejandro Santos ◽

Cláudia Afonso ◽

...

Keyword(s):

Older Adults ◽

Sodium Intake ◽

Increased Risk

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Body mass index and clinical outcomes in patients with intracerebral haemorrhage: results from the China Stroke Center Alliance

Stroke and Vascular Neurology ◽

10.1136/svn-2020-000534 ◽

2021 ◽

pp. svn-2020-000534

Author(s):

Zhentang Cao ◽

Xinmin Liu ◽

Zixiao Li ◽

Hongqiu Gu ◽

Yingyu Jiang ◽

...

Keyword(s):

Body Mass Index ◽

Hospital Mortality ◽

Body Mass ◽

Intracerebral Haemorrhage ◽

Final Analysis ◽

Normal Weight ◽

Discharge Disposition ◽

Increased Risk ◽

Significant Difference ◽

Stroke Center

Background and aimObesity paradox has aroused increasing concern in recent years. However, impact of obesity on outcomes in intracerebral haemorrhage (ICH) remains unclear. This study aimed to evaluate association of body mass index (BMI) with in-hospital mortality, complications and discharge disposition in ICH.MethodsData were from 85 705 ICH enrolled in the China Stroke Center Alliance study. Patients were divided into four groups: underweight, normal weight, overweight and obese according to Asian-Pacific criteria. The primary outcome was in-hospital mortality. The secondary outcomes included non-routine discharge disposition and in-hospital complications. Discharge to graded II or III hospital, community hospital or rehabilitation facilities was considered non-routine disposition. Multivariable logistic regression analysed association of BMI with outcomes.Results82 789 patients with ICH were included in the final analysis. Underweight (OR=2.057, 95% CI 1.193 to 3.550) patients had higher odds of in-hospital mortality than those with normal weight after adjusting for covariates, but no significant difference was observed for patients who were overweight or obese. No significant association was found between BMI and non-disposition. Underweight was associated with increased odds of several complications, including pneumonia (OR 1.343, 95% CI 1.138 to 1.584), poor swallow function (OR 1.351, 95% CI 1.122 to 1.628) and urinary tract infection (OR 1.532, 95% CI 1.064 to 2.204). Moreover, obese patients had higher odds of haematoma expansion (OR 1.326, 95% CI 1.168 to 1.504), deep vein thrombosis (OR 1.506, 95% CI 1.165 to 1.947) and gastrointestinal bleeding (OR 1.257, 95% CI 1.027 to 1.539).ConclusionsIn patients with ICH, being underweight was associated with increased in-hospital mortality. Being underweight and obese can both increased risk of in-hospital complications compared with having normal weight.

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What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽

10.1136/bmjopen-2021-049974 ◽

2021 ◽

Vol 11 (6) ◽

pp. e049974

Author(s):

Luciana Pereira Rodrigues ◽

Andréa Toledo de Oliveira Rezende ◽

Letícia de Almeida Nogueira e Moura ◽

Bruno Pereira Nunes ◽

Matias Noll ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Study Protocol ◽

Average Length ◽

Length Of Hospital Stay ◽

Case Control Studies ◽

Cross Sectional ◽

Increased Risk ◽

Review Study ◽

The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

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Percepção da imagem corporal e indicadores antropométricos e de composição corporal associados em idosos

Brazilian Journal of Kinanthropometry and Human Performance ◽

10.5007/1980-0037.2018v20n6p525 ◽

2019 ◽

Vol 20 (6) ◽

pp. 525-534

Author(s):

Iasmim Batista Correia ◽

Nathalie De Almeida Silva ◽

Paulo Granges e Silva ◽

Tarciana Nobre de Menezes

Keyword(s):

Older Adults ◽

Body Image ◽

The Elderly ◽

Body Image Dissatisfaction ◽

Normal Weight ◽

The Body ◽

Image Perception ◽

Cross Sectional ◽

Significance Level ◽

Body Image Perception

Aging leads to psychological losses and various physical changes that, associated with body-stereotyped patterns imposed by society, can cause disturbances in the body image perception (BIP) in the elderly. The aim of this study was to evaluate BIP in older adults living in the city of Campina Grande / PB and its relationship with different anthropometric and body composition indicators. This cross-sectional study was carried out with older adults of both sexes enrolled in the Family Health Strategy of Campina Grande, PB. BIP was considered as a dependent variable and body mass index (BMI), waist circumference (WC), triceps skinfold (TSF), and arm fat area (AFA) as independent variables. The association between BIP and anthropometric indicators was verified using the Pearson chi-square test (X²), simple and multiple logistic regression, with significance level of p <0.05. Overall, 420 older adults were interviewed (68.1% women), of whom 409 reported their actual body image perception. Regarding the perception of idealized body image, 11 individuals did not respond and 230 were satisfied, since 179 desired another silhouette. Individuals with BMI indicative of overweight / obesity were more likely of showing body image dissatisfaction compared to those with normal weight. Subjects with excessive TSF showed greater body image dissatisfaction in relation to those with normal weight. Women were more likely of showing body image dissatisfaction. Thus, it was observed that variables BMI, TSF and sex were independently associated with body image satisfaction.

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P20 Parental understanding of concussion in youth rugby is significantly improved by viewing the RFU concussion education video

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.97 ◽

2019 ◽

Vol 90 (3) ◽

pp. e31.1-e31

Author(s):

T Samuel ◽

K Aquilina ◽

W Dawes

Keyword(s):

Parental Education ◽

Cross Sectional Study ◽

Educational Video ◽

Sectional Study ◽

Online Questionnaire ◽

Cross Sectional ◽

Parental Experience ◽

Increased Risk ◽

Significant Difference ◽

Composite Scores

ObjectivesTo investigate the current understanding parents have of concussion in their rugby-playing children aged 9–17.DesignCross-sectional studySubjects86 parents from four clubs completed an online questionnaireMethodsAreas covered (1) Parental experience of concussion (2) Rate of viewing of the RFU concussion educational video (RFUCEV), (3) Identification of symptoms of concussion (4) Understanding of the risk of concussion. Each participant was given a composite score, out of 19, based on their performance in symptom identification and true/false questions. Independent-sample two-tailed t-tests were conducted to analyse scores, primarily controlling for viewing of the RFUCEVResultsThere was a significant difference in the scores between the group that had viewed the RFUCEV (n=32, M=14.75, SD=2.55) and those who had not (n=54, M=13.05, SD=2.87); t(84)=2.75, p=0.00721. Additionally, over 25% of parents reported that their child had suffered a concussion, and this was also found to significantly improve the awareness score (p=0.04678)ConclusionsStatistically significant improvement in composite scores after viewing the RFUCEV makes it reasonable to require compulsory parental education prior to signing up a child to play rugby. This would build on the protocol changes made by the RFU in 2014 and further progress the safety of the sport. We suggest the video be improved to emphasise the areas highlighted as inadequately understood, including the increased risk of concussion in under-18s compared to adults.

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Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.690 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 214-214

Author(s):

Michael McKee ◽

Yunshu Zhou ◽

Joshua Ehrlich ◽

Elham Mahmoudi ◽

Jennifer Deal ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Self Care ◽

Household Activity ◽

Cross Sectional ◽

Age Related ◽

Increased Risk ◽

Lower Mobility ◽

Independent Effects ◽

The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

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Evaluation of neurodevelopment of preterm infants using Bayley III scale

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/s1519-38292015000100004 ◽

2015 ◽

Vol 15 (1) ◽

pp. 47-55 ◽

Cited By ~ 5

Author(s):

Fernanda Veiga de Góes ◽

Maria Dalva B. B. Méio ◽

Rosane Reis de Mello ◽

Denise Morsch

Keyword(s):

Preterm Infants ◽

Motor Development ◽

High Frequency ◽

Expressive Language ◽

Cross Sectional Study ◽

Receptive Language ◽

Abnormal Development ◽

Cross Sectional ◽

Increased Risk ◽

Significant Difference

Objectives: to assess cognitive, motor, and language development in preterm infants, and perinatal, neonatal and socioeconomic factors associated with abnormal development. Methods: a cross-sectional study was carried out with 104 preterm infants (gestational ages < 33 weeks) (17 - 30 months corrected ages) using the Bayley III Scale. Logistic regression analysis was performed and prevalence ratios calculated. Results: the average language score (81.9) was low, while cognitive (93.7) and motor (91.1) scores were within normal values. There were deficiencies in receptive but not in expressive language. Male sex (OR 2.55 CI 1.01-6.44) and neonatal pneumonia (OR 33.85 CI 3.3-337.8) were associated with abnormal language scores. No factor was associated with abnormal cognitive scores; male gender indicated an increased risk of abnormal motor scores. The lack of a father was a risk factor for impaired motor development (PR: 2.96, CI: 5.6 - 1.55). There was no statistically significant difference in the development of small and appropriate for gestational age children. Conclusions: the Bayley III Scale was useful for assessing language and cognition separately, discriminating between receptive and expressive language. There was a high frequency of language deficiencies, especially in receptive language. Although motor and cognitive average scores were within the normal range, there was a high frequency of children with delayed development in these areas, especially motor development.

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