The independent role of deprivation in abdominal obesity beyond income poverty. A population-based household survey in Chinese adults

2018 ◽  
Vol 41 (3) ◽  
pp. 476-486 ◽  
Author(s):  
Gary Ka-Ki Chung ◽  
Roger Yat-Nork Chung ◽  
Dicken Cheong-Chun Chan ◽  
Francisco Tsz-Tsun Lai ◽  
Hung Wong ◽  
...  
Keyword(s):  
Hong Kong ◽  
Abdominal Obesity ◽  
Critical Role ◽  
Household Survey ◽  
Population Based ◽  
Community Dwelling ◽  
Income Poverty ◽  
Inverse Association ◽  
General Obesity ◽  
Individual Level

Abstract Background Individual-level deprivation takes into account the non-monetary aspects of poverty that neither income poverty nor socio-economic factors could fully capture; however, it has rarely been considered in existing studies on social inequality in obesity. Therefore, we examined the associations of deprivation, beyond income poverty, with both general and abdominal obesity. Methods A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed via face-to-face household interviews between 2014 and 2015. Deprivation was assessed by a Deprivation Index specific to the Hong Kong population. General obesity was defined as body mass index (BMI) ≥ 25 kg/m2, while abdominal obesity was defined as waist circumference (WC) ≥ 90 cm/80 cm for male/female. Multivariable binary logistic regressions were performed. Results Deprivation was independently associated with abdominal obesity (odds ratios (OR) = 1.68; 95% confidence intervals (CI): 1.27–2.22); however, no significant association was found with general obesity (OR=1.03; CI: 0.77–1.38). After additional adjustment for BMI, deprivation remained strongly associated with abdominal obesity (OR=2.00; CI: 1.41–2.83); and after further adjustment for WC, deprivation had a marginal inverse association with general obesity (OR=0.72; CI: 0.51–1.01). Conclusions Deprivation is an important risk factor of abdominal obesity and plays a critical role in capturing the preferential abdominal fat deposition beyond income poverty.

scholarly journals Deprivation is associated with anxiety and stress. A population-based longitudinal household survey among Chinese adults in Hong Kong

2020 ◽  
pp. jech-2020-214728
Author(s):  
Roger Yat-Nork Chung ◽  
Michael Marmot ◽  
Jonathan Ka-Long Mak ◽  
David Gordon ◽  
Dicken Chan ◽  
...  
Keyword(s):  
Mental Illness ◽  
Hong Kong ◽  
Mental Health Problems ◽  
Household Survey ◽  
Population Based ◽  
Income Poverty ◽  
Cross Sectional ◽  
Increased Risk ◽  
Using Data ◽  
Over Time

BackgroundMental illness is a major disease burden in the world and disproportionately affects the socially disadvantaged, but studies on the longitudinal association of poverty with anxiety and stress are rare, especially in Asia. Using data from Hong Kong, we aimed to (1) assess the cross-sectional association of poverty with anxiety and stress at baseline, and (2) to examine whether baseline poverty and change in poverty status over time are associated with a subsequent change in anxiety and stress.MethodsData were obtained from two waves of a territory-wide longitudinal survey in Hong Kong, with sample sizes of n=1970 and n=1224 for baseline and follow-up, respectively. Poverty was measured with a Deprivation Index and income-poverty. Anxiety and stress symptoms were assessed using Chinese Depression, Anxiety and Stress Scale—21 Items. We conducted cross-sectional and longitudinal analyses on the association of poverty with anxiety and stress.OutcomesDeprivation, but not income-poverty, was significantly associated with both outcomes at baseline. Increased deprivation over time was associated with greater score and increased risk of anxiety and stress. Persistent deprivation over time was associated with greater anxiety and stress, and increased risk of incident anxiety.InterpretationDeprivation could have significant independent effects on anxiety and stress, even after adjusting for the effects of income-poverty. Greater attention should be paid to deprivation in policymaking to tackle the inequalities of mental health problems, especially since stress and anxiety are precursors to more severe forms of mental illness and other comorbidities.

scholarly journals General and central obesity operate differently as predictors of falls requiring medical care in older women: a population-based cohort study in Spain

2020 ◽  
Author(s):  
Ygor Hermenegildo-López ◽  
Helena Sandoval-Insausti ◽  
Carolina Donat-Vargas ◽  
Jose Ramón Banegas ◽  
Fernando Rodríguez-Artalejo ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Medical Care ◽  
Older Women ◽  
Abdominal Obesity ◽  
Regression Models ◽  
Population Based ◽  
Normal Weight ◽  
General Obesity ◽  
Logistic Regression Models ◽  
Overweight Women

Abstract Objectives to examine the association of general and abdominal obesity with falls, falls requiring medical care and falls with fractures in older women. Design a population-based prospective cohort of 1,185 women aged ≥60 in Spain, followed up from 2008 to 2010 through 2012. Measures weight, height and waist circumference were measured at baseline using standardised techniques. Participants were classified according to body mass index as normal weight (<25), overweight (25–29.9) and general obesity (≥30). Abdominal obesity was defined as waist circumference >88 cm. In 2012, participants reported the falls experienced in the previous year. Logistic regression models were mutually adjusted for general and abdominal obesity and for main confounders. Results in this cohort of older women, a total of 336 women experienced falls, 168 of them had falls requiring medical care and 64 falls with fractures. For falls, no association was found with general obesity nor abdominal obesity. However, compared with normal weight, overweight women had a decreased risk for falls requiring medical care [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.34–0.94] and for falls with fractures (OR 0.27; 95% CI 0.12–0.63). The corresponding values for general obesity were 0.44 (0.24–0.81) and 0.30 (0.11–0.82). Abdominal obesity was positively associated with falls requiring medical care (OR 1.82; 95% CI 1.12–2.94) and falls with fractures (OR 2.75; 95% CI 1.18–6.44). Conclusions in older women, general obesity may protect from falls requiring medical care and falls with fractures. On the contrary, abdominal obesity increased the risk of suffering from types of falls.

Socioeconomic disadvantages over the life-course and their influence on obesity among older Hong Kong Chinese adults

2020 ◽  
Vol 30 (5) ◽  
pp. 1013-1018 ◽  
Author(s):  
Gary K K Chung ◽  
Francisco T T Lai ◽  
Dicken C Chan ◽  
Hung Wong ◽  
Eng-Kiong Yeoh ◽  
...  
Keyword(s):  
Hong Kong ◽  
Life Course ◽  
Abdominal Obesity ◽  
Cumulative Risk ◽  
Hong Kong Chinese ◽  
Mobility Models ◽  
General Obesity ◽  
Chinese Adults ◽  
Socioeconomic Mobility ◽  
The Life Course

Abstract Background The life-course perspective on socioeconomic inequality in health is a burgeoning field of research. Nonetheless, the three classic life-course models (i.e. sensitive period, cumulative risk and social mobility models) have rarely been simultaneously applied to studies on obesity. Therefore, this study examined the associations of socioeconomic positions (SEPs) across life stages and their associated life-course models with both general and abdominal obesity. Methods Face-to-face interviews were conducted among 1077 community-dwelling adults aged 50 or above during 2014–15 in Hong Kong. Experiences of poverty, educational attainment and deprivation of necessities represented respondents’ SEP in childhood, early adulthood and late adulthood, respectively. General and abdominal obesity were defined as body mass index ≥25 kg m−2 and waist-to-height ratio >0.5. Multivariable modified Poisson regression with a robust error variance was performed. Results Respondents with low childhood SEP tended to have reduced risk of general obesity [relative risk (RR) = 0.85; 95% confidence interval (CI) = 0.72–1.00], whereas those with low childhood SEP and low late-adulthood SEP tended to have increased risk of abdominal obesity (RR = 1.10; 95% CI = 1.00–1.21 and RR = 1.14; 95% CI = 1.03–1.26, respectively). Cumulative socioeconomic disadvantages showed a dose–response relationship with abdominal obesity. Also, those with upward socioeconomic mobility had lower risk of abdominal obesity, whereas those with downward socioeconomic mobility had greater risk. Conclusions Low SEP, especially in childhood, exerted contrasting effects on general and abdominal obesity among older Hong Kong Chinese adults. The three life-course models operated simultaneously in determining the risk of abdominal obesity, while support for cumulative risk and social mobility models was weak in general obesity.

scholarly journals 1402Thyroid stimulating hormone (TSH) is associated with general and abdominal obesity in girls during puberty

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Yingying Wang
Keyword(s):  
Logistic Regression ◽  
Abdominal Obesity ◽  
Regression Models ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
General Obesity ◽  
Logistic Regression Models ◽  
The Impact ◽  
Serum Tsh ◽  
Stimulating Hormone

Abstract Background Childhood is an important public health issue. Although both thyroid hormone and menarche are known to play a role in body metabolism and energy expenditure, no population-based study has been conducted to investigate the impact of TSH on adipogenesis among population-based girls around puberty. Methods A multi-stage cluster sampling method was used to select one junior middle school from each of 4 study areas: Minhang District in Shanghai, Haimen City in Jiangsu Province, Yuhuan City and Deqing County in Zhejiang Province. A total of 474 girls aged 11 to 14 years from 4 schools were enrolled. Information on demographic factors and puberty stage were collected, and anthropometric measurements and thyroid hormones were determined. Multivariate logistic regression models were used to assess the associations of Thyroid stimulating hormone (TSH) with the risk of obesity measured by body mess index (BMI) and waist circumference (WC). Results Of the 474 girls, the prevalences of BMI-based general obesity and WC-based abdominal obesity were 19.8% (94/474) and 21.7% (103/474), respectively. Compared with normal weight girls, the mean serum TSH concentration was significantly higher in BMI-based general overweight or obese girls (P = 0.037), but not in WC-based central overweight or obese girls (P = 0.173). In the multiple logistic regression models, for girls with highest tertile of serum TSH concentration relative to those in the lowest tertile, the odds ratios were 2.58 (95% CI 1.32 to 5.04) and 2.50 (95% CI 1.30 to 4.81) for overweight or obesity based on BMI and WC after adjustment for puberty stage and other covariates. Conclusions Serum TSH concentration was positively associated with both general and abdominal obesity in school-age girls and the association was independent of puberty. Key messages thyroid stimulating hormone; general obesity; central obesity; school-aged girls; puberty

scholarly journals Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1738
Author(s):  
Jaime Pajuelo-Ramírez ◽  
Harold Torres-Aparcana ◽  
Rosa Agüero-Zamora ◽  
Antonio M. Quispe
Keyword(s):  
Abdominal Obesity ◽  
Household Survey ◽  
Cross Sectional Study ◽  
Inverse Association ◽  
Cross Sectional ◽  
Age And Gender ◽  
Younger Men ◽  
Andean Countries ◽  
National Household Survey ◽  
And Gender

Background: Abdominal obesity represents an accurate predictor of overall morbidity and mortality, which is worrisome because it is also continuously increasing across Andean countries. However, its relationship with altitude remains unclear. The objective of this study was to assess the association between altitude and abdominal obesity in Peru, and how sociodemographic variables impact this association. Methods: We estimated the prevalence of abdominal obesity in Peru and analyzed its association with altitude using the data from the 2012-2013 National Household Survey (ENAHO). During this survey, a representative sample of Peruvians was screened for abdominal obesity, using waist circumference as a proxy, and the Adult Treatment Panel III guidelines cutoffs. Results: Data were analyzed from a sample of 20,489 Peruvians (51% male). The prevalence of abdominal obesity was estimated at 33.6% (95% CI: 32.5 to 34.6%). In Peru, altitude was significantly and inversely associated with abdominal obesity, decreasing with higher altitudes: 1500-2999 meters above mean sea level (MAMSL) vs <1500 MAMSL, adjusted prevalence rate [aPR]= 0.86 (95% CI: 0.75 to 0.97); ≥3000 MAMSL vs <1500 MAMSL, aPR= 0.98 (95% CI: 0.87 to 1.11), when adjusting by age, gender and residence area (rural/urban). However, this association was significantly modified by age and gender (p< 0.001). Conclusion: Abdominal obesity is highly prevalent in Peru and decreases significantly with altitude, but age and gender modify this association. Thus, abdominal obesity appears to affect older women from low altitudes more than younger men from high altitudes.

scholarly journals Correction: Prevalence and risk factors of chlamydia infection in Hong Kong: A population-based geospatial household survey and testing

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0199767
Author(s):  
William Chi Wai Wong ◽  
Yanping Zhao ◽  
Ngai Sze Wong ◽  
William L. Parish ◽  
Heidi Yin Hai Miu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hong Kong ◽  
Household Survey ◽  
Population Based ◽  
Chlamydia Infection

Differential educational patterning of cardiometabolic risks between women and men among community-dwelling Chinese adults in Hong Kong: the mediating role of obesity

2021 ◽  
pp. 1-33
Author(s):  
Gary K.K. Chung ◽  
Francisco T.T. Lai ◽  
Heidi Hung ◽  
Eng-Kiong Yeoh ◽  
Roger Y. Chung
Keyword(s):  
Hong Kong ◽  
Clinical Data ◽  
Abdominal Obesity ◽  
Education Level ◽  
Community Dwelling ◽  
Binary Logistic Regression Analysis ◽  
Health Examination ◽  
Educational Inequalities ◽  
Anthropometric Measures ◽  
Cross Sectional

Abstract Objectives: Educational inequalities in cardiometabolic diseases (CMD) are globally recognised; nonetheless, evidence on potential explanatory mechanisms and effective strategies for CMD prevention and inequality reduction is relatively scarce in Asia. Therefore, this study examined the extent and potential mediators of the association of education level with CMD conditions (i.e., hypertension and diabetes) in an advanced economy in Asia. Design: A cross-sectional study. Setting: This territory-wide cross-sectional Population Health Survey in 2014/15 was performed in Hong Kong. Demographic, socioeconomic, and lifestyle factors were collected via questionnaire, while clinical data on blood pressure and glucose levels, lipid profiles, and anthropometric measures were obtained during health examination. Hypertension and diabetes statuses were objectively defined by both clinical data and the use of relevant medications. Participants: 2297 community-dwelling adults aged between 15-84 years recruited via systematic replicated sampling of living quarters. Results: Multivariable binary logistic regression analysis showed that lower education level was significantly associated with hypertension among women but not men, whereas similar pattern was also observed for diabetes and other related clinical risk factors. Also, general and abdominal obesity were independently associated with hypertension and diabetes among both women and men, and substantially mediated the observed inequalities across education levels among women. Specifically, abdominal obesity was a particularly strong risk factor and mediator for diabetes. Conclusion: Educational patterning of CMD was more apparent among women in Hong Kong. Obesity control appears to be important for both overall CMD prevention and reduction of educational inequalities in CMD among women.

scholarly journals Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

2020 ◽  
Author(s):  
Felix Teufel ◽  
Pascal Geldsetzer ◽  
Jennifer Manne-Goehler ◽  
Omar Karlsson ◽  
Viola Koncz ◽  
...  
Keyword(s):  
Low Income ◽  
Early Life ◽  
Adult Height ◽  
Population Based ◽  
Average Height ◽  
Inverse Association ◽  
Middle Income ◽  
Individual Level ◽  
Middle Income Countries ◽  
World Regions

<b>Objective:</b> The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are not well understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes, and may inform how adverse environmental conditions in early life affect diabetes risk. We therefore systematically analyzed the association of adult height and diabetes across LMICs, where such conditions are prominent. <p> </p> <p><b>Research Design and Methods:</b> We pooled individual-level data from nationally representative surveys in LMICs that included anthropometric measurements and diabetes biomarkers. We calculated odds ratios (ORs) for the relationship between attained adult height and diabetes using multilevel mixed-effects logistic regression models. We estimated ORs for the pooled sample, major world regions, and individual countries, in addition to stratifying all analyses by sex. We examined heterogeneity by individual-level characteristics.</p> <p><br> <b>Results:</b> Our sample included 554,122 individuals across 25 population-based surveys. Average height was 161.7 cm (95% CI: 161.2–162.3) and the crude prevalence of diabetes was 7.5% (95% CI: 6.9–8.2). We found no relationship between adult height and diabetes across LMICs globally or in most world regions. When stratifying our sample by country and sex, we found an inverse association between adult height and diabetes in 5% of analyses (2/50). Results were robust to alternative model specifications.</p> <p> </p> <p><b>Conclusions:</b> Adult height is not associated with diabetes across LMICs. Environmental factors in early life reflected in attained adult height likely differ from those predisposing individuals for diabetes. </p>

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