Home Environment Factors and Health Behaviors of Low-income, Overweight, and Obese Youth.
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ABSTRACT:
SUBMITTER: Conlon BA
PROVIDER: S-EPMC7413305 | biostudies-literature | 2019 Mar
REPOSITORIES: biostudies-literature
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Project description:BackgroundOverweight and obesity are associated with diabetes, hypertension and chronic kidney disease (CKD). However, there is scarce information from lower income countries about undiagnosed obesity-associated conditions. This information is necessary for healthcare planning and for assessment of Global Burden of Disease.MethodsWe assessed the prevalence of obesity-associated conditions in 656 overweight (n = 360) and obese (n = 296) adults from inner-city Portoviejo (Ecuador), in descriptive field research, based on an opportunistic and selective sampling strategy.ResultsOf 316 men and 340 women, 73% met criteria for prehypertension (27%) or hypertension (46%), 50% met criteria for prediabetes (30%) or diabetes (20%), 11% had an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 consistent with chronic kidney disease (CKD) and 5.5% had pathological albuminuria for a total CKD prevalence of 16%. Age-related prevalence data were generated. In all participants, serum total cholesterol and triglycerides were >200 and >150 mg/dl, respectively. Hyperuricemia and microhematuria (<2%) were uncommon. Women were more likely to have low eGFR (18 vs 5%, p 0.000). Diabetes and pathological albuminuria prevalence were higher in obese than in overweight participants (15 vs 12%, p 0.018; and 8 vs 4%, p 0.0199, respectively).DiscussionIn conclusion, undiagnosed hypertension, diabetes and CKD were more common than expected in overweight and obese persons from Ecuador. Detection rates exceeded official estimates of prevalene of these conditions. Screening the overweight/obese for these conditions, especially at the age ranges at higher risk, may be cost-effective to identify a high number of persons who may benefit from early inexpensive intervention.
| S-EPMC7863779 | biostudies-literature
Project description:Extant research has typically examined neighborhood characteristics in isolation using variable-centered approaches; however, there is reason to believe that perceptions of the neighborhood environment influence each other, requiring the use of person-centered approaches to study these relationships. The present study sought to determine profiles of youth that differ in their perceptions of their neighborhoods and objective neighborhood characteristics, and whether these profiles are associated with youth coping. Participants were low-income, African American youth (N= 733; 51.0% female, M age = 18.76 years, SD = 1.71) from a metropolitan city who were originally recruited for the Youth Opportunity program in Baltimore, Maryland. A latent profile analysis was conducted which included self-reported neighborhood social cohesion, collective efficacy, disorder, violence, and disadvantage derived from census data. Coping behaviors, specifically positive cognitive restructuring, problem-focused coping, distraction strategies, and avoidant behaviors were assessed via self-reported questionnaires. Four neighborhood profiles were identified: highest disorder (20.0%); highest violence/highest disadvantage (5.2%); high violence (26.6%); and highest cohesion/lowest disorder (48.2%). Individuals in the highest violence/highest disadvantage profile reported higher positive cognitive restructuring and problem-focused coping than the other profiles. These findings warrant an investigation into the individual assets and contextual resources that may contribute to more positive coping behaviors among youth in more violent and disadvantaged neighborhoods, which has the potential to improve resilient outcomes among youth in similar at-risk settings.
| S-EPMC8306217 | biostudies-literature
Project description:BackgroundWe conducted secondary data analyses to examine the associations between sleep duration, sleep quality, sleep disturbance and ≥ 5% of weight loss in low-income overweight or obese postpartum women enrolled in a community-based lifestyle behavior intervention study aimed at prevention of weight gain.MethodsParticipants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children in Michigan. The Pittsburgh Sleep Quality Index was used to assess sleep duration, sleep quality, and sleep disturbance. All participants were assessed and weighed at baseline (T1, 569 participants), 4-month (T2, 367 participants), and 7-month from T1 (T3, 332 participants). Descriptive statistics and mixed-effects regression analysis were performed.ResultsParticipants reported longer sleep duration (p = 0.048), better sleep quality (p = 0.003) and less sleep disturbance (p < 0.001) over time. There were no significant mean body weight changes at T2 and T3. However, a significantly higher proportion of women lost ≥5% of body weight at T3 (23.1%) than T2 (12.5%, p = 0.001). Sleep duration, quality, and disturbance were not significantly associated with ≥5% of weight loss.ConclusionImprovements in sleep duration, sleep quality and sleep disturbance over time were not associated with ≥5% of weight loss in low-income overweight or obese postpartum women.Trial registrationClinical Trials NCT01839708; retrospectively registered February 28, 2013.
| S-EPMC6442411 | biostudies-literature
Project description:PurposeThe purpose of this study was to explore unmet healthcare needs among low-income overweight and obese women and to identify the factors affecting unmet healthcare needs.MethodsThe study was a secondary analysis of data from the 2017 Korea National Health and Nutrition Examination Survey. A final sample of 388 out of 8,127 participants was analyzed using complex descriptive statistics, the chi-square test, the independent t-test, and logistic regression.ResultsThe mean age of the participants was 66.51±1.05 years. Unmet healthcare needs were experienced by 19.4% of low-income overweight and obese women. Women with depression, stress, and poor self-reported health status were significantly more likely than their counterparts to experience unmet healthcare needs. Poor self-reported health status was confirmed to be related to unmet health needs in low-income overweight and obese women (odds ratio, 2.65; p=.011).ConclusionThe study provides the novel insight that the unmet healthcare needs of low-income overweight and obese women were influenced by self-reported health status. Healthcare providers should make efforts to develop strategies to reduce unmet healthcare needs among low-income overweight and obese women, who constitute a vulnerable population.
| S-EPMC9334183 | biostudies-literature
Project description:BackgroundFor people who are overweight or obese, maintaining a metabolically healthy status can decrease the risks of developing cardiovascular diseases and Type 2 diabetes. Despite this, only a limited amount of research has discussed the metabolically healthy overweight and obesity (MHOO) population in Asia and the factors associated with them maintaining their metabolic health.MethodsThis study enrolled 195 MHOO participants from communities in northern Taiwan during 2009-2010 (baseline). Of the 195 participants, 89 completed the follow-up assessment after a median follow-up time of nine years. Body type was determined by body mass index (BMI, kg/m2). We defined overweight as a BMI ≥ 24 kg/m2 and <27 kg/m2 and defined obese as a BMI ≥ 27 kg/m2. Metabolic health was defined as the absence of cardiometabolic diseases and the presence of ≤1 of the cardiometabolic risk factors, namely hypertension, hyperglycemia, hypertriglyceridemia, and low serum high-density lipoprotein cholesterol. Metabolic health, BMI, and other covariates were evaluated at both baseline and follow-up. Generalized estimating equations (GEE) models were used to analyze the factors associated with maintenance of metabolic health during the follow-up period.ResultsAt baseline, the mean age of the study participants was 47.4 (SD 5.3) years and 46 (51.7%) of the participants were women. There were 51 (57.3%) individuals who maintained their metabolic health status at the time of the nine-year follow-up. The detrimental factors pertaining to metabolic health included older age, longer duration until follow-up, BMI ≥ 27 kg/m2, and increase in waist circumference. No significant relationships were observed between sociodemographic factors and lifestyle factors, such as sex, level of education, cigarette smoking, alcohol consumption, and physical activity, and sustained metabolic health among MHOO individuals.ConclusionsTo maintain metabolic health and prevent negative changes in health status, control of bodyweight and waist circumference should remain a priority for MHOO individuals even when there are no metabolic disorders present.
| S-EPMC9012173 | biostudies-literature
Project description:BackgroundExisting physical activity surveys have not been validated for use with low-income overweight and obese young mothers. This study aimed to validate the Pregnancy Infection and Nutrition 3 (PIN3) physical activity survey and to explore whether its validity varied by race/ethnicity and body mass index (BMI) category when including or excluding child and adult care activities in the target population.MethodsParticipants were recruited from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and were asked to fill out the PIN3 survey and wear an Actigraph accelerometer. Validity was assessed (N = 42) using Spearman correlation coefficient.ResultsRegardless of inclusion or exclusion of child and adult care activity, the PIN3 survey showed evidence of validity for moderate (correlation coefficients 0.33 [p = 0.03]; 0.40 [p = 0.08]) but not vigorous (-0.01 [p = 0.91]; -0.06 [p = 0.69]) physical activity. The mean minutes per week spent in moderate, vigorous and moderate-vigorous physical activity measured by the PIN3 were substantially higher than when measured by accelerometer, for example, 588 (PIN3) versus 148 (accelerometer) minutes per week. Also, correlations between self-reported and objective monitored activity varied substantially by race/ethnicity and BMI category, for example, 0.29 (p = 0.18) for overweight women versus 0.57 (p = 0.007) for obese women; 0.27 (p = 0.20) for African American versus 0.66 (p = 0.001) for white.ConclusionsThe PIN3 survey may be adequate for many applications where quick and practical assessments are needed for moderate physical activity data in low-income overweight and obese young mothers. The substantial differences in mean minutes per week between the PIN3 and accelerometer may be due to over-reported physical activity by the study participants.Trial registrationClinical Trials Number: NCT01839708.
| S-EPMC4331310 | biostudies-literature
Project description:Many worksite health promotion programs ignore the potential influence of working conditions on unhealthy behaviors.A study of nursing home employees (56% nursing aides) utilized a standardized questionnaire. We analyzed the cross-sectional associations between workplace stressors and obesity, cigarette smoking, and physical inactivity.Of 1506 respondents, 20% reported exposure to three or more workplace stressors (physical or organizational), such as lifting heavy loads, low decision latitude, low coworker support, regular night work, and physical assault. For each outcome, the prevalence ratio was between 1.5 and 2 for respondents with four or five job stressors. Individuals under age 40 had stronger associations between workplace stressors and smoking and obesity.Workplace stressors were strongly associated with smoking, obesity, and physical inactivity, even among the lowest-status workers. Current working conditions affected younger workers more than older workers. Although this study is cross-sectional, it has other strengths, including the broad range of work stressors studied. Strenuous physical work and psychosocial strain are common among low-wage workers such as nursing home aides. Workplace health promotion programs may be more effective if they include measures to reduce stressful work environment features, so that working conditions support rather than interfere with employee health.
| S-EPMC4561990 | biostudies-other
Project description:African Americans and low-income whites have higher mortality than the U.S. general population. This study prospectively investigated the combined influence of major lifestyle factors and poverty on mortality in this vulnerable population.Data were collected in 2002-2009 from 79,101 Southern Community Cohort Study participants, of which 67% were African American and 55% had household incomes <$15,000. Mortality outcomes were identified from the National Death Index though December 31, 2011 (data analyzed in 2014-2015). Healthy behavior scores were created based on tobacco smoking, alcohol intake, diet, physical activity, and sedentary time. The primary analysis was performed based on the score created by counting each participant as having met/not met public health guidelines for each behavior.Healthy behavior scores were associated with reduced cancer, cardiovascular disease, and all-cause mortality. Associations were stronger for whites than African Americans: hazard ratios for all-cause mortality comparing participants meeting four or five guidelines versus participants meeting zero were 0.41 (95% CI=0.30, 0.55) for African American men; 0.36 (95% CI=0.24, 0.55) for white men; 0.46 (95% CI=0.36, 0.59) for African American women; and 0.27 (95% CI=0.18, 0.43) for white women. The association between healthy lifestyle and all-cause mortality was weaker among those with incomes <$15,000 than those with higher income, particularly in men (p<0.05 for interaction).This study demonstrates the importance of health behaviors on mortality among all groups, but highlights the need for additional research to identify factors contributing to high risk of mortality among low-income and African American populations.
| S-EPMC4992598 | biostudies-literature
Project description:BackgroundInflammation is a common factor in adverse pregnancy outcomes (APOs). Behavioral factors influence inflammatory markers and APOs but rarely have been investigated simultaneously in pregnancy. Our purpose was to determine how diet, physical activity, and obesity are associated with interleukin (IL)-6 in early and late pregnancy.MethodsWe conducted a secondary analysis of 49 overweight/obese pregnant women. Health behavior data, including diet quality using the Dietary Inflammatory Index (DII®); physical activity (Leisure Time Physical Activity scale); body mass index (BMI); and plasma IL-6 concentrations were collected at 13-16 weeks (early pregnancy) and 34-36 weeks (late pregnancy) gestation. Multiple linear regression analyses were used to determine the amount of variance explained in early and late pregnancy IL-6 concentrations by early and late pregnancy diet, physical activity, and BMI.ResultsEarly diet and early BMI were the strongest predictors of early IL-6 concentrations (R2 = 0.43; p < .001) and late IL-6 concentrations (R2 = 0.30; p < .001). Late BMI predicted late IL-6 (R2 = .11; p = .02). Change in diet over pregnancy predicted late IL-6 (R2 = 0.17; p = .03).ConclusionThese findings suggest that maternal diet and BMI in early pregnancy, which likely reflects prepregnancy status, may have a greater impact on inflammatory processes than factors later in pregnancy. Future work should assess if behavioral factors before pregnancy produce similar relationships to those reported here, which may clarify the timing and type of lifestyle interventions to effectively reduce APOs.
| S-EPMC8755950 | biostudies-literature
Project description:Violent exposure among low-income, Black youth has reached alarming rates. Using administrative data that centers racial equity to understand risk factors and aid in prevention is a promising approach to address this complex problem. Medical records were linked to a comprehensive county-level integrated data system using a case-control design. Chi-square tests, T-tests, and multivariate logistic regression assessed for between and within group differences among (1) youth who presented to an emergency department (N = 429) with an assault or gunshot wound (GSW) and a matched sample of non-injured youth (N = 5000); and, (2) youth with GSW injuries (N = 71) compared to assault injuries (N = 358). Injured youth present with greater early adversity, trauma, and prolonged poverty compared to non-injured peers. Youth with GSW injuries differ from assault in several key ways. An ecosystem of care is needed to address the multifaceted causes of Black youth's severe violence exposure that are rooted in systemic racism and poverty. Integrated data using a racial equity lens can help to illuminate opportunities in this ecosystem of care.
| S-EPMC9274622 | biostudies-literature