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Obesity, lifestyle risk-factors, and health service outcomes among healthy middle-aged adults in Canada.

ABSTRACT: The extent to which uncomplicated obesity among an otherwise healthy middle-aged population is associated with higher longitudinal health-care expenditures remains unclear.To examine the incremental long-term health service expenditures and outcomes associated with uncomplicated obesity, 9398 participants of the 1994-1996 National Population Health Survey were linked to administrative data and followed longitudinally forward for 11.5?years to track health service utilization costs and death. Patients with pre-existing heart disease, those who were 65?years of age and older, and those with self-reported body mass indexes of <18.5?kg/m² at inception were excluded. Propensity-matching was used to compare obesity (+/- other baseline risk-factors and lifestyle behaviours) with normal-weight healthy controls. Cost-analyses were conducted from the perspective of Ontario's publicly-funded health care system.Obesity as an isolated risk-factor was not associated with significantly higher health-care costs as compared with normal weight matched controls (Canadian $8,294.67 vs. Canadian $7,323.59, P?=?0.27). However, obesity in combination with other lifestyle factors was associated with significantly higher cumulative expenditures as compared with normal-weight healthy matched controls (CAD$14,186.81 for those with obesity?+?3 additional risk-factors vs. CAD$7,029.87 for those with normal BMI and no other risk-factors, P?

SUBMITTER: Alter DA

PROVIDER: S-EPMC3439326 | biostudies-other | 2012 Aug

REPOSITORIES: biostudies-other

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Obesity, lifestyle risk-factors, and health service outcomes among healthy middle-aged adults in Canada.

Alter David A DA Wijeysundera Harindra C HC Franklin Barry B Austin Peter C PC Chong Alice A Oh Paul I PI Tu Jack V JV Stukel Therese A TA

BMC health services research 20120804

<h4>Background</h4>The extent to which uncomplicated obesity among an otherwise healthy middle-aged population is associated with higher longitudinal health-care expenditures remains unclear.<h4>Methods</h4>To examine the incremental long-term health service expenditures and outcomes associated with uncomplicated obesity, 9398 participants of the 1994-1996 National Population Health Survey were linked to administrative data and followed longitudinally forward for 11.5 years to track health servi ...[more]

PMID: 22863333

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Project description:BackgroundThere is a current lack of consensus on defining metabolically healthy obesity (MHO). Limited data on dietary and lifestyle factors and MHO exist. The aim of this study is to compare the prevalence, dietary factors and lifestyle behaviours of metabolically healthy and unhealthy obese and non-obese subjects according to different metabolic health criteria.MethodCross-sectional sample of 1,008 men and 1,039 women aged 45-74 years participated in the study. Participants were classified as obese (BMI ? 30 kg/m(2)) and non-obese (BMI < 30 kg/m(2)). Metabolic health status was defined using five existing MH definitions based on a range of cardiometabolic abnormalities. Dietary composition and quality, food pyramid servings, physical activity, alcohol and smoking behaviours were examined.ResultsThe prevalence of MHO varied considerably between definitions (2.2% to 11.9%), was higher among females and generally increased with age. Agreement between MHO classifications was poor. Among the obese, prevalence of MH was 6.8% to 36.6%. Among the non-obese, prevalence of metabolically unhealthy subjects was 21.8% to 87%. Calorie intake, dietary macronutrient composition, physical activity, alcohol and smoking behaviours were similar between the metabolically healthy and unhealthy regardless of BMI. Greater compliance with food pyramid recommendations and higher dietary quality were positively associated with metabolic health in obese (OR 1.45-1.53 unadjusted model) and non-obese subjects (OR 1.37-1.39 unadjusted model), respectively. Physical activity was associated with MHO defined by insulin resistance (OR 1.87, 95% CI 1.19-2.92, p = 0.006).ConclusionA standard MHO definition is required. Moderate and high levels of physical activity and compliance with food pyramid recommendations increase the likelihood of MHO. Stratification of obese individuals based on their metabolic health phenotype may be important in ascertaining the appropriate therapeutic or intervention strategy.

Project description:Sleep misperception has long been a major issue in the field of insomnia research. Most studies of sleep misperception examine sleep underestimation by comparing the results of polysomnography conducted in a laboratory environment with patients' sleep diary entries. We aimed to investigate psychosocial characteristics of adults who underestimated or overestimated sleep time in a nonclinical, middle-aged community-dwelling population. We collected one week of sleep data with wrist-worn accelerometers. We used egocentric social network analysis to analyze the effects of psychosocial factors. Among 4,060 study participants, 922 completed the accelerometer substudy. Underestimation was defined as an accelerometer-measured sleep time ≥ 6 h and a subjective sleep time < 6 h. Overestimation was defined as an objective sleep time < 6 h and a subjective sleep time ≥ 6 h. Psychosocial characteristics of the sleep misperception group were evaluated using multivariate regression analysis. A total of 47 participants underestimated sleep time, and 420 overestimated sleep time. Regression analysis revealed that women, living with spouse, economic satisfaction, and bridging potential had protective effects against sleep underestimation. Blame from a spouse involved a 3.8-times higher risk of underestimation than the control group (p = 0.002). In men, discussing concerns with a spouse had a protective effect against underestimation (p < 0.001). Economic satisfaction, feeling social network-based intimacy, and support from a spouse were associated with overestimation in women. In men, feeling social network-based intimacy was also associated with overestimation (p < 0.001). We found that social relationship quality was related to sleep overestimation and underestimation. This association was marked in women. Good social relationships may have positive effects on sleep misperception via attenuation of negative emotional reactions and effects on emotional regulation.

Project description:BackgroundNo studies have assessed the association between daytime napping and obesity in China. The study aimed to examine the association between daytime napping and obesity among Chinese middle-aged and older adults, and to evaluate the difference between the aforementioned association in men and women.MethodsOverall, 14 685 participants aged 45 years and older were included by using data from China Health and Retirement Longitudinal Study (CHARLS) in 2015. A multivariable logistic regression model was used to investigate the relationship between daytime napping and obesity after adjusting for potential confounders. Stratified analyses were performed to examine the association differences by sex. Besides, the Cochran-Armitage test for trend was used to detect if there was a significant dose-response relationship between daytime napping and obesity.ResultsThe mean age of participants was 60.32, and the mean daytime napping duration was 38.97 minutes. In the sample, compared with no daytime napping group, the risks of being obese were higher in both moderate daytime napping group (1-60 minute/d) (odds ratio OR = 1.27, 95% confidence interval (CI) = 1.13-1.44) and extend long daytime napping group (>60 minute/d) (OR = 1.34, 95% CI = 1.15-1.56). In sex stratification, these significant correlations only existed in women but not in men. Compared with no daytime napping, women who napped 1-60 minute/d and over 60 minute/d were more likely to be obese (OR = 1.37, 95% CI = 1.18-1.59 and OR = 1.49, 95% CI = 1.23-1.81, respectively). Besides, the Cochran-Armitage trend test revealed that the prevalence rate of obesity increased as the daytime napping duration increased (P < 0.001).ConclusionsThe study established the relationship between daytime napping and obesity in a general Chinese population. The association, however, was only detected among women. Furthermore, there was a dose-response relationship between daytime napping and obesity among women. Future studies may verify this association by using a longitudinal design and focus on the mechanisms behind such association.

Dataset Information

Obesity, lifestyle risk-factors, and health service outcomes among healthy middle-aged adults in Canada.

Publications

Obesity, lifestyle risk-factors, and health service outcomes among healthy middle-aged adults in Canada.

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