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Over recent decades, Americans have transitioned from working in active jobs to working in sedentary jobs, and there have been dramatic increases in hours worked for certain demographic groups. While a body of research documents that time spent working is associated with increased body mass index (BMI), this paper explores possible mechanisms for that relationship using time use data. This paper finds that, for workers in non-strenuous jobs, 10 additional hours spent working are associated with an increase in BMI of 0.424 for women and 0.197 for men, representing an increase of 2.5 and 1.4 pounds, respectively. The paper does not find a relationship between working time and BMI for workers in strenuous jobs. For workers in non-strenuous jobs, the effect of time spent working on BMI becomes smaller after accounting for time spent sleeping for both men and women and time spent in exercise and food preparation for women only; the effect becomes larger after accounting for screen time for both men and women and time spent in secondary eating and commuting for women only. Screen time is the single time use channel associated with the largest differences in the estimated effect of time spent working on BMI for both women and men employed in non-strenuous jobs. After controlling for all time use channels, the effect of hours worked on BMI decreases for women, but increases for men. These findings suggest plausible mechanisms for the association between time spent working and obesity. [ABSTRACT FROM AUTHOR]

Background: This paper examined the gap between obesity and its diagnosis for cohorts of patients with overweight, obesity, and morbid obesity in the Veterans Administration (VA) population. Using the risk adjustment models, it also identified factors associated with the underdiagnosis of obesity. Methods: Analysis was performed on a VA data set. We identified diagnosed patients and undiagnosed patients (identified through BMI but not diagnosed using ICD-10 codes). The groups' demographics were compared using nonparametric chi-square tests. We used logistic regression analysis to predict the likelihood of the omission of diagnosis. Results: Of the 2,900,067 veterans with excess weight, 46% were overweight, 46% had obesity, and 8% of them had morbid obesity. The overweight patients were the most underdiagnosed (96%), followed by the obese (75%) and morbidly obese cohorts (69%). Older, male, and White patients were more likely to be undiagnosed as overweight and obese; younger males were more likely to be undiagnosed as morbidly obese. (p < 0.05) Comorbidities significantly contributed to diagnosis. Conclusions: The underdiagnosis of obesity continues to be a significant problem despite its prevalence. Diagnosing obesity accurately is necessary to provide effective management and treatment. [ABSTRACT FROM AUTHOR]

Childhood obesity is a public health concern in the United States. Consequences of childhood obesity include metabolic disease and heart, lung, kidney, and other health-related comorbidities. Therefore, the early determination of obesity risk is needed and predicting the trend of a child's body mass index (BMI) at an early age is crucial. Early identification of obesity can lead to early prevention. Multiple methods have been tested and evaluated to assess obesity trends in children. Available growth charts help determine a child's current obesity level but do not predict future obesity risk. The present methods of predicting obesity include regression analysis and machine learning-based classifications and risk factor (threshold)-based categorizations based on specific criteria. All the present techniques, especially current machine learning-based methods, require longitudinal data and information on a large number of variables related to a child's growth (e.g., socioeconomic, family-related factors) in order to predict future obesity-risk. In this paper, we propose three different techniques for three different scenarios to predict childhood obesity based on machine learning approaches and apply them to real data. Our proposed methods predict obesity for children at five years of age using the following three data sets: (1) a single well-child visit, (2) multiple well-child visits under the age of two, and (3) multiple random well-child visits under the age of five. Our models are especially important for situations where only the current patient information is available rather than having multiple data points from regular spaced well-child visits. Our models predict obesity using basic information such as birth BMI, gestational age, BMI measures from well-child visits, and gender. Our models can predict a child's obesity category (normal, overweight, or obese) at five years of age with an accuracy of 89%, 77%, and 89%, for the three application scenarios, respectively. Therefore, our proposed models can assist healthcare professionals by acting as a decision support tool to aid in predicting childhood obesity early in order to reduce obesity-related complications, and in turn, improve healthcare. [ABSTRACT FROM AUTHOR]

Background: Diagnosis and treatment for individuals with brain tumors during childhood involves sequelae, including abnormal weight gain. This symptom is commonly clustered with fatigue and increased risk for cardiovascular disease. Children's Oncology Group recommendations include annual surveillance of body mass index (BMI) and cardiometabolic comorbidities; however, there has been little emphasis on individualized screening early in survivorship. Purpose: The primary purpose of this paper is to describe the findings of abnormal weight gain and its correlates in a sample of young childhood brain tumor survivors during early survivorship. Design and Methods: This cross‐sectional multi‐site study included brain tumor survivors of ages 8–12 years who were less than 6 years posttreatment. Convenience sampling from two pediatric cancer centers in the southern United States was utilized. Data collected included BMI, parent report of sleep, and child report of fatigue and stress. Results: The sample (N = 21) consisted of children who had received chemotherapy, radiation treatment, and surgery for childhood brain tumor. BMI in overweight and obese categories exceeded normative samples with 38% at or above the 85th percentile. There were clinically significant relationships with fatigue, stress about weight, tumor location, cranial radiation, chemotherapy, and recurrence Practice Implications: Screening for abnormal weight gain and related factors, such as fatigue should begin early in survivorship after childhood brain tumor treatment completion with the aim of health promotion and disease prevention. Adiposity measurement techniques should be utilized in future clinical and research settings to improve assessment of cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Objective: This paper reviews available studies on the relationship between acculturation and obesity among children of immigrants who have at least one foreign-born parent. Methods: A systematic review of relevant studies was undertaken using PubMed, Web of Science, and PsychInfo. Results: The initial search identified 1317 potentially relevant publications, of which 21 were retained after three rounds of screening. Most studies were conducted in the U.S. The majority of studies used BMI or overweight/obesity prevalence as the outcome variable, while two studies used dietary intake. Three studies used standardized acculturation scales, while most of the studies used generation, duration of residency in host country, and language as proxy measures of acculturation. The relationship between acculturation and outcomes varied between the host countries and origin countries for children of immigrants. Conclusion: This study suggests children of immigrants with different cultural backgrounds may interact with host countries to varying degrees, ultimately influencing their diet behaviours and body weight status. Researchers are encouraged to adopt standardized acculturation scales to compare the results across countries and populations. [ABSTRACT FROM AUTHOR]

The purpose of this cross-sectional study was to investigate the relationship between Body Mass Index (BMI), cholesterol, and cancer in United States (US) adults. Data were collected from the 2020 Medical Expenditure Panel Survey (MEPS). Eligible participants were US adults (≥18 years) with data on BMI, cholesterol, and cancer status, who were alive at the end of the data collection period. An adjusted logistic regression model assessed associations between eight possible combinations of BMI and cholesterol status (independent variable) with cancer diagnosis (dependent variable). Among 27,805 individuals in the 2020 MEPS data, 20,818 met the eligibility criteria (weighted N = 252,340,615). Of these 2668 (weighted N = 29,770,359) had cancer and 18,150 (weighted N = 222,570,256) did not have cancer. In the adjusted logistic regression model, underweight and normal weight individuals with high cholesterol were associated with higher odds of cancer (odds ratio, OR = 2.002, and 95% confidence interval, CI = 1.032–3.885, and OR = 1.326 and 95% CI = 1.047–1.681, respectively), while obese individuals with normal cholesterol were associated with lower odds of cancer (OR = 0.681; 95% CI = 0.543–0.853) compared to normal weight individuals with normal cholesterol. This study offers insights into specific groups of individuals who may be prioritized for cancer prevention. Further research is required to investigate these findings in additional subpopulations. [ABSTRACT FROM AUTHOR]

Background: This study investigated the association between body mass index (BMI) and myopia in the United States. Methods: This cross-sectional study included 8,000 participants from the 1999 to 2008 National Health and Nutrition Examination Survey (NHANES). BMI was classified into four groups: < 18.5, 18.5 – 24.9, 25–29.9, and > 29.9. Three diagnostic thresholds were used for myopia A\B\C: spherical equivalent ≤ −0.5\−0.75\−1 diopters in the right eye. Multivariate logistic regression analysis and smooth curve fitting were performed to evaluate the association between BMI and myopia. Results: The incidence of myopia was 39.4%. BMI was correlated with myopia, with each 1 kg/m2 increase in BMI associated with a 1% increase in the risk of myopia (OR, 1.01; 95% CI 1.01 1.02; p < 0.05). In myopia B, after adjusting for confounding factors, compared with the reference group (BMI 18.5–24.9), participants with a BMI of 25–29.9 and greater than 29.9 had a 14% and 25% increased risk of myopia, respectively (OR 1.14; 95% CI 1.01 1.29; p = 0.037, OR 1.25; 95% CI 1.08 1.44; p = 0.003), which was similar to the results for myopic A (OR, 1.15; 95% CI 1.02 1.3; p = 0.027, OR 1.19; 95% CI 1.03 1.37; p = 0.018) and myopia C (OR 1.15; 95% CI 1.01 1.31; p = 0.035, OR 1.18; 95% CI 1.01 1.37; p = 0.032). Moreover, there was a linear relationship between myopia and BMI (p for nonlinearity = 0.767). Conclusions: Myopia using all three diagnostic thresholds was positively associated with higher BMI. This suggests a potential association between myopia and higher BMI in the American population, warranting further investigations. [ABSTRACT FROM AUTHOR]

The United States is experiencing a major public health problem relating to increasing levels of excess body fat. This paper is about the relationship in the United States between trends in the distribution of body mass index (BMI), including trends in overweight and obesity, and demographic change. We provide estimates of the counterfactual distribution of BMI that would have been observed in 2003–2008 had demographics remained fixed at 1980 values, roughly the beginning of the period of increasing overweight and obesity. We find that changes in demographics are partly responsible for the changes in the population distribution of BMI and are capable of explaining about 8.6% of the increase in the combined rate of overweight and obesity among women and about 7.2% of the increase among men. We also use demographic projections to predict a BMI distribution and corresponding rates of overweight and obesity for 2050. [ABSTRACT FROM PUBLISHER]

Aim: This paper evaluates trends in the childhood and adolescent associations between family income, height and body mass index (BMI) between the periods 1971--1980 and 1999--2008. Subjects and methods: US-born children (aged 2--11) and adolescents (aged 12--19) in the NHANES I, NHANES II and 1999--2008 NHANES are evaluated for BMI and height using flexibly-estimated structured additive regression models. Results: Three trends are identified: BMI gains have been greater in lower-income relative to higher-income children and adolescents; height has increased more in lower-income relative to higher-income children (but not in adolescents); and BMI has increased more in taller children than shorter children (but not in adolescents). Following from these trends is that contemporary children exhibit a negative height-income interaction effect on BMI such that the inverse association between income and BMI is larger in taller children. Similar results hold when categorical obesity is considered but with modest height-related changes and income-height interaction effect in adolescents. Race--sex differences are explored and descriptive evidence on the potential role of changes in caloric intake is presented. Conclusion: The relationship between the economic environment and growth in US youth has changed in recent decades. Contemporary taller and lower-income children exhibit greater body mass and obesity. [ABSTRACT FROM AUTHOR]

Abstract: This paper examines the relationship between body composition and wages in the United States. We develop measures of body composition – body fat (BF) and fat-free mass (FFM) – using data on bioelectrical impedance analysis (BIA) that are available in the National Health and Nutrition Examination Survey III and estimate wage models for respondents in the National Longitudinal Survey of Youth 1979. Previous research uses body size or BMI as measures of obesity despite a growing concern that they do not distinguish between body fat and fat-free body mass or adequately control for non-homogeneity inside the human body. Therefore, measures presented in this paper represent a useful alternative to BMI-based proxies of obesity. Our results indicate that BF is associated with decreased wages for both males and females among whites and blacks. We also present evidence suggesting that FFM is associated with increased wages. We show that these results are not the artifacts of unobserved heterogeneity. Finally, our findings are robust to numerous specification checks and to a large number of alternative BIA prediction equations from which the body composition measures are derived. [ABSTRACT FROM AUTHOR]

Abstract: The substantial increase in the prevalence of child obesity over recent decades and its association with a number of negative health and economic outcomes suggests its strong potential as an influence on the lifecourse development of health and productivity. This paper evaluates interactive effects between family socioeconomic status (SES) and height on child obesity in the United States. Using the 1999–2006 National Health and Nutrition Examination Surveys (NHANES), the results of this paper confirm previous findings that taller children exhibit greater propensity towards obesity as measured by body mass index (BMI) and that obesity is inversely related to family SES as measured by poverty status. The analysis adds to the existing literature by showing that the magnitude of the SES–obesity association is larger in taller children. Age and sex patterns are evaluated that suggest the SES–height interaction persists through childhood and adolescence in males but is only evident in females during adolescence. Interaction effects are also shown to be most evident in white males and Hispanic females. Policy implications are discussed and directions for future work are suggested. [Copyright &y& Elsevier]

Obesity among U.S. adolescents ages 12–19 rose from 4.6% in 1963–1965 to 17.4% in 2003–2004. This paper contributes to the literature on the impact of unhealthy body mass index (BMI) on health (e.g., obesity) and human capital (e.g., schooling) investments of adolescents. We use the propensity score method to study 8,388 individuals who responded to survey Waves I through III of the National Longitudinal Study of Adolescent Health (Add Health), for students in grades 7–12. We estimate an economic model that captures longer-term effects of BMI categories (obesity and overweight separately) on on-time (dichotomous) high school graduation. We control for characteristics at the individual, household, and community levels. Baseline probit regression estimates were improved upon by using matching estimators (propensity scores yield consistent estimate of the average treatment on the treated) based on the nearest neighbor and the more robust kernel density weighting schemes. Results from both full and reduced models suggest no adverse impact of overweight or obesity on timely high school completion for males, but a significant average negative effect on females. Investigating disparities in effects across both gender and race, we isolate the adverse effects primarily to white and Asian females. No significant effects were found for African-Americans. One of the novel contributions of our research is that the significant effects of gender- and race- specific adolescent obesity and overweight conditions reach beyond high school GPA standing to also impact on-time high school graduation status. [ABSTRACT FROM AUTHOR]

Abstract: A growing body of literature has documented a link between neighborhood context and health outcomes. However, little is known about the relationship between neighborhood context and body mass index (BMI) or whether the association between neighborhood context and BMI differs by ethnicity. This paper investigates several neighborhood characteristics as potential explanatory factors for the variation of BMI across the United States; further, this paper explores to what extent segregation and the concentration of disadvantage across neighborhoods help explain ethnic disparities in BMI. Using data geo-coded at the census tract-level and linked with individual-level data from the Third National Health and Examination Survey in the United States (U.S.), we find significant variation in BMI across U.S. neighborhoods. In addition, neighborhood characteristics have a significant association with body mass and partially explain ethnic disparities in BMI, net of individual-level adjustments. These data also reveal evidence that ethnic enclaves are not in fact advantageous for the body mass index of Hispanics—a relationship counter to what has been documented for other health outcomes. [Copyright &y& Elsevier]

With advances in the treatment of HIV, people living with HIV (PLWH) are now expected to have a near-normal life expectancy, but challenges remain in the form of substantially poorer health-related quality of life (HRQoL) than the general population. Being overweight or obese may pose an additional burden in PLWH, but few studies have evaluated the relationship between body mass index (BMI) and HRQoL in PLWH. This study aimed to evaluate and describe the association between HRQoL and BMI among PLWH in the US. Data were obtained from the 2018 and 2019 US National Health and Wellness Survey, an online, self-reported, general population survey. Analyses included 575 PLWH who self-reported a physician diagnosis and prescription use for the treatment of HIV, as well as 1725 propensity score matched non-HIV controls. After adjusting for age, sex, race, and comorbidities, higher BMI was associated with poorer physical (β = −0.18, p = 0.005) and general (β = −0.42, p = 0.014) HRQoL among PLWH. Additionally, PLWH reported poorer mental, physical, and general HRQoL than non-HIV controls; these relationships were not moderated by BMI. The potential negative impact of higher BMI on patients' humanistic outcomes should be considered in HIV management, including selection of treatment. [ABSTRACT FROM AUTHOR]

In this paper we question whether prior cross-national differences in food attitudes still exist and if so, to what extent. Due to societal evolutions such as sedentarism and globalization, international variations in food attitudes may not be as pronounced as currently believed. A cross-sectional web-based survey was carried out in the United States, the United Kingdom, France and Belgium. A total of 2167 respondents (52% women; mean age = 39.0 years, SD = 11.4) participated. To successfully combat obesity, a joint approach focusing on food choice and physical activity is required; therefore we included behavioral measures by means of choice tasks for these two important drivers. Further, the extent to which respondents subscribe to the unhealthy = tasty intuition, together with health and taste interest were investigated. Socio-demographic information and self-reported heights and weights were also incorporated. Logistic regressions were fitted with weight status as the dependent variable and the attitudinal and behavioral measures as independent variables. Our findings indicate that having a higher interest in healthy eating decreases the chance of being overweight (odds = 0.88) and believing that unhealthy food is tasty significantly increases the chance of being obese by 1.18 times. Overall, we find that food attitudes have largely converged across the countries we investigated. [ABSTRACT FROM AUTHOR]

Abstract Financial aid lowers the cost of higher education and improves educational attainment. Based on the correlation between education and health, one might expect aid to improve health, but little evidence exists. I use a shock in Social Security benefits that occurred in 1981 to test the relationship between aid, education, and health. Minor children of retired, disabled, or deceased parents are eligible for their own Social Security benefits, and until 1981 college-aged recipients could continue to receive these benefits conditional on college enrollment. Using difference-in-differences, I show that aid reduced women's long-run body mass index and general health, but had no effect on men. I find that financial aid improved educational attainment for beneficiaries, which is the plausible mechanism between aid and health. Consistent with the effects on health, the educational effects are concentrated in women. Finally, I use Social Security benefits as an instrument for attending college to estimate the effect of education on long-run weight and general health. [ABSTRACT FROM AUTHOR]

Little is known about how biological and psychological consequences of adolescent stressful life events (SLEs) are jointly associated with socioeconomic and relational outcomes in adulthood. To address this gap, the present study involved testing a model based on the life course perspective that posits adolescent SLE trajectories produce parallel trajectories of depressive symptoms and weight status, which are jointly associated with socioeconomic status and intimate relationship quality in adulthood. Prospective data over 13 years from a nationally representative sample of 11,677 US adolescents was utilized. The results demonstrated that trajectories of BMI and depressive symptoms, which showed contemporaneous and longitudinal comorbidities over the early life course, were influenced by adolescent SLEs. Both BMI and depressive symptoms trajectories are additively and jointly associated with socioeconomic status and intimate relationship quality in adulthood. Additionally, adolescent SLE trajectories are directly associated with these adult outcomes. These observed associations persisted even after controlling for early family socioeconomic adversity and race/ethnicity. The theoretical and practical implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This paper evaluates the association between income and physical development in a nationally representative sample of contemporary US schoolchildren followed from kindergarten to eighth grade (average ages of 6–14). A generalized linear mixed modeling framework is used to evaluate height and body mass index (BMI) as both levels and annualized growth in a pooled sample. Contemporary US schoolchildren show income variation in height that is significant but modest at around .1cm (in kindergarten) to .4cm (eighth grade) increases per doubling of income. An exception is found for Hispanic children who show faster height velocity associated with higher income through childhood yielding a 1.0cm increase per doubling of income by the eighth grade. All groups except black males show a negative relationship between income and BMI that becomes stronger with age with an average .8kg/m2 lower BMI per doubling of income by the eighth grade. These results are robust to the inclusion of baseline anthropometric controls. The analysis suggests that higher-income US schoolchildren enter mid-adolescence as taller but with lower proportional body mass relative to their lower-income counterparts. [Copyright &y& Elsevier]

Abstract: This paper examined the importance of household and economic contextual factors as determinants of ethnic disparities in adolescent body mass index (BMI). Individual-level data from the National Longitudinal Survey of Youth 1997 for the years 1997 through 2000 were combined with economic contextual data on food prices, outlet density and median household income. The Oaxaca–Blinder decomposition method was used to examine the factors that could help explain ethnic disparities in BMI. Ethnic differences in household demographic, parental socioeconomic status (SES), and economic contextual factors explained the majority of the male black–white (63%), male Hispanic–white (78%) and female Hispanic–white (62%) BMI gaps but less than one-half of the female black–white BMI gap (44%). We found that adding the economic contextual factors increased the explained portion of the ethnic BMI gap for both female and male adolescents: the economic contextual factors explained 28% and 38% of the black–white and Hispanic–white BMI gaps for males and 13% and 8% of the black–white and Hispanic–white BMI gaps for females, respectively. Parental SES was more important in explaining the Hispanic–white BMI gap than the black–white BMI gap for both genders, whereas neighborhood economic contextual factors were more important in explaining the male BMI gap than the female BMI gap for both black–white and Hispanic–white ethnic disparities. A significantly large portion of the ethnic BMI gap, however, remained unexplained between black and white female adolescents. [Copyright &y& Elsevier]

Abstract: This paper examines the impact of job loss due to business closings on body mass index (BMI) and alcohol consumption. We suggest that the ambiguous findings in the extant literature may be due in part to unobserved heterogeneity in response and in part due to an overly broad measure of job loss that is partially endogenous (e.g., layoffs). We improve upon this literature using: exogenously determined business closings, a sophisticated estimation approach (finite mixture models) to deal with complex heterogeneity, and national, longitudinal data from the Health and Retirement Study. For both alcohol consumption and BMI, we find evidence that individuals who are more likely to respond to job loss by increasing unhealthy behaviors are already in the problematic range for these behaviors before losing their jobs. These results suggest the health effects of job loss could be concentrated among “at risk” individuals and could lead to negative outcomes for the individuals, their families, and society at large. [Copyright &y& Elsevier]

Abstract: This paper studies the association between weight and labor market outcomes among legal immigrants to the United States from developing countries using the first nationally representative survey of such individuals. We find that being overweight or obese is associated with a lower probability of employment among women who have been in the U.S. less than five years, but we find no such correlation among men who have been in the U.S. less than five years, or among women or men who have been in the U.S. longer than five years. We generally find no significant association between weight and either wages, sector of employment, or work limitations for either women or men. Possible explanations for these findings are discussed. [Copyright &y& Elsevier]

Abstract: The purpose of this paper is to determine if living arrangements influence dietary variety and other health behaviors among American college students. A generalized linear model was used to assess differences between students in various living arrangements. Results showed that off-campus students were more likely to be overweight/obese, consume more alcohol, and smoke than those who lived on-campus or with parents. Compared to students who lived off-campus, those who lived on-campus consumed a larger variety of fruits, vegetables, and dairy products. Those who lived off-campus consumed less variety of grains compared to those who lived with parents. There were no significant differences in variety of meat, meat alternatives, or snacks between the three groups. To prevent future chronic diseases, health educators should target off-campus students to improve dietary and lifestyle behaviors. [Copyright &y& Elsevier]

Abstract: Obesity is a rapidly growing public health issue. This paper investigates obesity''s relationship to individuals’ wealth by analyzing data from a large U.S. longitudinal socio-economic survey. The results show a large negative association between BMI and White female''s net worth, a smaller negative association for Black women and White males and no relationship for Black males. Weight changes and dieting also appear associated with wealth changes. Individuals who lose small amounts of weight experience little change in net worth, but those who lose large amounts of weight have a dramatically improved financial position, with Whites showing larger changes than Blacks. [Copyright &y& Elsevier]

BACKGROUND: Taxi/for-hire vehicle (FHV) drivers are a predominantly immigrant, male, and growing population in large, metropolitan cities in the U.S. at risk for cardiovascular conditions. OBJECTIVE: This review sought to systematically investigate the literature given mounting evidence of poor taxi/FHV driver health. METHODS: A systematic search of peer-reviewed journal articles that included a range of cardiovascular risks and conditions among taxi/FHV drivers in the U.S. was conducted. RESULTS: 8800 journal articles were initially found. 14 eligible articles were included: 3 mixed methods articles, 1 qualitative article, and 10 quantitative articles. Articles spanned 13 cardiovascular risks and conditions, including tobacco, nutrition, physical activity, stress, depression, body mass index/waist circumference, cholesterol, blood glucose/diabetes, air pollution, sleep, blood pressure/hypertension, heart disease, and stroke. The majority of studies were cross-sectional and utilized convenience samples. CONCLUSIONS: Rigorous and high quality research is needed to further investigate rates of cardiovascular health in this population. The complexity of data collection in this group presents challenges to this endeavor. The high prevalence of poor nutrition, limited physical activity, diabetes, and blood pressure across studies indicates an urgent need to address low rates of health care access at a policy level and to design targeted workplace interventions. [ABSTRACT FROM AUTHOR]

Few studies have derived data-driven dietary patterns in youth in the USA. This study examined data-driven dietary patterns and their associations with BMI measures in predominantly low-income, racial/ethnic minority US youth. Data were from baseline assessments of the four Childhood Obesity Prevention and Treatment Research (COPTR) Consortium trials: NET-Works (534 2–4-year-olds), GROW (610 3–5-year-olds), GOALS (241 7–11-year-olds) and IMPACT (360 10–13-year-olds). Weight and height were measured. Children/adult proxies completed three 24-h dietary recalls. Dietary patterns were derived for each site from twenty-four food/beverage groups using k-means cluster analysis. Multivariable linear regression models examined associations of dietary patterns with BMI and percentage of the 95th BMI percentile. Healthy (produce and whole grains) and Unhealthy (fried food, savoury snacks and desserts) patterns were found in NET-Works and GROW. GROW additionally had a dairy- and sugar-sweetened beverage-based pattern. GOALS had a similar Healthy pattern and a pattern resembling a traditional Mexican diet. Associations between dietary patterns and BMI were only observed in IMPACT. In IMPACT, youth in the Sandwich (cold cuts, refined grains, cheese and miscellaneous) compared with Mixed (whole grains and desserts) cluster had significantly higher BMI (β = 0·99 (95 % CI 0·01, 1·97)) and percentage of the 95th BMI percentile (β = 4·17 (95 % CI 0·11, 8·24)). Healthy and Unhealthy patterns were the most common dietary patterns in COPTR youth, but diets may differ according to age, race/ethnicity or geographic location. Public health messages focused on healthy dietary substitutions may help youth mimic a dietary pattern associated with lower BMI. [ABSTRACT FROM AUTHOR]

South Asian individuals in the United States are at an increased risk of type 2 diabetes (T2DM); however, the mechanisms behind this are not well understood. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study is the only longitudinal cohort of South Asians in the United States and provides key insights as to the epidemiology of T2DM in South Asians. Evidence from the MASALA study suggests that South Asians experience a disproportionately high burden of prevalent and incident T2DM compared with members of other race/ethnic groups. Higher insulin resistance in South Asians, even with low body mass index (BMI), more impairment in insulin secretion, and greater deposition of ectopic fat likely play a role in T2DM etiology. Furthermore, South Asian migrants to the United States experience a range of factors related to acculturation, social networks, and religious beliefs, which may impact physical activity and dietary practices. Interventions to prevent T2DM in South Asians should include a focus on cultural factors related to health and should consider the complete mechanistic pathway and the relative contributions of insulin resistance, β cell dysfunction, and ectopic fat deposition on T2DM development in South Asians, particularly in those with lower BMI. [ABSTRACT FROM AUTHOR]

Objectives To examine work characteristics in relation to body mass index (BMI) and risk of obesity. Methods We analyzed data from 1150 participants working 20+ h week−1 from the 2014 National NIOSH Quality of Work Life Survey, based on a representative sample of US workers. We used multiple linear regression for BMI and multiple logistic regression for obesity to estimate associations with 19 different work characteristics plus one set of occupational categories controlling for age, gender, race/ethnicity, education, marital status, job physical exertion, and television watching. Results We found significant positive linear associations between BMI and night shift (versus day shift) schedule (B = 2.28, P = 0.008) and blue-collar (versus management/professional) work (B = 1.75, P = 0.008). Night shift schedule [odds ratio (OR) = 2.19, P = 0.029], sales/office work (OR = 1.55, P = 0.040), and blue-collar work (OR = 2.63, P = 0.006) were associated with increased risk of obesity versus 'healthy weight'. No other statistically significant associations between work characteristics and BMI or obesity were observed. Conclusions Night shift schedule and blue-collar work were related to increased BMI and obesity risk in US workers in 2014. Identifying risk factors in blue-collar work and redesigning jobs to reduce those risk factors, and reducing night shift work, could play a role in reducing the prevalence of obesity in the USA. [ABSTRACT FROM AUTHOR]

There is a lack of research on associations of social jetlag with eating behaviours and obesity among adolescents. We examined the associations of social jetlag with eating behaviours and BMI in adolescents before and after adjustment for potential confounders. Self-report data were collected from 3060 adolescents (48·1 % female, mean age 15·59 (sd 0·77) years) from the Fragile Families and Child Wellbeing Study. In regression models, social jetlag predicted odds of consumption of breakfast, fruits/vegetables, fast food and sweetened drinks and BMI percentile. Primary models adjusted for school night sleep duration, sex, age, household income and youth living arrangements; secondary models further adjusted for race/ethnicity. In fully adjusted models, greater social jetlag was associated with lower odds of consumption of breakfast (OR = 0·92, P = 0·003) and fruits/vegetables (OR = 0·92, P = 0·009) and higher odds of consumption of fast food (OR = 1·18, P < 0·001) and sweetened drinks (OR = 1·18, P < 0·001). Social jetlag was positively associated with BMI percentile after additional adjustment for eating behaviours (b = 0·84, P = 0·037), but this relationship was attenuated after adjustment for race/ethnicity (b = 0·72, P = 0·072). Ethnoracial differences in social jetlag may attenuate the association of social jetlag with BMI and should be considered in future studies of circadian misalignment, eating behaviours and obesity markers. [ABSTRACT FROM AUTHOR]

• We analyzed 143 near-side crash occupants in the United States from 2010–2015. • Poor performance in US side impact crash tests was linked to poor injury outcomes. • Delta-V, age, sex, BMI, and side impact crash test performance all affect injury. The objective of this paper was to develop an injury risk model relating real world injury outcomes in near-side crashes with U.S. New Car Assessment Program (NCAP) test performance, crash, and occupant properties. The study was motivated by the longer-term goal of predicting injury outcomes in a future fleet in which all vehicles are expected to have passive safety performance equivalent to a 5-star NCAP rating level (the highest star rating and lowest risk of injury). The dataset used to evaluate injury risk was the National Automotive Sampling System / Crashworthiness Data System (NASS/CDS). Case years 2010–2015 were used. An injured occupant was defined as a vehicle occupant who experienced an injury of maximum Abbreviated Injury Scale (AIS) of 2 or greater, or who were fatally injured. Injury severity was scored using AIS-2005 (2008 update). Cases were selected in which front-row occupants of late-model vehicles were exposed to a near-side crash. Logistic regression was used to develop an injury model with delta-v, belt status, age, and gender as predictor variables. The side crash performance of each vehicle was identified and added to the model by matching each case with the associated performance in the NCAP moving deformable barrier side impact crash test. NCAP MDB test performance, delta-v, and occupant age, sex, and BMI were found to be significant predictors of injury risk. The effect of a 5 % higher risk in the MDB test (approximately one star rating worse) was comparable to a 2.84 km/h increase in delta-v. This model informs the development of active safety systems in a future fleet where vehicle passive safety performance is higher, quantified by the NCAP MDB test. [ABSTRACT FROM AUTHOR]

Relatively few studies have examined the physical health of children who experience parental separation. The few studies on this topic have largely focused on the United States and have used cross-sectional designs. Our study investigates the relationship between parental separation and children's body mass index (BMI) and overweight/obesity risk using the UK Millennium Cohort Study. Treating parental separation as a process, we analyze variations in children's physical health before and after the date of their parents' separation in order to capture potential anticipation, adaptation, delayed, or cumulative effects. We estimate fixed-effects models to account for the potential correlation between children's physical health and unobserved factors associated with parental separation, such as socioeconomic background and other time-invariant parental characteristics. We find no evidence of statistically significant anticipation effects in the build-up to parental separation or of statistically significant changes in children's physical health immediately after separation. However, our results show that in the longer term, the BMI of children whose parents separate significantly deviates from the BMI of children from intact families. Furthermore, this association is especially strong for separations that occur when children are under age 6. [ABSTRACT FROM AUTHOR]

Summary: Background: Restrictive feeding is implicated in pediatric obesity, and caregivers increase controlling feeding practices on the basis of higher child weight status. However, few studies have examined how child genetic and parenting characteristics together impact restrictive feeding. Objectives: We examined whether child body mass index (BMI) status predicts caregiver use of restrictive feeding and if this association is moderated by (i) caregiver strategies to manage their children's distress and (ii) child variations in the catechol‐O‐methyltransferase (COMT) gene (Val158Met, rs4680). Methods: Participants included 126 Caucasian children (50% girls) and their caregivers who were participating in a larger study in the USA. Caregivers reported on their feeding practices and responses to child distress when children were 2.5–3.5 years of age. Child anthropometric measurements were also obtained. Restrictive feeding was assessed again 1–1.5 years later. Genomic DNA was obtained from saliva samples, and COMT‐rs4680 was genotyped using TaqMan® methodology. Results: Child BMI percentile predicted subsequent caregiver restrictive feeding for children who were Met/Met and who had caregivers reporting higher use of negative responses to child distress. For Val carriers, BMI percentile predicted restrictive feeding when caregivers were below the mean on these responses. Conclusions: Caregivers are at risk for use of restrictive feeding practices when their children are at higher BMI percentiles, and this association increases when caregivers use more ineffective stress regulation practices and their children are homozygous for the Met allele. Prevention programmes might focus on parenting behaviours that foster emotion regulation and consider variation in child responses to parenting. [ABSTRACT FROM AUTHOR]

A great deal of research has investigated weight as a predictor for bullying victimization. However, weight is rarely examined in light of its potential role in explaining bullying perpetration, despite the fact that the definition of bullying typically requires a power imbalance, which can refer to either social power or physical size. Using negative binomial regressions, we investigated weight as a predictor of overt and relational bullying behaviors for a sample of 3208 6th-8th graders from 11 schools in a northeastern state. We examined whether this relationship differs by gender, and we explored whether objective size or perception of size is more predictive of perpetration. We also examined whether certain protective factors, like a positive school environment, moderated the effect of weight on bullying perpetration. We found that students who reported a higher BMI engaged in more overt, but not relational, bullying perpetration. Interestingly, students with misperceptions about their weight reported higher levels of both types of bullying perpetration, while students reporting a more positive school climate engaged in less overt and relational bullying. We also found gender differences in that girls are statistically more likely to commit overt bullying if they have a higher BMI. Our results suggest that prevention programs should address weight as a predictor of bullying behaviors, especially for girls, but also that body image and misperception of weight are important topics for prevention programs. [ABSTRACT FROM AUTHOR]

Eating disorders are currently the deadliest mental disorder in the United States, affecting an estimated 12%-25% of all college women. Previous research has found a positive correlation between sorority membership and eating disorders, but the causal link has not been firmly established. We contribute to the literature by investigating a possible causal link among sororities and diagnosed eating disorders, measurable weight outcomes, and disordered-eating behaviors using data from the American College Health Association Survey. We handle the potential endogeneity of sorority membership using propensity score matching and instrumental variable methods to determine whether joining a sorority is a cause of the weight-related outcomes we study. We find that sorority members exhibit worse weight-related outcomes than those not in a sorority. However, our propensity score matching and instrumental variable results suggest that, other than BMI, this is merely a correlation, and there is little evidence that sorority membership is a cause of the outcomes we study. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Prior studies of immigrants to the United States show significant weight gain after 10 years of US residence. Pediatric refugees are a vulnerable population whose post-immigration weight trajectory has not been studied. We examined the longitudinal weight trajectory of 1067 pediatric refugees seen in a single university based refugee health program between the dates of September 3, 2012 and September 3, 2014 to determine how quickly significant weight gain occurs post-arrival. The most recent BMI was abstracted from the electronic health record and charts reviewed to obtain serial BMI measurements in 3 year increments after the date of US arrival. The mean arrival BMI percentile for all refugees was 47th percentile. This increased significantly to the 63rd percentile within 3 years of US arrival ( p < 0.01). This rapid increase was largely attributable to African and South and Southeast Asian refugees. The overall prevalence of age and sex adjusted obesity rose from 7.4 % at arrival to 18.3 % within 9 years of US immigration exceeding the pediatric US national obesity prevalence of 16.9 %. Pediatric refugees are at increased risk of rapid weight gain after US immigration. Targeted interventions focused on prevention of weight gain in specific populations are warranted. [ABSTRACT FROM AUTHOR]

Background: Current studies report mixed results in health status and health behaviors after a diagnosis of cancer. The aim of our study is to investigate potential differences in lifestyle factors among cancer survivors and cancer-free individuals in a prospective cohort study conducted in the United States.Methods: Using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Trial, 10,133 cancer survivors were identified and compared to 81,992 participants without cancer to evaluate differences in body mass index (BMI), smoking, NSAID use, and physical activity.Results: Cancer survivors, compared to the cancer-free, were significantly less likely to engage in physical activity (odds ratio (OR) = 0.82, 95% CI = 0.77-0.88). Compared to those who were obese at baseline, cancer survivors were more likely to be at normal BMI at follow-up compared to the cancer-free (OR = 1.90, 95% CI = 1.42-2.54). Cancer survivors were less likely to report regular aspirin use as compared to the cancer-free population (OR = 0.86, 95 % CI = 0.82-0.92). Of the current smokers, cancer survivors were more likely to be former smokers at follow-up compared to the cancer-free (OR = 1.50, 95% CI = 1.30-1.74).Conclusion: Upon stratification by baseline health markers, cancer survivors practice healthier lifestyle habits such as smoking cessation and maintenance of a healthy weight. However, cancer survivors are less likely to be physically active as compared to cancer-free individuals, regardless of baseline practices.Implications For Cancer Survivors: For cancer survivors who reported poor health status and behaviors at baseline, a cancer diagnosis may encourage the practice of healthier lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Objective To assess the potential impact of missing data on body mass index (BMI) on the association between prepregnancy obesity and specific birth defects. Methods Data from the National Birth Defects Prevention Study (NBDPS) were analyzed. We assessed the factors associated with missing BMI data among mothers of infants without birth defects. Four analytic methods were then used to assess the impact of missing BMI data on the association between maternal prepregnancy obesity and three birth defects; spina bifida, gastroschisis, and cleft lip with/without cleft palate. The analytic methods were: (1) complete case analysis; (2) assignment of missing values to either obese or normal BMI; (3) multiple imputation; and (4) probabilistic sensitivity analysis. Logistic regression was used to estimate crude and adjusted odds ratios (aOR) and 95 % confidence intervals (CI). Results Of NBDPS control mothers 4.6 % were missing BMI data, and most of the missing values were attributable to missing height (~90 %). Missing BMI data was associated with birth outside of the US (aOR 8.6; 95 % CI 5.5, 13.4), interview in Spanish (aOR 2.4; 95 % CI 1.8, 3.2), Hispanic ethnicity (aOR 2.0; 95 % CI 1.2, 3.4), and <12 years education (aOR 2.3; 95 % CI 1.7, 3.1). Overall the results of the multiple imputation and probabilistic sensitivity analysis were similar to the complete case analysis. Conclusions Although in some scenarios missing BMI data can bias the magnitude of association, it does not appear likely to have impacted conclusions from a traditional complete case analysis of these data. [ABSTRACT FROM AUTHOR]

Chronic pain and overweight/obesity are prevalent public health concerns and occur at particularly high rates among Veterans. This study examined the prevalence and correlates of two common painful conditions (back pain and arthritis/ joint pain) among overweight/obese Veterans in Veterans Health Administration (VHA) care. Participants (N = 45,477) completed the MOVE!23, a survey intended to tailor treatment for Veterans in VHA's MOVE! weight-management program. Overall, 72% of the sample reported painful conditions, with 10% reporting back pain, 26% reporting arthritis/joint pain, and 35% reporting both. We used multinomial logistic regression with "no pain" as the reference category to examine the association between painful conditions and participant characteristics. After multivariable adjustment, female Veterans had higher odds of reporting arthritis/joint pain and combined back and arthritis/ joint pain than no pain. Participants with higher body mass index had higher odds of reporting arthritis/joint pain and both back and arthritis/joint pain. The likelihood of painful conditions was higher in Veterans with comorbidities (hypertension, hyperlipid-emia, lung disease, depression, anxiety, or posttraumatic stress disorder) and generally increased with the number of comorbidities reported (i.e., 5 or more). Overweight/obese Veterans frequently report painful conditions and, among those with pain, often have multiple comorbidities. These factors may increase the complexity of clinical management and necessitate refinements to weight-management programs. [ABSTRACT FROM AUTHOR]

Studies have reported that newly-arrived immigrants to the US often have better health outcomes, including lower body mass index (BMI) than established ones. This study tests the hypothesis about variation in initial BMI among immigrants who have come to the US during different time periods. Using 1989-2011 data from NHIS, we found that recent immigrants in general were larger at their time of arrival than the earlier ones. However, we also observed variations in initial BMI across racial and ethnic origin groups. For example, we found the trends for Hispanic and Asian immigrants to have increased during the study period. The average initial BMI for recent Hispanic immigrant cohorts surpassed the upper limit for normal weight. While earlier cohorts of Asian immigrants had much lower initial BMI than other immigrant groups, the estimated annual increase among Asians was the most rapid. Our findings support the observation about the rising body weight and obesity rates worldwide. The policy implications of our findings were also discussed. [ABSTRACT FROM AUTHOR]

The article discusses a study on obesity prevalence and interventions targeted at military youth. Topics covered include the effects of obesity on military recruitment, retention and retirement, the relationship between physical activity levels and body mass index of active duty military personnel, and the relevance of implementing prevention and treatment interventions for overweight and obesity.

ObjectiveTo provide a richer understanding of food access and purchasing practices among US urban food desert residents and their association with diet and BMI.DesignData on food purchasing practices, dietary intake, height and weight from the primary food shopper in randomly selected households (n 1372) were collected. Audits of all neighbourhood food stores (n 24) and the most-frequented stores outside the neighbourhood (n 16) were conducted. Aspects of food access and purchasing practices and relationships among them were examined and tests of their associations with dietary quality and BMI were conducted.SettingTwo low-income, predominantly African-American neighbourhoods with limited access to healthy food in Pittsburgh, PA, USA.SubjectsHousehold food shoppers.ResultsOnly one neighbourhood outlet sold fresh produce; nearly all respondents did major food shopping outside the neighbourhood. Although the nearest full-service supermarket was an average of 2·6 km from their home, respondents shopped an average of 6·0 km from home. The average trip was by car, took approximately 2 h for the round trip, and occurred two to four times per month. Respondents spent approximately $US 37 per person per week on food. Those who made longer trips had access to cars, shopped less often and spent less money per person. Those who travelled further when they shopped had higher BMI, but most residents already shopped where healthy foods were available, and physical distance from full-service supermarkets was unrelated to weight or dietary quality.ConclusionsImproved access to healthy foods is the target of current policies meant to improve health. However, distance to the closest supermarket might not be as important as previously thought, and thus policy and interventions that focus merely on improving access may not be effective. [ABSTRACT FROM PUBLISHER]

American Indian (AI) children have a combined overweight and obesity prevalence of 53 %. Behaviors that contribute to obesity, such as sugar sweetened beverage (SSB) intake and time spent in physical activity (PA), have been poorly explored in this population. The purpose of this study is to report body mass index (BMI), SSB intake, and time spent in PA of 7-to-13-year-old AI children who reside in rural and urban areas in Oklahoma. Cross-sectional survey study. Self-reported SSB intake in the last month, and time spent in PA were collected via questionnaires. Height and weight were professionally measured. The sample included 124 7-to-13-year-old AI children who attended a diabetes prevention summer camp in 2013. BMI percentile, overweight and obesity prevalence, SSB intake, time spent in PA, and number of participants meeting the Physical Activity Guidelines for Americans. Descriptive characteristics for BMI percentile, overweight and obesity, SSB intake, time spent in PA, and meeting PA recommendations were calculated using means, standard deviations, and frequencies. Independent t test and Chi square analyses were used to test for gender differences. Participants were 10.2 ± 1.5 years old and 57 % female. Sixty-three percent were overweight or obese. Children consumed 309 ± 309 kcal/day of SSB and spent 4.4 ± 3.8 h per week in moderate-to-vigorous PA. Approximately 32 % met the 2008 Physical Activity Guidelines for Americans. No gender differences were observed. The prevalence of overweight and obesity was higher than previously reported in a similar population, and higher than that of US children in the general population. SSB intake and physical activity levels were also found to be higher in this group than in the general population. [ABSTRACT FROM AUTHOR]

Preterm birth (PTB) is a leading cause of newborn deaths and morbidities. The pregnancy risk assessment monitoring system (PRAMS) from the U.S., and the maternity experiences survey (MES) from Canada, which was modeled from PRAMS, were used to examine between-country differences in risk factors of preterm birth. The adjusted risk ratio and population attributable fraction (PAF) were calculated for modifiable and semi-modifiable risk factors of PTB, and all measures were compared between the U.S. and Canada. PTB was defined here as a live singleton birth between 28 and 37 completed weeks gestation (using the clinical gestational age estimate) where the baby was living with the mother at the time of the survey. The PTB risk was 7.6 % (SE = 0.2) in the U.S. and 4.9 % (SE = 0.3) in Canada. The a priori high risk category of factors was almost always more prevalent in the U.S. than Canada, suggesting broad social differences, but individually most of these differences were not associated with PTB. The underlying risk of PTB was generally higher in the U.S. in both the higher risk and referent categories, and the risk ratios for most risk factors were similar between the countries. The primary exception was for recurrence of PTB, where the risk ratio (RR) and PAF were much higher in Canada. We observed between-country differences in both the prevalence of risk factors and the adjusted RR. Further between-country comparisons may lead to important inferences as to the influence of modifiable risk factors contributing to PTB. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the relationship between obesity and mental health disorders (MHD) such as serious psychological distress (SPD), anxiety and depression in active duty personnel in the U.S. Army, Navy and Marine Corps. It describes how the study was conducted and the use of the 2005 U.S. Department of Defense Health Related Behaviors Survey. It also mentions the need for personnel screening to identify MHD risk elements.

Purpose: Tea ( Camellia sinensis) is a widely consumed beverage, and laboratory and some intervention studies have indicated the potential health benefits of hot tea. The present study examines the association between tea consumption (evaluating hot and iced tea independently) and markers for metabolic syndrome adults in a sample of 6,472 who participated in the 2003-2006 National Health and Nutrition Examination surveys. Methods: Tea consumption was evaluated using food frequency questionnaires and 24-h dietary recalls. Seventy percent of the sample reported any consumption of iced tea and 16 % were daily consumers, whereas approximately 56 % of this sample reported hot tea consumption and 9 % were daily consumers. Results: Hot tea consumption was inversely associated with obesity: tea consumers had lower mean waist circumference and lower BMI (25 vs. 28 kg/m in men; 26 vs. 29 kg/m in women; both P < 0.01) than non-consumers after controlling for age, physical activity, total energy intake, and other confounders. For iced tea consumption, the association was reversed: increased iced tea consumption was associated with higher BMI, greater waist circumference, and greater subcutaneous skinfold thickness after controlling for age, physical activity, energy intake, sugar intake, and other confounders. Hot tea consumption was associated with beneficial biomarkers of cardiovascular disease risk and inflammation (increased high-density lipoprotein-associated cholesterol and decreased C-reactive protein in both sexes, and reduced triglycerides in women), whereas the association with iced tea consumption was again reversed. Conclusions: These cross-sectional results support growing laboratory data, which demonstrate the negative association of hot tea intake with markers of MetS. [ABSTRACT FROM AUTHOR]

The disproportionate number of individuals who are obese or overweight in the low-income U.S. population has raised interest in the influence of neighborhood conditions and public assistance programs on weight and health. Generally, neighborhood effects and program participation effects have been explored in separate studies. We unite these two areas of inquiry, using the 1968-2005 Panel Study of Income Dynamics (PSID) to examine the long-term effects of childhood Supplemental Nutrition Assistance Program (SNAP) participation, neighborhood conditions, and the interaction of these two, on adult body mass index (BMI). Using sibling fixed-effects models to account for selection bias, we find that relative to children in other low-income families, children in SNAP-recipient households have higher average adult BMI values. However, the effects of childhood SNAP usage are sensitive to both residential neighborhood and age at receipt. For those growing up in advantaged neighborhoods, projected adult BMI is higher for children in SNAP-recipient households than for children in low-income, nonrecipient households. In contrast, for those growing up in less-advantaged areas, adult BMI differences between children in SNAP-recipient and those in low-income, nonrecipient households are small. SNAP usage during preschool years (0 to 4) has no impact on adult BMI scores. However, at later childhood ages, the time elapsed receiving SNAP income increases adult BMI values relative to a condition of low-income nonreceipt. [ABSTRACT FROM AUTHOR]

Objective To investigate the role of smoking cessation in body weight. Data Sources 2004-2005 and 2009-2010 Behavioral Risk Factor Surveillance Surveys ( BRFSS) ( N = 349,000), Centers for Disease Control and Prevention; Tax Burden on Tobacco (Orzechowski and Walker 2010). Study Design The Gaussian treatment effect model is estimated for three age categories by gender. Treatment effects of quitting smoking on body mass index ( BMI) by quit length are calculated. Principal Findings Quitting is found to be endogenous. Differentiated effects of quitting smoking on BMI are found among quitters by gender, between age groups, and by length of time since quitting smoking, and positive association between smoking cessation and body weight confirmed. Declining smoking rates have only a modest effect in the overweight population. The effects of quitting on BMI are considerably lower among younger men and women. Conclusion The price that must be paid, in terms of weight gain, to enjoy the health benefits of smoking cessation is trivial even for the obese population. [ABSTRACT FROM AUTHOR]

Fatigue has been linked to adverse safety outcomes, and poor quality or decreased sleep has been associated with obesity (higher body mass index, BMI). Additionally, higher BMI is related to an increased risk for injury; however, it is unclear whether BMI modifies the effect of short sleep or has an independent effect on work-related injury risk. To answer this question, the authors examined the risk of a work-related injury as a function of total daily sleep time and BMI using the US National Health Interview Survey (NHIS). The NHIS is an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian population. Data were pooled for the 7-yr survey period from 2004 to 2010 for 101 891 'employed' adult subjects (51.7%; 41.1 ± yrs of age [mean ± SEM]) with data on both sleep and BMI. Weighted annualized work-related injury rates were estimated across a priori defined categories of BMI: healthy weight (BMI: <25), overweight (BMI: 25-29.99), and obese (BMI: ≥30) and also categories of usual daily sleep duration: <6, 6-6.99, 7-7.99, 8-8.99, and ≥9 h. To account for the complex sampling design, including stratification, clustering, and unequal weighting, weighted multiple logistic regression was used to estimate the risk of a work-related injury. The initial model examined the interaction among daily sleep duration and BMI, controlling for weekly working hours, age, sex, race/ethnicity, education, type of pay, industry, and occupation. No significant interaction was found between usual daily sleep duration and BMI ( p = .72); thus, the interaction term of the final logistic model included these two variables as independent predictors of injury, along with the aforementioned covariates. Statistically significant covariates ( p ≤ .05) included age, sex, weekly work hours, occupation, and if the worker was paid hourly. The lowest categories of usual sleep duration (<6 and 6-6.9 h) showed significantly ( p ≤ .05) elevated injury risks than the referent category (7-8 h sleep), whereas sleeping >7-8 h did not significantly elevate risk. The adjusted injury risk odds ratio (OR) for a worker with a usual daily sleep of <6 h was 1.86 (95% confidence interval [CI]: 1.37-2.52), and for 6-6.9 h it was 1.46 (95% CI: 1.18-1.80). With regards to BMI, the adjusted injury risk OR comparing workers who were obese (BMI: ≥30) to healthy weight workers (BMI: <25) was 1.34 (95% CI: 1.09-1.66), whereas the risk in comparing overweight workers (BMI: 25-29.99) to healthy weight risk was elevated, but not statistically significant (OR = 1.08; 95% CI: .88-1.33). These results from a large representative sample of US workers suggest increase in work-related injury risk for reduced sleep regardless of worker's body mass. However, being an overweight worker also increases work-injury risk regardless of usual daily sleep duration. The independent additive risk of these factors on work-related injury suggests a substantial, but at least partially preventable, risk. (Author correspondence: ) [ABSTRACT FROM AUTHOR]