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Background: The present study aimed to investigate the type and timing of ultra‐processed foods (UPF) consumption and its association with dietary intake (DI) and physical activity (PA) in women with obesity living in poverty. Methods: A cross‐sectional study was employed. Obesity was defined by at least two criteria (body mass index, waist circumference or % fat mass). Poverty was defined as the three lowest classes of the Brazilian Economic Classification Criterion. PA was measured with triaxial accelerometers and DI was assessed with three 24‐h dietary recalls. Foods were categorised according to the NOVA classification, with UPF classified into five subgroups, as well as the timing of consumption into six meals. Results: In total, 56 adult women were included. Overall energy intake was 1653.21 (503.22) kcal/day. UPF intake was 21.62% (11.94%) kcal/day, being higher at breakfast (4.91% kcal/day), afternoon snack (5.39% kcal/day) and dinner (5.01% kcal/day). Only UPF subgroup 4 (sandwich biscuits, sweets, or treats) showed a positive association with energy intake (β = 54.40 [27.6, 81.10] kcal/day) and a negative association with protein intake (β = −0.31% [−0.48%, −0.14%] kcal/day). UPF consumption in morning (β = −0.41% [−0.79%, −0.02%] kcal/day) and afternoon (β = −0.18% [−0.33%, −0.04%] kcal/day) snacks was associated with lower protein intake. Furthermore, lunchtime UPF consumption was positively associated with walking time (β = 0.16% [0.02%; 0.30%]) and steps/hour (β = 8.72 [1.50; 15.94] steps/h). Conclusions: Women with obesity living in poverty consume more UPF during breakfast, afternoon snack and dinner. Physical activity is positively associated with UPF consumption at lunch. UPF, such as sandwich biscuits, sweets or treats, contribute to increasing energy intake and reducing protein intake. Key points: The distribution of ultra‐processed foods (UPF) consumption throughout the day was evaluated.UPF were more consumed during main meals compared to snacks.Only sandwich biscuits, sweets and treats were associated with increased energy intake and reduced protein intake.Physical activity measured by triaxial accelerometers was associated with UPF consumption at lunch. [ABSTRACT FROM AUTHOR]

This article examines the relationship between food insecurity and binge eating and weight loss behaviors among low-income adult primary care patients. The study found that food insecure participants were more likely to report binge eating behavior compared to food secure participants. However, both groups had a high prevalence of concurrent binge eating and weight loss behaviors. The study suggests that clinicians should be aware of and address potential disordered eating behaviors among low-income patients at risk of food insecurity. The limitations of the study include its sample size and lack of diagnostic criteria for eating disorders. [Extracted from the article]

The COVID‐19 pandemic and associated policies may have impacted body weight and related lifestyle behaviors. Using 2017–2020 Behavioral Risk Factor Surveillance System data, we estimate the effects of COVID‐19 lockdown on Body Mass Index (BMI) and the probability of obesity among adults in the United States. Our triple‐differences approach, using recent pre‐pandemic years as counterfactuals, identifies statistically significant lockdown‐induced increases in body weight. Event study results highlight a lagged effect of lockdown on body weight, with BMI increases manifesting 2 months post‐lockdown. These effects are particularly pronounced among non‐white adults, low‐income individuals, females, and metropolitan residents. The lockdown's impact on mental health, a potential mechanism driving BMI increases, is concentrated among non‐white, low‐income adults. We observe potential post‐lockdown changes in diet and sedentary behaviors, evidenced by increased Google searches for high‐calorie foods, food delivery apps, and video streaming. Google searches related to healthy habits, such as exercise, yield mixed results. [ABSTRACT FROM AUTHOR]

Nutrition plays a critical and crucial role in addressing neglected tropical diseases (NTDs) and their complications, as they often contribute to malnutrition, which can worsen the impact of these conditions. Therefore, it is necessary to investigate the nutritional status of mycetoma patients, which has not been explored previously. This descriptive cross-sectional hospital-based study was conducted at the Mycetoma Research Center (MRC), University of Khartoum, Sudan. The study included 179 confirmed mycetoma patients and an equal number of age- and sex-matched normal controls. The nutritional status of the mycetoma patients was assessed and compared with that of the control group. The majority of the patients were young adults with varying educational levels, predominantly from Central Sudan. The foot was the most commonly affected part; most patients had lesions more than 10 cm in diameter. The Body Mass Index (BMI) was calculated for both study groups, revealing that 43.5% of the patients and 53.6% of controls had a normal BMI. Furthermore, 36% of patients were underweight, contrasting with only 11% in the control group. Correlation analyses indicated no significant associations between BMI and age groups, educational levels, daily meals, food quantity, and appetite in the study population (p > 0.05). Similarly, no significant differences were observed in BMI concerning disease duration and affected sites (p = 0.0577). The Kruskal-Wallis test did not reveal significant differences in BMI means among the groups. The study revealed that most participants consumed three meals daily, and the control group showed a more robust appetite and consumed more food than the patient group (p = 0.005). Nevertheless, there were no significant differences in the consumption of different food types between the patient and control groups and among different BMI categories (p = 0.025 and 0.040, respectively). Author summary: Mycetoma primarily affects low-income people in limited-resource communities in tropical and subtropical regions. The affected mycetoma are of low socioeconomic and health education status, and their localities' health and medical facilities are frequently inadequate. Hence, they present with massive, complicated disease; thus, the treatment outcome is suboptimal. Mycetoma has many disabilities and psychosocial effects, which may affect the patient nutritional status. Furthermore, most of the mycetoma epidemiological risk factors are indistinct and unclear. With this background, this study was conducted to determine the effect of the disease on the patients' nutritional status and to determine if nutrition has a role in mycetoma susceptibility. The study included 179 patients with confirmed mycetoma and age and sex-matched 179 controls from their communities. The mean patients' height was 160±14.31cm, and for the control was 166.78±10.97 cm. The patients' body weight mean was 56.09±17.67kg; for the control, it was 67.53±16.41kg, and no statistically significant differences existed. The body mass index showed a higher percentage of underweight individuals in the patients group, which was statistically significant. No significant correlations existed between the study population BMI groups and their demographic characteristics. There were many similarities between the studied patients and the control regarding the dietary habits and diet intake. More in-depth studies are needed to determine the causal and effect relationship between mycetoma and the affected population. Nutritional support and education, while encouraging intake of therapeutic/functional locally available food items, should be fundamental in the different mycetoma management activities and measurements. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine modifiable mediators for socioeconomic disparities in childhood obesity in the United States.Methods: This study used the data of 1,211 mother-child dyads from a US national birth cohort from pregnancy to 6 years post partum. Socioeconomic status was indicated by maternal education (college graduate vs. less) and family income (>185% vs. ≤185% of the poverty line). Single- and multiple-factor mediation analyses were conducted for socioeconomic disparities in childhood obesity at 6 years, adjusting for demographics.Results: The confounder-adjusted relative risk of childhood obesity was 1.79 for low maternal education and 1.42 for low family income. Low-maternal-education-related obesity was individually mediated by maternal preconception BMI (percentage of indirect effect, 8.8%), smoking during pregnancy (7.0%), infant weight gain (14.4%), child sleep duration (11.4%), and TV viewing during weekdays at 6 years (4.9%). Low-family-income-related obesity was mediated by maternal preconception BMI (18.5%), smoking during pregnancy (6.3%), child sleep duration (12.8%), and the home learning environment at 6 years (26.2%). In multiple-mediator analysis, significant mediators together mediated 54.0% of maternal-education-related or 39.4% of family-income-related disparities.Conclusions: Maternal preconception BMI, smoking during pregnancy, infant weight gain, child sleep, TV viewing, and the home learning environment substantially mediated socioeconomic disparities in childhood obesity in the United States. [ABSTRACT FROM AUTHOR]

Background: Habits surrounding health behaviors (i.e., sleep, physical activity, diet) are developed in toddlerhood. Lack of consistent health habits may increase obesity risk among toddlers in low-income families.Purpose: To compare the role of sleep onset consistency, physical activity and diet quality as mediators between household poverty and toddler weight.Methods: Two hundred and seven toddlers (mean age = 20.2 months, 46% female, 68.1% Black) participating in an obesity prevention trial were assessed at three time points over 12 months. Using Actical accelerometers, we assessed sleep and physical activity at each time point for up to 1 week. We defined sleep onset consistency as the standard deviation of sleep onset across all days. We calculated the Healthy Eating Index-2015 from a 24-hr dietary recall. We used WHO standards to calculate BMI-for-age z-scores from toddlers' weight/length, and calculated poverty ratio from parent-reported income and family size. Multilevel mediation models tested toddler sleep onset consistency, physical activity, and diet quality as mediators between household poverty and toddler BMI z-score.Results: Toddlers from households with higher poverty ratios had more inconsistent sleep onset times. Toddlers with more inconsistent sleep onset times had higher BMI z-scores across all timepoints, even when accounting for physical activity and diet quality. Sleep onset consistency indirectly explained the association between household poverty and BMI z-score.Conclusions: Inconsistent sleep schedules could help explain the association between poverty and BMI. Future research should examine strategies to support low-income families to develop and maintain routines as a mechanism to prevent obesity and reduce disparities.Trial Registration Number: NCT02615158. [ABSTRACT FROM AUTHOR]

The relationship between body mass index (BMI) and stroke type has remained controversial despite studies demonstrating that BMI is related to stroke risk, especially in specific groups. We assessed the age- and sex-associated impacts of BMI on stroke type in a low-income, poorly educated population in China. The association of BMI with stroke type was estimated using Cox regression analyses in this prospective cohort study, after adjusting for sex, age, education level, hypertension, diabetes, smoking, and alcohol drinking status. During the follow-up period, 638 stroke cases occurred among the 3,906 participants included in this prospective study. For men aged <65 years, being overweight was an independent predictor of all stroke subtypes, compared with normal-weight individuals; the hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.98 (1.52–2.58) for total stroke, 1.69 (1.22–2.33) for ischemic stroke, and 3.62 (2.09–6.25) for hemorrhagic stroke, all P < 0.001. Being underweight was also an independent predictor of hemorrhagic stroke (HR, 5.10; 95%CI, 1.80–14.50, P = 0.002). For women <65-years-old, being overweight was a risk factor for total (HR, 1.38; 95% CI, 1.01–1.89; P = 0.044) and hemorrhagic strokes (HR, 2.06; 95% CI, 1.00–4.28; P = 0.050); obesity was a risk factor for total (HR, 2.47; 95% CI, 1.60–3.82) and ischemic strokes (HR, 2.53; 95% CI, 1.54–4.15), all P < 0.001. These findings suggest that weight management should be a high priority for substantially reducing the heavy burden of strokes in rural China among both men and women <65-years-old; men<65-years-old should maintain their weight within a reasonable range. [ABSTRACT FROM AUTHOR]

The article discusses a study that compares maternal and fetal outcomes between treatment with lifestyle modification or lifestyle modification and pharmacological therapy in Latina women with gestational diabetes mellitus (GDM). Study highlights Reli-On blood glucose meter given to patients for its use by the pharmacist, assessment of Bilirubin levels for every infant at 24 hours and again at discharge, and risk factors associated with the development of GDM.

Background: Dietary patterns that align with recommended guidelines appear to minimize long-term weight gain in the general population. However, prospective associations between diet quality and weight change in disadvantaged adults have not been examined. This study examined associations between concurrent change in diet quality and body mass index (BMI) over 5 years among women living in socioeconomically disadvantaged neighbourhoods.Methods: Dietary intake and BMI were self-reported among 1242 women living in disadvantaged neighbourhoods in Victoria, Australia, at three time points from 2007/08 to 2012/13. Diet quality was evaluated using the Australian Dietary Guideline Index (DGI). Associations between concurrent change in diet quality and BMI were assessed over the three time points using fixed effects and mixed models. Models were adjusted for age, smoking, menopausal status, education, marital status, number of births, urban/rural location and physical activity.Results: Average BMI increased by 0.14 kg/m2 per year increase in age in the fixed effects model, and by 0.13 kg/m2 in the mixed model (P < 0.0001). BMI decreased by 0.014 kg/m2 for a woman of average age with each unit increase in DGI score in the fixed effects model (p < 0.0001), and by 0.012 kg/m2 in the mixed model (P = 0.001). The rate of change in BMI with age was greater for those with a lower DGI score than for those with a higher score (P < 0.10).Conclusions: Positive change in diet quality was associated with reduced BMI gain among disadvantaged women. Supporting disadvantaged women to adhere to population-level dietary recommendations may assist them with long-term weight management. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. Methods: We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal. Patients randomly assigned to CHWs also received 6 months of support tailored to their goals and preferences. Results: Support from CHWs (vs goal-setting alone) led to improvements in several chronic diseases (changes in glycosylated hemoglobin: -0.4 vs 0.0; body mass index: -0.3 vs -0.1; cigarettes per day: -5.5 vs -1.3; systolic blood pressure: -1.8 vs -11.2; overall P = .08), self-rated mental health (12-item Short Form survey; 2.3 vs -0.2; P = .008), and quality of care (Consumer Assessment of Healthcare Providers and Systems; 62.9% vs 38%; P < .001), while reducing hospitalization at 1 year by 28% (P = .11). There were no differences in patient activation or self-rated physical health. Conclusions: A standardized CHW intervention improved chronic disease control, mental health, quality of care, and hospitalizations and could be a useful population health management tool for health care systems. [ABSTRACT FROM AUTHOR]

Background: Globally, overweight and obesity are becoming a mounting concern, impacting negatively on the health of populations especially in low-income settings. However, there is paucity of epidemiological information available in Ghana to support intervention activities. We conducted a study among public servants to estimate overweight/obesity, hypertension and diabetes prevalence and associated risk factors. Methods: A descriptive cross sectional survey involving 271 purposively sampled public servants aged 20 to 59 years was conducted. We used a structured questionnaire to collect data on eating patterns, risk factors for overweight and obesity, as well as data on socio-demographics and physical activity. Anthropometric measurements were carried out and body mass index (BMI) calculated. Information on blood pressure and diabetes was also gathered. We used descriptive statistical and logistic regression analyses to, respectively, estimate overweight/obesity prevalence, and examine associations between behavioral factors and overweight/obesity and hypertension/diabetes. Results: The overall hypertension/diabetes, overweight and obesity prevalence were 20, 29.9 and 4.8% respectively. The study found that marital status (p < 0.001), leisure time with physical activity and level of physical activity during work (p < 0.035) as well as morbidities such as diabetes and hypertension (p < 0.012) were significantly associated with BMI. Findings showed no significant relationship between mealtime, eating habits, education, age and body mass index. Even though prevalence of overweight/obesity was higher among respondents who travelled to work by car compared to respondents who used motor bikes or walked, the association between weight status and means of transport was not statistically significant. Both smoking (p = 0.730) and alcohol consumption (p = 0.109) were not linked to weight status. Conclusion: Population-based interventions are needed to promote nutritious food selection and consumption, physical activity and healthy life styles. We also recommend that age and gender-specific interventions should be designed and implemented by relevant authorities to promote and support healthy living and healthy-lifestyles at home and in workplaces. [ABSTRACT FROM AUTHOR]

Background: Population exposed to chronic undernutrition in early life seems to be more susceptible to obesity in adulthood due to the development of mechanisms that improve the efficiency of energy use. Therefore, these individuals have relatively reduced energy requirements (thrifty phenotype).Objective: To investigate, among women living on severe socioeconomic vulnerability, whether short stature, a marker for undernutrition in early life, is associated with excess body weight but not with a high energy intake.Methods: This cross-sectional study, carried out between July and November 2008, evaluated 1308 women from all (N = 39) Quilombola communities of Alagoas. Adequacy of energy intake was estimated by the ratio between energetic ingestion and the estimated energy requirement (EER).Results: The prevalence of short stature (≤ 154.8 cm) was 43.0% and 52.4% had excess body weight (body mass index ≥ 25 kg/m2), being that 33.1% were overweight and 19.3% obese. Excess body weight was higher among women with short stature (56.6% vs 49.2%; P = .008), even after adjusting for age, energy intake, and per capita income (prevalence ratio = 1.16; 95% confidence interval = 1.04; 1.28). The ratio of energy intake/EER was independent of women's stature.Conclusion: Excess body weight among Quilombola women represents a serious health problem. Short stature was significantly associated with excess body weight but not with a high energy intake. "Thrifty phenotype" may be one of the plausible explanations for this finding. [ABSTRACT FROM AUTHOR]

Efforts to improve health behavior in youth at the in- Association between poverty and obesity is needed to Income was related to higher BMI outcomes as well. [Extracted from the article]

Objective: This study assessed the prevalence and consistency of high values of weight, height, and BMI considered to be biologically implausible (BIV) using cut points proposed by WHO among 8.8 million low-income children (13.7 million observations).Methods: Cross-sectional and longitudinal analyses were performed among 2- to 4-year-olds who were examined from 2008 through 2011.Results: Overall, 2.7% of the body size measurements were classified as BIVs; 95% of these BIVs were very high. Among the subset of children (3.6 million) examined more than once, most of those who initially had a high weight or BMI BIV also had a high BIV at the second examination; odds ratios were >250. Based on several alternative classifications of BIVs, the current cut points likely underestimate the prevalence of obesity by about 1%.Conclusions: Many of the extremely high values of body size currently flagged as BIVs are unlikely to be errors. Increasing the z-score cut points or using a percentage of the maximum values in the National Health and Nutrition Examination Survey, could improve the balance between removing probable errors and retaining those that are likely correct. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between food insecurity and coping strategies (actions taken to manage economic stress) hypothesized to worsen glucose control in patients with diabetes.Design: Using a cross-sectional telephone survey and clinical data, we compared food-insecure and food-secure individuals in their use of coping strategies. Using logistic regression models, we then examined the association between poor glucose control (glycated Hb, HbA1c≥8·0 %), food insecurity and coping strategies.Setting: An urban medical centre, between June and December 2013.Subjects: Four hundred and seven adults likely to be low income (receiving Medicaid or uninsured and/or residing in a zip code with >30 % of the population below the federal poverty level) with type 2 diabetes.Results: Of respondents, 40·5 % were food insecure. A significantly higher percentage of the food-insecure group reported use of most examined coping strategies, including foregone medical care, participation in the Supplemental Nutrition Assistance Program (SNAP)) and use of emergency food programmes. Food insecurity was associated with poor glucose control (OR=2·23; 95 % CI 1·22, 4·10); coping strategies that were more common among the food insecure were not associated with poor glucose control. Among the food insecure, receipt of SNAP was associated with lower risk of poor glucose control (OR=0·27; 95 % CI 0·09, 0·80).Conclusions: While food insecurity was associated with poor glucose control, most examined coping strategies did not explain this relationship. However, receipt of SNAP among food-insecure individuals was associated with better diabetes control, suggesting that such programmes may play a role in improving health. [ABSTRACT FROM AUTHOR]

Despite greater risk for poor nutrition, inactivity, and overweight, some low-income children are able to maintain a healthy weight. We explore if a strong family sense of coherence (FSOC) acts as a protective factor against childhood obesity for low-income preschool children. Families with a strong FSOC view challenges as predictable, understandable, worthy of engaging, and surmountable. Data were collected from 321 low-income mothers and their preschool children in five states between March 2011 and May 2013. FSOC was assessed using the Family Sense of Coherence Scale. A 16-item checklist was used to assess practicing healthy child behaviors (fruit and vegetable consumption and availability, physical activity, and family meals) and limiting unhealthy child behaviors (sweetened beverage and fast food consumption, energy dense snack availability, and screen time). Child body mass index (BMI) z-scores were calculated from measured height and weight. FSOC was significantly associated with practicing healthy child behaviors (β = 0.32, p < .001). We did not find a statistically significant association between FSOC and limiting unhealthy child behaviors or child BMI z-scores in fully adjusted models. Our results suggest the importance of family functioning in predicting health behaviors around food consumption and availability, physical activity, and family meals. [ABSTRACT FROM AUTHOR]

Disadvantaged communities provide adverse psychosocial exposures that have been linked to high levels of stress, and this may provide one explanatory pathway linking socioeconomic disadvantage to obesity. This study used hair cortisol analysis to quantify associations between stress and body mass index (BMI), and between hair cortisol and perceived psychological stress levels, in women and children living in socioeconomically disadvantaged neighborhoods. Participants were a volunteer sample of 70 women from the Resilience for Eating and Activity Despite Inequality study, including 30 maternal–child pairs. Women self-reported body weight, height and perceived psychological stress using the Perceived Stress Scale (PSS), and provided hair samples for themselves and their child. Children’s body weight and height were measured. Following extraction, hair cortisol levels were measured using enzyme-linked immunosorbent assay. Multiple linear regression models examined associations between stress and BMI, and between hair cortisol and perceived stress levels in women and children. Women’s hair cortisol levels were not associated with their BMI or PSS scores. Women’s PSS scores were positively associated with their BMI (p = 0.015). Within maternal–child pairs, mothers and children’s hair cortisol levels were strongly positively associated (p = 0.006). Maternal hair cortisol levels and PSS scores were unrelated to their child’s zBMI. Children’s hair cortisol levels were not associated with their zBMI or with their mother’s PSS score. Findings suggest that cortisol-based and perceived psychological measures of stress may be distinct among women and children living in disadvantaged neighborhoods. Perceived psychological measures may be more important predictors of weight-related risk. [ABSTRACT FROM PUBLISHER]

Summary Physiological stress responses are proposed as a pathway through which stress can “get under the skin” and lead to health problems, specifically obesity. We tested associations of salivary alpha amylase (sAA) diurnal patterns and stress responses with body mass index (BMI) in young, low-income children (51% male; 54% non-Hispanic white). Diurnal saliva samples were collected three times per day across three days for 269 children (M age 50.8 months, SD 6.3). Individual sAA intercept and slope values were calculated using random effect models to represent morning sAA levels and rate of sAA change across the day. A subset of children ( n = 195; M age 56.6 months, SD 6.9) participated in a lab-based behavioral stress protocol. Area under the curve increase (AUCI) across four timepoints was calculated to represent increase in sAA output during stress elicitation. Children were weighed and height measured and BMI z -score was calculated. Linear regression was used to evaluate associations of sAA intercept, sAA slope, and sAA AUCI with BMI z -score, controlling for child age, sex, and race/ethnicity; maternal weight status; and family income-to-needs ratio. Diurnal and stress–response sAA patterns were related to child adiposity: for each 1-standard deviation unit (SDU) decrease in morning sAA level, the child's BMI z -score increased by 0.11 (SE 0.05) SDU's ( p < .04); for each 1-SDU increase in sAA slope across the day, the child's BMI z -score increased by 0.12 (SE 0.05) SDU's ( p < .03); and for each 1-SDU decrease in sAA AUCI during the stress elicitation, the child's BMI z -score increased by 0.14 (SE 0.06) SDU's ( p < .03). Blunted stress responses and atypical diurnal patterns of sAA have been found following exposure to chronic life stressors such as poverty. Findings suggest that associations of stress, sAA, and elevated body mass index may develop very early in the lifespan. [ABSTRACT FROM AUTHOR]

We propose a penalized maximum likelihood estimator of copula densities that is based on the multivariate exponential series density estimator. We employ an approximate likelihood cross validation method to select the smoothing parameter. We demonstrate the usefulness of the proposed method via Monte Carlo simulations. We apply this method to estimate copula densities between children's and parents' body mass indices (BMI). Our results suggest that the dependence relationship is generally asymmetric and stronger for females. We also find a higher intergenerational BMI dependence for low income families. [ABSTRACT FROM AUTHOR]

Highlights: [•] Among low-income preschoolers psychosocial stress predicted hypocortisolism. [•] Hypocortisolism predicted a higher risk of overweight. [•] Reduced satiety responsiveness mediated the association in girls. [•] Emotional overeating mediated the association in boys. [Copyright &y& Elsevier]

Summary: No known studies have tested the hypothesis that a blunted pattern of cortisol reactivity to stress, which is often found following exposure to chronic life stressors, is associated with a higher body mass index (BMI) in very young children. Low-income children (n =218, mean age 56.6 (range: 38.1–78.5; SD 7.0) months, 49.1% male, 56.4% white, 16.1% black, 11.5% Hispanic/Latino) participated in a series of behavioral tasks designed to elicit stress. Cortisol was sampled in saliva 5 times during the protocol, and area under the curve (AUC), representing total cortisol output during stress elicitation, was calculated. Children were weighed and height measured and body mass index (BMI) z-score was calculated. Linear regression was used to evaluate the association between cortisol AUC and BMI z-score, controlling for child age, sex, and race/ethnicity (non-Hispanic white vs. not); primary caregiver weight status (overweight, defined as BMI≥25 vs. not); and family income-to-needs ratio. Mean child BMI z-score was 0.88 (SD=1.03). Mean cortisol AUC was 6.11μg/dL/min (SD=10.44). In the fully adjusted model, for each 1-standard deviation unit decrease in cortisol AUC, the child's BMI z-score increased by 0.17 (SE 0.07) standard deviation units (p <0.02). A blunted cortisol response to stress, as is often seen following chronic stress exposure, is associated with increased BMI z-score in very young children. Further work is needed to understand how associations between stress, cortisol, and elevated body mass index may develop very early in the lifespan. [Copyright &y& Elsevier]

Abstract: Obesity is becoming a serious issue in many developing countries, with negative implications for economic growth and human wellbeing. While previous micro level studies on obesity have mostly used cross-section data, we analyze trends and determinants with panel data from Indonesia. Over the past 20years, obesity has increased remarkably in Indonesia across all population groups, including rural and low income strata. The problem is particularly severe among women. Panel regressions confirm that changing food consumption patterns, coupled with decreasing physical activity, directly contribute to this trend. From a policy perspective, nutrition awareness and education campaigns, combined with programs to support leisure time exercise especially for women, seem to be most promising to contain the obesity pandemic. [Copyright &y& Elsevier]

Abstract: Contrary to conventional wisdom, NHANES data indicate that the poor have never had a statistically significant higher prevalence of overweight status at any time in the last 35 years. Despite this empirical evidence, the view that the poor are less healthy in terms of excess accumulation of fat persists. This paper provides evidence that conventional wisdom is reflecting important differences in the relationship between income and the body mass index. The first finding is based on distribution-sensitive measures of overweight which indicates that the severity of overweight has been higher for the poor than the nonpoor throughout the last 35 years. The second finding is from a newly introduced estimator, unconditional quantile regression (UQR), which provides a measure of the income-gradient in BMI at different points on the unconditional BMI distribution. The UQR estimator indicates that the strongest relationship between income and BMI is observed at the tails of the distribution. There is a statistically significant negative income gradient in BMI at the obesity threshold and some evidence of a positive gradient at the underweight threshold. Both of these UQR estimates imply that for those at the tails of the BMI distribution, increases in income are correlated with healthier BMI values. [Copyright &y& Elsevier]

In this paper, we study the impact of child care subsidy receipt on low-income children's weight outcomes in the fall and spring of kindergarten using data from the Early Childhood Longitudinal Study, Kindergarten Cohort. Our results suggest that subsidy receipt is associated with increases in BMI and a greater likelihood of being overweight and obese. Using quantile regression methods, we find substantial variation in subsidy effects across the BMI distribution. Specifically, child care subsidies have no effect on BMI at the lower end of the distribution, inconsistent effects in the middle of the distribution, and large effects at the top of the distribution. Our results point to the use of non-parental child care, particularly center-based services, as the key mechanism through which subsidies influence children's weight outcomes. [ABSTRACT FROM AUTHOR]

Abstract: This study explores the heterogenous relationship between Food Stamp Program (FSP) participation and body mass index (BMI) for low income individuals whose per capita family income falls in the bottom two quintiles. We estimate changes in the dispersion of the entire distribution of BMI following FSP participation using a quantile regression model in both cross-sectional and longitudinal analyses. For women, we find that the mean OLS estimate of FSP participation underestimates the extent of the positive association with BMI at the top quantiles in both cross-sectional and longitudinal individual fixed effects models. Controlling for individual fixed effects in the quantile regression model reduces the estimated magnitude of the association by a factor of three to four, although the estimates remain statistically significant for women. For men, a marginally statistically significant positive association of FSP participation with BMI is found at the top quantiles compared to no statistically significant mean estimate although the association is no longer statistically significant when time-constant individual heterogeneity is adjusted for in the individual fixed effect models. [Copyright &y& Elsevier]

This paper examines the interactive effect between the price of unhealthy foods and Food Stamp Program participation on body weight status among low-income women in the United States. We merged the panel data of the National Longitudinal Survey of Youth 1979 cohort in 1985-2002 and the Cost of Living Index data compiled by the American Chamber of Commerce Researchers Association by using geographic identifiers. Using the merged data, we used panel econometric models to examine the impact of unhealthy food prices on the food stamp-eligible U.S. population. Our results indicate that higher prices for unhealthy food can partially offset the positive association between Food Stamp Program participation and bodyweight among low-income women. [ABSTRACT FROM AUTHOR]

Background: The beneficial effect of physical activity for the prevention of a range of chronic diseases is widely acknowledged. These chronic conditions are most pronounced in economically disadvantaged groups where physical activity levels are consistently lower, yet this group is particularly difficult to recruit and retain in physical activity programmes. This study examined the perceptions of participants, non-participants, and exercise leaders in a low-income area regarding barriers, motives, and enabling factors for organised physical activity with a view to improving recruitment and retention. Methods: A mixed methods research approach was adopted to guide data collection and analysis. A survey, incorporating the Motivation for Physical Activity Measure - Revised (MPAM-R), was used to assess the motivations of 152 physical activity session participants in a highly deprived suburban neighbourhood. The MPAM-R data were analysed using t tests, analyses of variance to estimate age, body mass index, and activity mode differences and Pearson's correlation coefficient to address associations. Semi-structured interviews were also conducted with 33 local residents who did not participate in activity sessions and with 14 activity session leaders. All interviews were audio-taped, transcribed verbatim and analyzed using an inductive thematic approach. Results: Participants reported cost, childcare, lack of time and low awareness as barriers to joining activity classes. The need for support, confidence and competence in order to take up activity was widely expressed, particularly among women. Once people are active, high levels of social interaction, interest and enjoyment are associated with improved levels of retention, with different types of physical activity scoring differently on these factors. Conclusions: This study suggests that some factors such as cost, the fear of 'walking in alone', accessibility of facilities, and appropriate communication strategies may be of particular importance to increasing recruitment of low income groups. Interventions targeting this group should consider low cost sessions and childcare; activities popular with the target group and associated with good recruitment and retention; sessions held at accessible times; a focus on fun and socialising; well-researched and designed communications strategies; targeting of friendship groups; clearly branded beginners' sessions, and the potential of social marketing as strategies. The evidence presented here suggests that the current UK government approach designed to 'enable and guide people's choices' may not be sufficient if low-income groups are to be effectively supported in changing their health behaviours. [ABSTRACT FROM AUTHOR]

Abstract: Background: Low-income populations have higher rates of type 2 diabetes and it is the hope of the investigators to increase support for the dissemination of evidence-based prevention programs aimed at children from poor families. Objective: To determine the prevalence of high blood glucose, obesity, low fitness, and energy insufficiency levels among children from poor families. Design: The cross-sectional study conducted in fall 2001 used fasting capillary glucose, body mass index, body fat, step test, and three 24-hour dietary recalls to assess diabetes risk factor levels. Subjects: Participants were 1,402 fourth-grade students aged 8 to 10 years. The racial/ethnic backgrounds were 80% Mexican American, 10% African American, 5% Asian American, and 5% non-Hispanic white. Statistical analysis performed: All data were analyzed for descriptive statistics and frequencies of distribution. Means were computed by sex for all diabetes risk factors and t test conducted to determine differences between sexes. Results: Nearly 75% of participants lived in households with <$20,400 annual income. Although 44% of students were energy insufficient, 33% were obese, and 7% had high blood glucose levels. Most of these students had marginal to unacceptable fitness levels and consumed high energy-dense and low nutrient-dense foods. Conclusions: Children living in poverty have high levels of diabetes risk factors and need early detection and intervention programs. Prudent advice might be to increase physical activity and intake of nutrient-dense foods rather than to restrict energy intake. [Copyright &y& Elsevier]

The article presents a study on the effects of poor living conditions in the growth and malnutrition of children in the rural areas of Zimbabwe. The study investigated the case of 982 children aged 6-17 years. Data acquired from mean values of their height, weight, skinfolds, cormic index, body mass index (BMI), and fat percentage were analyzed. Results showed that boys and girls, ages 11-15 and 8-15 respectively, were stunting and underweight. Also, a severe malnutrition case appeared in the data.

Asthma is a serious health problem that is more prevalent among low-income persons. The risk of asthma and the severity of its symptoms may be increased by the low dietary intake of magnesium and other nutrients that protect against asthma, coupled with the high energy intakes that result in overweight and obesity. This study compared people with asthma to healthy controls, and showed that total body magnesium stores decreased with increasing weight, as measured by body mass index (BMI). Replacing low-magnesium foods with high-magnesium foods may be a practical, low-cost way to help reduce the risk of obesity and low magnesium status in people with asthma, especially in at-risk, low-income groups. [ABSTRACT FROM AUTHOR]

Abstract: The study reported here explored the associations of body mass index (BMI), socio-economic status (SES), and beverage consumption in a very low-income population. A house-to-house survey was conducted in 2003 of 12,873 Mexican adults. The sample was designed to be representative of the poorest communities in seven of Mexico''s 31 states. Greater educational attainment was significantly associated with higher BMI and a greater prevalence of overweight (25⩽BMI<30) and obesity (30⩽BMI) in men and women. The combined prevalence of overweight and obesity was over 70% in women greater than the median age of 35.4 years with at least some primary education compared with a prevalence of 45% in women below the median age with no education. In both sexes, BMI was positively correlated with education, occupation, quality of housing conditions, household assets, and subjective social status. BMI and household income were significantly correlated in women but not in men. In the models including all SES variables, education, occupation, housing conditions and household assets all contributed independently and significantly to BMI, and household income and subjective social status did not. Increased consumption of alcoholic and carbonated sugar beverages was associated with higher SES and higher BMI. Thus, in spite of the narrow range of socio-economic variability in this population, the increased consumption of high calorie beverages may explain the positive relationship between SES and BMI. The positive associations between SES and BMI in this low-income, rural population are likely to be related to the changing patterns of food availability, food composition, consumption patterns and cultural factors. Contextually sensitive population-level interventions are critically needed to address obesity and overweight in poor populations, particularly in older women. [Copyright &y& Elsevier]

Objectives This article, based on longitudinal data, follows a sample of people who were aged 20 to 56 in 1994/95 to determine the percentage who made the transition from normal to overweight, or from overweight to obese by 2002/03. Characteristics that increased the chances of overweight people becoming obese are examined. Data sources The data are from five cycles of the National Population Health Survey, 1994/95 through 2002/03. Analytical techniques Cox proportional hazards modelling was used to identify variables associated with an increased or decreased risk of becoming obese; 1,937 men and 1,184 women who were overweight in 1994/95 were selected. Main results Close to a third (32%) of people who were aged 20 to 56 and of normal weight in 1994/95 had become overweight by 2002/03. During the same period, almost a quarter of those who had been overweight in 1994/95 had become obese. Among people who were overweight, the risk of obesity was relatively high for younger men and members of low-income households. Overweight men who smoked or who had activity restrictions had a high risk of obesity. Physical activity helped women avoid obesity. [ABSTRACT FROM AUTHOR]

The article focuses on the prevention of adiposity. It states that it is a major global health issue with levels differing according to nations. It further states that the U.S. has the highest Body Mass Index and its prevalence is expected to increase globally. It also says that obesity prevention can lower the risk of cardio-vascular diseases but lifestyle habits, genetic and environmental factors limit its prevention. It also states that the low income populations are in a greater need of treatment due to their limited access to health services. It also says that the U.S. Preventive Services Task Force recommends high-intensity prevention programs including physical activity and behavioral counseling.