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Introduction: Tobacco smoking co-occurs with behavioural risk factors including diet, alcohol use and obesity. However, the association between behavioural risk factors and heavy smoking (>20cig/day) compared to light-moderate smoking is unknown. The link between behavioural risk factors and future smoking for both ex and current smokers is also unknown. This study sought to examine these relationships. It is hypothesised that behavioural risk factors will be more strongly associated with heavy smoking., Method: Data from Wave 7 (2007) of the Household and Labour Dynamics in Australia (HILDA) survey was analysed using logistic regression to determine relationships between diet (fruit and vegetable consumption, and unhealthy diet choices), alcohol consumption, obesity and physical activity with light-moderate smoking and heavy smoking. The association between these risk factors and future smoking (2008) was assessed for current and ex-smokers (2007)., Results: Obese respondents were less likely to be light/moderate smokers (RRR: 0.53; 95% CI: 0.43, 0.66) but not heavy smokers. Those who consume confectionary weekly were less likely to be light/moderate smokers (RRR: 0.73; 95% CI: 0.61, 0.87), but not heavy smokers. Smokers in 2007 were more likely to continue smoking in 2008 if they consumed 1-4 drinks per occasion (OR: 2.52; 95% CI: 1.13, 5.62). Ex-smokers in 2007 were less likely to relapse in 2008 if they consumed recommended levels of both fruit and vegetables (OR: 0.31; CI: 0.10, 0.91)., Conclusion: The relationships between heavy smoking and behavioural risk factors differ from moderate-light smoking. Future primary care interventions would benefit from targeting multiple risk factors, particularly for heavy smokers., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Diet is a major determinant of obesity; however, findings from the studies examining how dieting to lose weight affects weight gain have been inconclusive., Purpose: Our aim was to examine the longitudinal association of frequency of dieting for weight loss with (a) obesity status and (b) body mass index (BMI) change., Methods: We used data from Waves 9 (2009) and 10 (2010) of the Household Income and Labour Dynamics in Australia (HILDA) survey. Binominal logistic regression estimated the association of frequency of dieting in 2009 on probability of obesity in 2010. Multinomial logistic regression estimated the association of frequency of dieting in 2009 on the probability of BMI gain versus BMI maintenance and BMI loss between 2009 and 2010. The analysis sample size was 8824., Results: Compared to those who were never on a diet in the previous year, the odds of obesity were 1.9, 2.9, and 3.2 times higher among those who were on a diet once, more than once, and always, respectively. Similarly, the odds of BMI gain versus BMI maintenance and also versus BMI loss were higher among those who dieted than those who did not., Conclusions: Dieting to lose weight can contribute to the risk of future obesity and weight gain. Losing weight requires a commitment to change one's lifestyle and a sustained effort to maintain a healthy diet and engage in physical activity.

Background: Understanding occupational variations in health risks is necessary to identify high risk groups. We examined the recent prevalence of obesity, heavy alcohol consumption, smoking, and leisure time physical activity (PA) across occupations., Methods: Data from the 2010 National Health Interview Survey were used. Analysis was limited to adults, 18 and older who had a job or business the week before the interview (n = 14,754). Adjusted prevalences of outcomes across occupations were calculated using logistic regression., Results: The highest prevalence of obesity was within community and social services and morbid obesity was in computer and mathematical occupations. That of smoking was highest in healthcare support, heavy drinking in food preparation and serving related, and non-adherence to PA recommendations in the farming, fishing, and forestry occupations., Conclusion: Important health risk factors vary across occupations. Worksite and public health interventions need to be designed and modified to address such occupational health disparities., (© 2014 Wiley Periodicals, Inc.)

Objective: The aim of this research was to compare the risk of all-cause mortality and mortality from all cancers combined, lung cancer, respiratory diseases, cardiovascular diseases and diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers., Methods: Data were from 1997 to 2004 National Health Interview Survey (with response rates ranging from 70% to 80%) which were linked to records in the National Death Index. Mortality follow-up was through 31 December 2006. The sample was limited to normal-weight smokers and overweight/obese ex-smokers 25 years of age and older (n=52,819). HR from Cox regression was computed to represent mortality effect., Results: Results showed that in both women and men, normal-weight smokers, relative to overweight or obese ex-smokers, had a higher risk of mortality from all causes combined, all cancers combined, lung cancer, cardiovascular and respiratory diseases. Among women, there was no difference in mortality risk from diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Among men, there was some evidence that the risk of mortality was higher in obese ex-smokers than normal-weight smokers., Conclusions: This article concludes that, overall, mortality risk is smaller in overweight or obese ex-smokers than normal-weight smokers. Smoking cessation interventions can tailor messages that highlight the greater reduction in mortality associated with quitting, compared with potential weight gain., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objective: The aim of this research was to assess the association of prolonged financial stress (FS) with subsequent obesity., Design and Methods: Data were from Waves 8 (2008), 9 (2009), and 10 (2010) of Household Income and Labor Dynamics in Australia (HILDA) survey. The outcome was obesity measured in 2010. Prolonged FS was defined as having experienced FS in both 2008 and 2009. FS was measured in each year using seven questionnaire items. Analyses adjusted for health, physical activity, income, education, baseline obesity, and other covariates., Results: Prolonged FS was a strong predictor of subsequent obesity. The adjusted risk of being obese in 2010 were 20% higher (RR: 1.20; 95% CI: 1.10-1.30) among individuals who experienced FS in both 2008 and 2009 than those who did not experience FS in either year. The association of FS with obesity was independent of income and constant across income categories., Conclusions: Obesity prevention research should pay more attention to FS as an important dimension of economic deprivation, a concept that is distinct from common indicators of socioeconomic status such as income. Future research can examine the effect of financial education and counseling programs that help individuals with such skills as money management, budgeting, and saving on a reduction in FS and obesity., (Copyright © 2013 The Obesity Society.)

Objective: To estimate the costs of health care and lost productivity attributable to overweight and obesity in New Zealand (NZ) in 2006., Methods: A prevalence-based approach to costing was used in which costs were calculated for all cases of disease in the year 2006. Population attributable fractions (PAFs) were calculated based on the relative risks obtained from large cohort studies and the prevalence of overweight and obesity. For each disease, the PAF was multiplied by the total health care cost. The costs of lost productivity associated with premature mortality were estimated using both the Human Capital approach (HCA) and Friction Cost approach (FCA)., Results: Health care costs attributable to overweight and obesity were estimated to be NZ$686m or 4.5% of New Zealand's total health care expenditure in 2006. The costs of lost productivity using the FCA were estimated to be NZ$98m and NZ$225m using the HCA. The combined costs of health care and lost productivity using the FCA were $784m and $911m using the HCA., Conclusion: The cost burden of overweight and obesity in NZ is considerable., Implications: Policies and interventions are urgently needed to reduce the prevalence of obesity thereby decreasing these substantial costs., (© 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.)

We examine the impact of neighborhood socioeconomic conditions and "built environments" on obesity and overweight prevalence among U.S. children and adolescents using the 2007 National Survey of Children's Health. The odds of a child's being obese or overweight were 20-60 percent higher among children in neighborhoods with the most unfavorable social conditions such as unsafe surroundings; poor housing; and no access to sidewalks, parks, and recreation centers than among children not facing such conditions. The effects were much greater for females and younger children; for example, girls ages 10-11 were two to four times more likely than their counterparts from more favorable neighborhoods to be overweight or obese. Our findings can contribute to policy decisions aimed at reducing health inequalities and promoting obesity prevention efforts such as community-based physical activity and healthy diet initiatives.

Purpose: This study examines changes between 2003 and 2007 in obesity and overweight prevalence among U.S. children and adolescents 10 to 17 years of age from detailed racial/ethnic and socioeconomic groups., Methods: The 2003 (N=46,707) and 2007 (N=44,101) National Survey of Children's Health were used to calculate overweight and obesity prevalence (body mass index [BMI] > or = 85th and > or = 95th percentiles, respectively). Logistic regression was used to model odds of obesity., Results: In 2007, 16.4% of U.S. children were obese and 31.6% were overweight. From 2003 to 2007, obesity prevalence increased by 10% for all U.S. children but increased by 23%-33% for children in low-education, low-income, and higher unemployment households. Obesity prevalence increased markedly among Hispanic children and children from single-mother households. In 2007, Hispanic, non-Hispanic Black, [corrected] and American Indian children had 3.0-3.8 times higher odds of obesity and overweight than Asian children; children from low-income and low-education households had 3.4-4.3 times higher odds of obesity than children from higher socioeconomic households. The magnitude of racial/ethnic and socioeconomic disparities in obesity and overweight prevalence increased between 2003 and 2007, with substantial social inequalities persisting even after controlling for behavioral factors., Conclusions: Social inequalities in obesity and overweight prevalence increased because of more rapid increases in prevalence among children in lower socioeconomic groups.

Purpose: This study examines independent and joint associations between several socioeconomic, demographic, and behavioral characteristics and obesity prevalence among 46,707 children aged 10-17 years in the United States., Methods: The 2003 National Survey of Children's Health was used to calculate obesity prevalence. Logistic regression was used to estimate odds of obesity and adjusted prevalence., Results: Ethnic minority status, non-metropolitan residence, lower socioeconomic status (SES) and social capital, higher television viewing, and higher physical inactivity levels were all independently associated with higher obesity prevalence. Adjusted obesity prevalence varied by age, gender, race/ethnicity, and SES. Compared with affluent white children, the odds of obesity were 2.7, 1.9 and 3.2 times higher for the poor Hispanic, white, and black children, respectively. Hispanic, white, and black children watching television 3 hours or more per day had 1.8, 1.9, and 2.5 times higher odds of obesity than white children who watched television less than 1 hour/day, respectively. Poor children with a sedentary lifestyle had 3.7 times higher odds of obesity than their active, affluent counterparts (adjusted prevalence, 19.8% vs. 6.7%)., Conclusions: Race/ethnicity, SES, and behavioral factors are independently related to childhood and adolescent obesity. Joint effects by gender, race/ethnicity, and SES indicate the potential for considerable reduction in the existing disparities in childhood obesity in the United States.

Background: Regular physical activity reduces the risk of a number of diseases, prevents obesity, and has positive psychological effects. Approximately one-third of the Australian population has been reported as totally sedentary. We investigated socioeconomic predictors of being sedentary in a nationally representative sample of Australian adults. Methods: We analyzed data from 8643 females and 7600 males who responded to the 2001 National Health Survey. Multivariate logistic regression was used to examine the association of being sedentary with a range of socioeconomic measures. Results: Adjusting for demographics, body-mass index, and smoking, we found that low socioeconomic status, indicated by low education level, blue-collar occupation, low income and area social disadvantage, increased the probability that people were sedentary. Conclusions: This research highlights that targeting people from lower socioeconomic backgrounds with strategies to increase participation in physical activity may reduce morbidity and mortality associated with being sedentary. [ABSTRACT FROM AUTHOR]

This study examines racial/ethnic, nativity, and sociodemographic variations in the prevalence of maternal hypertension in the United States. The 2014-2015 national birth cohort data (N = 7,966,573) were modeled by logistic regression to derive unadjusted and adjusted differentials in maternal hypertension consisting of both pregnancy-related hypertension and chronic hypertension. Substantial racial/ethnic differences existed, with prevalence of maternal hypertension ranging from 2.2% for Chinese and 2.9% for Vietnamese women to 8.9% for American Indians/Alaska Natives (AIANs) and 9.8% for non-Hispanic blacks. Compared with Chinese women, women in all other ethnic groups had significantly higher risks of maternal hypertension, with Filipinos, non-Hispanic blacks, and AIANs showing 2.0 to 2.9 times higher adjusted odds. Immigrant women in most racial/ethnic groups had lower rates of maternal hypertension than the US-born, with prevalence ranging from 1.9% for Chinese immigrants to 10.3% for US-born blacks. Increasing maternal age, lower education, US-born status, nonmetropolitan residence, prepregnancy obesity, excess weight gain during pregnancy, and gestational diabetes were other important risk factors. AIANs, non-Hispanic whites, blacks, Puerto Ricans, and some Asian/Pacific Islander subgroups were at substantially higher risk of maternal hypertension. Ethnicity, nativity status, older maternal age, and prepregnancy obesity and excess weight gain should be included among the criteria used for screening for gestational hypertension. [ABSTRACT FROM AUTHOR]

Background: A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia.Methods and Findings: Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011-12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence.Conclusions: This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs saved would accrue to the most disadvantaged quintiles in Australia. Whilst those in more disadvantaged areas would pay more SSB tax, the difference between areas is small. The equity of the tax could be further improved if the tax revenue were used to fund initiatives benefiting those with greater disadvantage. [ABSTRACT FROM AUTHOR]

Objective The aim of this research was to compare the risk of all-cause mortality and mortality from all cancers combined, lung cancer, respiratory diseases, cardiovascular diseases and diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Methods Data were from 1997 to 2004 National Health Interview Survey (with response rates ranging from 70% to 80%) which were linked to records in the National Death Index. Mortality follow-up was through 31 December 2006. The sample was limited to normal-weight smokers and overweight/obese ex-smokers 25 years of age and older (n=52 819). HR from Cox regression was computed to represent mortality effect. Results Results showed that in both women and men, normal-weight smokers, relative to overweight or obese ex-smokers, had a higher risk of mortality from all causes combined, all cancers combined, lung cancer, cardiovascular and respiratory diseases. Among women, there was no difference in mortality risk from diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Among men, there was some evidence that the risk of mortality was higher in obese ex-smokers than normal-weight smokers. Conclusions This article concludes that, overall, mortality risk is smaller in overweight or obese ex-smokers than normal-weight smokers. Smoking cessation interventions can tailor messages that highlight the greater reduction in mortality associated with quitting, compared with potential weight gain. [ABSTRACT FROM AUTHOR]

BACKGROUND: School recess provides a daily opportunity for physical activity engagement. The purpose of this study was to examine physical activity levels during recess by gender, ethnicity, and grade, and establish the contribution of recess to daily school physical activity levels. METHODS: Two hundred and ten children (45% boys) from grades 3 to 6 in 4 elementary schools had their physical activity during school quantified using uni-axial accelerometry every 5 seconds for 5 consecutive school days. Data were collected in fall 2009. The proportion of time spent engaged in physical activity during daily school recess was determined using existing age-appropriate cutpoints. The relative contribution of recess to school day physical activity was also determined. RESULTS: Boys were more active than girls during recess. Girls engaged in more sedentary activity than boys. No main effects for ethnicity were observed. Children in grades 3 and 5 were more active than children in grades 4 and 6. Recess contributed 17.9% and 15.5% toward boys' and girls' school day moderate-to-vigorous physical activity, respectively. CONCLUSION: Children engaged in physical activity during recess, though interventions may be needed to increase the intensity of activity in this context. [ABSTRACT FROM AUTHOR]