Application of obesity treatment algorithms to Canadian adults

Mason, Caitlin; Katzmarzyk, Peter T.

doi:10.1038/sj.ejcn.1602140

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…Therefore, an older adult with a BMI in the overweight range and any of the following risk factors would be considered a candidate for weight loss therapy: coronary heart disease or other atherosclerotic disease, gynecological abnormalities, osteoarthritis, gallstones, stress incontinence, smoking, hypertension, dyslipidemia, family history of premature heart disease, and physical inactivity. A large percentage of overweight older adults would have at least one of these risk factors and would, therefore, be considered candidates for weight loss therapy (6).…”

Section: Introductionmentioning

confidence: 99%

Morbidity and Mortality Risk Associated With an Overweight BMI in Older Men and Women

Janssen

2007

Obesity

157

116

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JANSSEN, IAN. Morbidity and mortality risk associated with an overweight BMI in older men and women. Obesity. 2007;15:1827-1840. Background: There is controversy as to whether older adults with a BMI in the overweight range (25 to 29.9 kg/m 2 ) are at increased health risk and whether they should be encouraged to lose weight. The purpose of this study was to determine whether older adults with a BMI in the overweight range are at increased morbidity and mortality risk. Methods: Participants consisted of 4968 older (Ն65 years) men and women from the Cardiovascular Health Study limited access dataset. Based on BMI (kg/m 2 ), participants were grouped into normal-weight (20 to 24.9 kg/m 2 ), overweight (25 to 29.9 kg/m 2 ), and obese (Ն30 kg/m 2 ) categories. Participants were followed for up to 9 years to determine if they developed 10 weight-related health outcomes that are pertinent to older adults. Cox proportional hazards models were used to estimate the hazards ratios of morbidity and mortality after adjusting for age, sex, income, smoking, and physical activity. Results: Compared with the normal-weight group, the risks of myocardial infarction, stroke, sleep apnea, urinary incontinence, cancer, and osteoporosis were not different in the overweight group (p Ͼ 0.05). The risks for arthritis and physical disability were modestly increased in the overweight group (p Ͻ 0.05), whereas the risk for type 2 diabetes was increased by 78% in the overweight group (p Ͻ 0.01). After adjusting for all relevant covariates, allcause mortality risk was 11% lower in the overweight group (p Ͻ 0.05). Conclusions: A BMI in the overweight range was associated with some modest disease risks but a slightly lower overall mortality rate. These findings suggest that a BMI cut-off point of 25 kg/m 2 may be overly restrictive for the elderly.

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Section: Introductionmentioning

confidence: 99%

Morbidity and Mortality Risk Associated With an Overweight BMI in Older Men and Women

Janssen

2007

Obesity

157

116

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“…Guo et al, 2004;Dzieniszewski et al, 2005;Magkos et al, 2005), in studies concerning intervention in overweight (e.g. Maffiuletti et al, 2005;Mason and Katzmarzyk, 2005;McQuigg et al, 2005), in epidemiological studies, including different aspects of nutrition (e.g. Hallal et al, 2005), and in disease risk studies (e.g.…”

Section: Introductionmentioning

confidence: 99%

Validity of overweight and obesity in a nation based on self-report versus measurement device data

et al. 2005

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Objective: To analyze overweight and obesity in a nation by self-report (SR) data and by data about the target person provided via other household members compared to measurement devices (MD). The magnitude of hypothesized under-reporting by the SR data should be estimated with adjustment for age, gender, and education. Design: Two cross-sectional studies, nationally representative health examination surveys (response rates: 61.4 and 73.2%, respectively). Setting: Adult general population of Germany aged 20-79 years. Subjects: Sample 1 included 6806 residents. Samples 2 (n ¼ 98 673) and 3 (n ¼ 34 960) included residents in the second survey. Measurements: In sample 1 MD data were collected, in sample 2 SR data were collected, and in sample 3 body weight and height information was provided from another household member living together with the target person. Results: MD data revealed higher proportions of overweight and obesity compared to SR. Among women with body mass index (BMI) 35.00 or higher, the odds ratio (OR) was 3.9 (95% confidence interval, CI, 3.2-4.7), and among men 2.8 (CI, 2.2-3.6) for MD versus SR. Data from other household members also revealed higher proportions of overweight and obesity than SR (OR for BMI 35.00 or higher 2.1, CI, 1.7-2.5, for data from other household members versus SR in women and OR 1.3, CI, 1.1-1.5, in men).

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“…In a large longitudinal study, Mason and colleagues have shown that the risk of all-cause mortality significantly increased in men meeting these criteria for weight loss treatment compared with normal weight men 19 . Mason and Katzmarzyk 20 also found that 24 % of Canadians would be eligible for weight loss treatment, according to these criteria. In 1995, about 40 % of the present study population would have been identified for weight loss treatment; by 2000 there was a significant increase in this prevalence in men and women.…”

Section: Discussionmentioning

confidence: 99%

“…In the present population, excluding the WC cut-offs of >88 cm in women and >102 cm in men would have excluded only 0·3 % of men and 1·0 % of women from those identified for weight loss treatment by the NIH treatment algorithm. In contrast, an additional 3·2 % and 4·2 % of men and women, respectively, would be considered at elevated risk according to the NIH algorithm using WC cut-offs of >80 cm in women and >94 cm in men; these levels are strongly correlated with a BMI of 25 or more 20 . All of these subjects were normal weight (BMI 18·5–24·9) with elevated WC and two or more CVD risk factors.…”

Section: Discussionmentioning

confidence: 99%

Prevalence in the eligibility for weight loss treatment in a Mediterranean population

et al. 2008

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in two independent population-based cross-sectional surveys. Cardiovascular risk factors, lifestyle measures and anthropometric variables were analysed. The prevalence of subjects meeting the criteria for weight loss treatment according to the National Institutes of Health algorithm significantly increased from 46·4 to 52·9 % in men and from 35·1 to 40·4 % in women from 1995 to 2000. Stratifying this analysis for age groups revealed a significant increase among women aged 25 to 39 years and the older age group (60 to 74 years) of both genders. This increase was mainly observed in men and women with primary school education. The high prevalence of subjects meeting the criteria for weight loss treatment and the increasing secular trend is an important issue for health policy. This trend is more pronounced in older age groups and among the population with a basic educational level. Weight gain: Obesity: Algorithm: WaistOne of the most important health issues in the 21st century is the continuous increase in body weight. Excess body weight is associated with several adverse health outcomes 1 -5 and with an increased mortality risk 6 -9 . Therefore, it is of importance to identify subjects that would benefit from weight loss treatment. Furthermore, monitoring secular changes of the need for weight loss treatment is necessary for the development of adequate strategies for weight control.The Obesity Education Initiative Expert Panel of the National Heart, Lung and Blood Institute, one of the US National Institutes of Health (NIH), proposed a treatment algorithm that was published by NIH with the aim to give health care professionals a guide to assess and treat obesity 10,11 . This treatment algorithm, based on BMI, waist circumferences (WC) and CVD risk factors, should help health practitioners to identify individuals in need of weight loss. The Spanish Society of Endocrinology and Nutrition adopted this algorithm for use in the Spanish population 12 . Indeed, early identification of individuals at high risk of morbidity and mortality related to excessive weight is important for health policy. However, to the best of our knowledge there are no data on the prevalence and secular trends of individuals in need of weight loss based on this treatment algorithm. Hence, the aim of the present study was to identify changes in the proportion of the population from a representative Mediterranean region eligible for weight loss treatment according to the NIH algorithm for men and women aged 25 to 74 years. Subjects and methods Study populationData of two independent and representative population-based surveys conducted in 1995 and 2000 in Girona (Spain) were used for this analysis. Recruitment procedures have been described in detail elsewhere 13 . From 6925 randomly selected and eligible subjects between 25 and 74 years of age, 4908 (2383 men and 2525 women) agreed to participate. Total participation rate reached 71 %. A two-stage sampling method was used in 1995 and 2000: thirty-three and seventeen towns, respectively, were r...

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Application of obesity treatment algorithms to Canadian adults

Cited by 3 publications

References 11 publications

Morbidity and Mortality Risk Associated With an Overweight BMI in Older Men and Women

Morbidity and Mortality Risk Associated With an Overweight BMI in Older Men and Women

Validity of overweight and obesity in a nation based on self-report versus measurement device data

Prevalence in the eligibility for weight loss treatment in a Mediterranean population

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