Excess weight and multimorbidity: putting people's health experience in risk factor epidemiology

Ezzati, Majid

doi:10.1016/s2468-2667(17)30093-2

Cited by 11 publications

(16 citation statements)

References 11 publications

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“…The HILDA uses the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) to categorize participants into an index of socioeconomic disadvantage, where higher SEIFA scores indicate a relative lack of disadvantage in general. 11 Information on physical activity was collected across all waves by asking the frequency of participation in regular moderate or intense physical activity for at least 30 minutes in a week. This single item is commonly used in the literature to assess physical activity.…”

Section: Assessment and Definition Of Covariatesmentioning

confidence: 99%

“…Excess weight is an established risk factor for several health problems, including type 2 diabetes, cardiovascular diseases (CVD), some cancers, chronic obstructive pulmonary diseases (COPD), and mortality. [11][12][13][14][15] In a study including more than 10 million participants from 239 prospective studies, all-cause mortality was minimal for persons with BMI between 20 and 25; however, each 5-unit increase in BMI above 25 was associated with a 49%, 38%, and 19% higher risk of CVD, respiratory disease, and cancer mortality, respectively. 13 Another study based on data from 12 European cohort studies found that each 5-unit increase in BMI was associated with an increase in CVD mortality of 34% in men and 29% in women.…”

Section: Introductionmentioning

confidence: 99%

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Weight Gain After Smoking Cessation and Risk of Major Chronic Diseases and Mortality

et al. 2021

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Key Points Question Is weight gain following smoking cessation associated with an increase in the risk of chronic diseases or mortality? Findings In this nationally representative cohort study of 16 663 Australian adults studied between 2006 and 2014, people who quit smoking had significantly lower risk of death than those who continued smoking regardless of change to weight and body mass index after quitting. Neither weight change nor body mass index change following smoking cessation was significantly associated with the risk of cardiovascular disease, type 2 diabetes, cancer, or chronic obstructive pulmonary disease. Meaning These findings suggest that postcessation weight gain poses a trivial risk of harm compared with the benefits of quitting, and smoking cessation interventions should include messages about the safety of postcessation weight gain.

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Section: Assessment and Definition Of Covariatesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Weight Gain After Smoking Cessation and Risk of Major Chronic Diseases and Mortality

et al. 2021

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“…incidence of cancer). This approach provides sound evidence for exposure-disease associations and has greatly advanced our understanding of disease aetiology [7]. The 2013-2020 World Health Organization (WHO) Global Action Plan for the Prevention and Control of NCDs aimed to prevent and control major NCDs and their key risk factors including obesity, tobacco use, physical inactivity, harmful alcohol use, and unhealthy diets [8,9].…”

Section: Introductionmentioning

confidence: 99%

Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study

Freisling

Viallon

Lennon

et al. 2020

BMC Med

178

155

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Background: Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. Methods: In this prospective cohort study, 291,778 participants (64% women) from seven European countries, mostly aged 43 to 58 years and free of cancer, cardiovascular disease (CVD), and type 2 diabetes (T2D) at recruitment, were included. Incident multimorbidity of cancer and cardiometabolic diseases was defined as developing subsequently two diseases including first cancer at any site, CVD, and T2D in an individual. Multi-state modelling based on Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (95% CI) of developing cancer, CVD, or T2D, and subsequent transitions to multimorbidity, in relation to body mass index (BMI), smoking status, alcohol intake, physical activity, adherence to the Mediterranean diet, and their combination as a healthy lifestyle index (HLI) score. Cumulative incidence functions (CIFs) were estimated to compute 10-year absolute risks for transitions from healthy to cancer at any site, CVD (both fatal and non-fatal), or T2D, and to subsequent multimorbidity after each of the three NCDs.(Continued on next page)

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“…Obesity affects 39.6% of the United States (US) adults, is a potent risk factor for the development of multiple chronic conditions, and contributes substantially to the nationwide epidemic of obesityassociated chronic conditions (OCC). [1][2][3][4][5] Current estimates indicate that one in four Americans have multiple chronic conditions, and obesity serves as an underappreciated root cause for this national epidemic. [2][3][4][5] Adult obesity and the most common OCC-type 2 diabetes mellitus, cardiovascular disease, cerebrovascular disease, and joint disorders-are known to increase health care resource utilization and economic burden on the society.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5] Current estimates indicate that one in four Americans have multiple chronic conditions, and obesity serves as an underappreciated root cause for this national epidemic. [2][3][4][5] Adult obesity and the most common OCC-type 2 diabetes mellitus, cardiovascular disease, cerebrovascular disease, and joint disorders-are known to increase health care resource utilization and economic burden on the society. 2,6 The burdens of uncontrolled OCC are rising nationwide, particularly in predominantly African American areas of the South affected by primary care health professional shortages.…”

Section: Introductionmentioning

confidence: 99%

Can primary care access reduce health care utilization for patients with obesity‐associated chronic conditions in medically underserved areas?

Dashputre

Surbhi

Podila

et al. 2020

Evaluation Clinical Practice

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Objectives: The prevalence and burdens of obesity-associated chronic conditions (OCC) are rising nationwide, particularly in health professional shortage areas (HPSA). This study examined the impact of access to primary care on health care utilization for vulnerable populations with OCC in the South. Methods: Adult patients with obesity (BMI ≥ 30 kg/m 2), greater than or equal to one additional OCC, and self-reported primary care access data were retrospectively identified from hospital and emergency department (ED) electronic medical records of a major health care system in the South. Multivariable logistic regression assessed factors associated with self-reported access to primary care. Multivariable zeroinflated negative binomial models assessed effect of HPSA residence on relationships between self-reported access to primary care and health care utilization. Results: A total of 29 674 patients were identified. Hypertension (76.1%), type 2 diabetes mellitus (34.1%), and hyperlipidemia (32.9%) were the most prevalent OCC. Males (odds ratio [OR]: 0.43; 95% confidence interval [CI], 0.40-0.47), unmarried (OR: 0.69; 95% CI, 0.63-0.76), and uninsured (OR: 0.29; 95% CI, 0.27-0.32) had lower odds of access to primary care. For patients living in HPSA (vs non-HPSA), access to primary care was associated with higher incidence of overall ED use (relative risk [RR]: 1.38; 95% CI, 1.19-1.61) and lower incidence of potentially preventable hospital use (RR: 0.59; 95% CI, 0.38-0.92). Conclusion: Paradoxically, access to primary care may increase ED use while reducing potentially preventable hospital utilization for patients with OCC in HPSA. Increasing access to primary care alone, without strengthening its capacity to serve the needs of vulnerable patients, may be insufficient to reduce hospital utilization.

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Excess weight and multimorbidity: putting people's health experience in risk factor epidemiology

Cited by 11 publications

References 11 publications

Weight Gain After Smoking Cessation and Risk of Major Chronic Diseases and Mortality

Weight Gain After Smoking Cessation and Risk of Major Chronic Diseases and Mortality

Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study

Can primary care access reduce health care utilization for patients with obesity‐associated chronic conditions in medically underserved areas?

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