Weighed down
Maternal Employment and Childhood Obesity - A European Perspective
Wencke Gwozdz et al.
Journal of Health Economics, forthcoming
Abstract:
The substantial increase in female employment rates in Europe over the past two decades has often been linked in political and public rhetoric to negative effects on child development, including obesity. We analyse this association between maternal employment and childhood obesity using rich objective reports of various anthropometric and other measures of fatness from the IDEFICS study of children aged 2-9 in 16 regions of eight European countries. Based on such data as accelerometer measures and information from nutritional diaries, we also investigate the effects of maternal employment on obesity's main drivers: calorie intake and physical activity. Our analysis provides little evidence for an association between maternal employment and childhood obesity, diet or physical activity.
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Alison Hope Alkon et al.
Geoforum, August 2013, Pages 126-135
Abstract:
In the past decade, progressive public health advocates and food justice activists have increasingly argued that food deserts, which they define as neighborhoods lacking available healthy foods, are responsible for the diet-related health problems that disproportionately plague low-income communities of color. This well meaning approach is a marked improvement over the victim-blaming that often accompanies popular portrayals of health disparities in that it attempts to shift the emphasis from individual eaters to structural issues of equitable development and the supply of health-inducing opportunities. However, we argue that even these supply-side approaches fail to take into account the foodways - cultural, social and economic food practices, habits and desires - of those who reside in so-called food deserts. In this paper, we present five independently conducted studies from Oakland and Chicago that investigate how low-income people eat, where and how they shop, and what motivates their food choices. Our data reveals that cost, not lack of knowledge or physical distance, is the primary barrier to healthy food access, and that low-income people employ a wide variety of strategies to obtain the foods they prefer at prices they can afford. This paper speaks to academic debates on food systems, food movements and food cultures. We hope that progressive policy makers, planners and food justice activists will also draw on it to ensure that their interventions match the needs, skills and desires of those they seek to serve.
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Obesity in Men With Childhood ADHD: A 33-Year Controlled, Prospective, Follow-up Study
Samuele Cortese et al.
Pediatrics, forthcoming
Objective: To compare BMI and obesity rates in fully grown men with and without childhood attention-deficit/hyperactivity disorder (ADHD). We predicted higher BMI and obesity rates in: (1) men with, versus men without, childhood ADHD; (2) men with persistent, versus men with remitted, ADHD; and (3) men with persistent or remitted ADHD versus those without childhood ADHD.
Methods: Men with childhood ADHD were from a cohort of 207 white boys (referred at a mean age of 8.3 years), interviewed blindly at mean ages 18 (FU18), 25 (FU25), and 41 years (FU41). At FU18, 178 boys without ADHD were recruited. At FU41, 111 men with childhood ADHD and 111 men without childhood ADHD self-reported their weight and height.
Results: Men with childhood ADHD had significantly higher BMI (30.1 ± 6.3 vs 27.6 ± 3.9; P = .001) and obesity rates (41.4% vs 21.6%; P = .001) than men without childhood ADHD. Group differences remained significant after adjustment for socioeconomic status and lifetime mental disorders. Men with persistent (n = 24) and remitted (n = 87) ADHD did not differ significantly in BMI or obesity rates. Even after adjustment, men with remitted (but not persistent) ADHD had significantly higher BMI (B: 2.86 [95% CI: 1.22 to 4.50]) and obesity rates (odds ratio: 2.99 [95% CI: 1.55 to 5.77]) than those without childhood ADHD.
Conclusions: Children with ADHD are at increased risk of obesity as adults. Findings of elevated BMI and obesity rates in men with remitted ADHD require replication.
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Physicians build less rapport with obese patients
Kimberly Gudzune et al.
Obesity, forthcoming
Objective: Physicians' negative attitudes towards patients with obesity are well documented. Whether or how these beliefs may affect patient-physician communication is unknown. We aimed to describe the relationship between patient BMI and physician communication behaviors (biomedical, psychosocial/lifestyle, and rapport building) during typical outpatient primary care visits.
Design and Methods: Using audio-recorded outpatient encounters from 39 urban PCPs and 208 of their patients, we examined the frequency of communication behaviors using the Roter Interaction Analysis System. The independent variable was measured patient BMI and dependent variables were communication behaviors by the PCP within the biomedical, psychosocial/lifestyle, and rapport building domains. We performed a cross-sectional analysis using multilevel Poisson regression models to evaluate the association between BMI and physician communication.
Results: PCPs demonstrated less emotional rapport with overweight and obese patients (IRR 0.65, 95%CI 0.48-0.88, p=0.01; IRR 0.69, 95%CI 0.58-0.82, p<0.01, respectively) than for normal weight patients. We found no differences in PCPs' biomedical or psychosocial/lifestyle communication by patient BMI.
Conclusions: Our findings raise the concern that low levels of emotional rapport in primary care visits with overweight and obese patients may weaken the patient-physician relationship, diminish patients' adherence to recommendations, and decrease the effectiveness of behavior change counseling.
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Angelina Sutin et al.
Psychological Science, forthcoming
Abstract:
Reciprocal relations between weight and psychological factors suggest that there are deep connections between mind and body. Personality traits are linked to weight gain; weight gain may likewise be associated with personality change. Using data from two diverse longitudinal samples (N = 1,919) collected at two time points an average of 10 years apart, we showed that significant weight gain is associated with increases in both impulsiveness and deliberation: In both samples, middle-aged adults who gained 10% or more of their baseline body weight by follow-up increased in their tendency to give in to temptation, yet were more thoughtful about the consequences of their actions. The present research moves beyond life events to implicate health status in adult personality development. The findings also suggest that interventions focusing on the emotional component of impulse control may be more effective because even people who become more thoughtful about the consequences of their actions may have limited success at inhibiting their behavior.
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The Impact of Physical Education on Obesity among Elementary School Children
John Cawley, David Frisvold & Chad Meyerhoefer
Journal of Health Economics, forthcoming
Abstract:
In response to the dramatic rise in childhood obesity, the Centers for Disease Control (CDC) and other organizations have advocated increasing the amount of time that elementary school children spend in physical education (PE) classes. However, little is known about the effect of PE on child weight. This paper measures that effect by instrumenting for child PE time with the state's mandated minimum number of minutes of PE, using data from the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K) for 1998-2004. Results from IV models indicate that PE lowers BMI z-score and reduces the probability of obesity among 5th graders. This effect is concentrated among boys; we find evidence that this gender difference is partly attributable to PE being a complement with other physical activity for boys, whereas they are substitutes for girls. This represents some of the first evidence of a causal effect of PE on youth obesity, and thus offers at least some support for the assumptions behind the CDC recommendations. We find no evidence that increased PE time crowds out time in academic courses or has spillovers to achievement test scores.
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Sonya Grier & Brennan Davis
Journal of Public Policy & Marketing, May 2013, Pages 116-128
Abstract:
Prior research has demonstrated that the proximity of fast-food restaurants to schools is related to higher youth body weight and also suggests that this relationship may be stronger in urban areas. Research also suggests that some segments of youth may be more vulnerable to this relationship than others. The authors investigate the relationship of fast-food proximity to middle and high schools and adolescent weight outcomes, with a focus on understanding intra-urban differences across groups defined by ethnicity and school income. Their results suggest that body weight associations with proximity to a fast-food restaurant from school are not equal for all youth. Black and Hispanic students at low-income and urban schools have higher associations between school-fast food distance and youth body weight, up to four times greater than general distance associations. The authors discuss their findings in light of the complexity of understanding the relationship between retail marketing proximity and weight-related associations among youth, as well as obesity disparities.
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Obesity, School Obesity Prevalence, and Adolescent Childbearing among U.S. Young Women
Jennifer Kane & Michelle Frisco
Social Science & Medicine, July 2013, Pages 108-115
Abstract:
In the United States, adolescent obesity reduces young women's odds of forming romantic and sexual partnerships but increases the likelihood of risky sexual behavior when partnerships occur. This led us to conduct a study examining the relationship between adolescent obesity and adolescent childbearing. Our study has two aims. We draw from prior research to develop and test competing hypotheses about the association between adolescent obesity and young women's risk of an adolescent birth. Drawing from risk regulation theory, we also examine whether the association between obesity and young women's risk of an adolescent birth may vary across high schools with different proportions of obese adolescents. Multilevel logistic regression models are used to analyze data from 4,242 female students in 102 U.S. high schools who participated in Wave I (1994-5) of the National Longitudinal Study of Adolescent Health. Results are the first to show that obesity reduces female adolescents' odds of childbearing, but that this association is not uniform across schools with different proportions of obese students. As the obesity prevalence in a school increases, so do obese young women's odds of childbearing. We conclude that understanding whether and how obesity is associated with young women's odds of having an adolescent birth requires attention to the weight context of high schools.
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Academic Performance and Childhood Misnourishment: A Quantile Approach
Kristen Capogrossi & Wen You
Journal of Family and Economic Issues, June 2013, Pages 141-156
Abstract:
This study assesses the impact of childhood BMI (underweight and overweight) on academic performance using data from the Early Childhood Longitudinal Study-Kindergarten Class. The modeling framework is innovative in that it focuses primarily on (i) controlling for potential endogeneity of BMI on academic performance (as both may be driven by other household characteristics), and (ii) examining marginal effects for the tails of the performance distribution (i.e., those lower performing students). We use Instrumental Variable Quantile Regression to address these two issues. We found that a child BMI had differential impacts across the performance distribution: it affected lower performing students more and may contribute to the achievement gap.
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Harvesting More Than Vegetables: The Potential Weight Control Benefits of Community Gardening
Cathleen Zick et al.
American Journal of Public Health, June 2013, Pages 1110-1115
Objectives: We examined the association of participation in community gardening with healthy body weight.
Methods: We examined body mass index (BMI) data from 198 community gardening participants in Salt Lake City, Utah, in relationship to BMI data for 3 comparison groups: neighbors, siblings, and spouses. In comparisons, we adjusted for gender, age, and the year of the BMI measurement.
Results: Both women and men community gardeners had significantly lower BMIs than did their neighbors who were not in the community gardening program. The estimated BMI reductions in the multivariate analyses were -1.84 for women and -2.36 for men. We also observed significantly lower BMIs for women community gardeners compared with their sisters (-1.88) and men community gardeners compared with their brothers (-1.33). Community gardeners also had lower odds of being overweight or obese than did their otherwise similar neighbors.
Conclusions: The health benefits of community gardening may go beyond enhancing the gardeners' intake of fruits and vegetables. Community gardens may be a valuable element of land use diversity that merits consideration by public health officials who want to identify neighborhood features that promote health.
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Do They Know What Is at Risk? Health Risk Perception among the Obese
Joachim Winter & Amelie Wuppermann
Health Economics, forthcoming
Abstract:
The perception of health risks and risky health behaviors are closely associated. In this paper, we investigate the accuracy of health risk perceptions among obese individuals, aged 50-62 years. We compare subjective risk perceptions for various diseases elicited in the American Life Panel to individual's objective risks of the same diseases. We find that obese individuals significantly underestimate their 5-year risks of arthritis or rheumatism and hypertension, whereas they systematically overestimate their 5-year risks of a heart attack and a stroke. Obese individuals are thus aware of some but not all obesity-related health risks. For given diseases, we document substantial heterogeneities in the accuracy of expectations across individuals.
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Adolescent Purchasing Behavior at McDonald's and Subway
Lenard Lesser et al.
Journal of Adolescent Health, forthcoming
Purpose: To assess whether adolescents purchasing food at a restaurant marketed as "healthy" (Subway) purchase fewer calories than at a competing chain (McDonald's).
Methods: We studied 97 adolescents who purchased a meal at both restaurants on different days, using each participant as his or her control. We compared the difference in calories purchased by adolescents at McDonald's and Subway in a diverse area of Los Angeles, CA.
Results: Adolescents purchased an average of 1,038 calories (standard error of the mean [SEM]: 41) at McDonald's and 955 calories (SEM 39) at Subway. The difference of 83 calories (95% confidence interval [CI]: -20 to 186) was not statistically significant (p = .11). At McDonald's, participants purchased significantly more calories from drinks (151 vs. 61, p < .01) and from side dishes (i.e., French fries or potato chips; 201 at McDonald's vs. 35 at Subway, p < .01). In contrast, they purchased fewer cups of vegetables at McDonald's (.15 vs. .57 cups, p < .01).
Conclusions: We found that, despite being marketed as "healthy," adolescents purchasing a meal at Subway order just as many calories as at McDonald's. Although Subway meals had more vegetables, meals from both restaurants are likely to contribute to overeating.
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Do Environmental Interventions Impact Elementary School Students' Lunchtime Milk Selection?
Keiko Goto et al.
Applied Economic Perspectives and Policy, June 2013, Pages 360-376
Abstract:
This paper examines whether environmental interventions increase elementary-school students' selection of white milk in the school cafeteria. At intervention school one, white milk was easily accessible, but students had to ask for chocolate milk. Here, intervention students significantly increased their selection of white milk. Further, there was no significant change in the ratio of white milk consumed to white milk selected during the examined period. At intervention school two, the visual cue of a threefold greater quantity of white compared to chocolate milk did not significantly alter selection patterns. These findings demonstrate that school-based practices that apply the theory of behavioral economics may offer useful policies and strategies for improving food selections.
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When Value Trumps Health in a Supersized World
Kelly Haws & Karen Page Winterich
Journal of Marketing, May 2013, Pages 48-64
Abstract:
Marketers often offer consumers the option to "supersize" a food purchase intended for immediate consumption. Supersized products may be attractive to consumers from the standpoint of the unit pricing because ordering a larger size of the same product results in a per-unit savings and offers consumers the opportunity to meet their value-based financial goals. In this article, the authors show that such pricing strategies not only lead to greater purchase and consumption but do so by affecting important consumer goals in unrelated domains - namely, by decreasing the importance placed on health goals. Although supersized pricing can have a powerful effect on purchase behavior, providing health cues can prevent the decreased focus on health. In addition, supersized pricing can be used to increase size choice of healthy foods. The authors discuss the study's contributions to theory, particularly for understanding decisions regarding the pursuit of multiple goals and, more specifically, those that lie at the intersection of health and finance. In addition, the results suggest both marketing and public policy implications, including those for the obesity epidemic and frequent use of supersized pricing strategies for unhealthy foods.
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Density and Proximity of Fast Food Restaurants and Body Mass Index Among African Americans
Lorraine Reitzel et al.
American Journal of Public Health, forthcoming
Objectives: The purpose of this study was to address current gaps in the literature by examining the associations of fast food restaurant (FFR) density around the home and FFR proximity to the home, respectively, with body mass index (BMI) among a large sample of African American adults from Houston, Texas.
Methods: We used generalized linear models with generalized estimating equations to examine associations of FFR density at 0.5-, 1-, 2-, and 5-mile road network buffers around the home with BMI and associations of the closest FFR to the home with BMI. All models were adjusted for a range of individual-level covariates and neighborhood socioeconomic status. We additionally investigated the moderating effects of household income on these relations. Data were collected from December 2008 to July 2009.
Results: FFR density was not associated with BMI in the main analyses. However, FFR density at 0.5, 1, and 2 miles was positively associated with BMI among participants with lower incomes (P ≤ .025). Closer FFR proximity was associated with higher BMI among all participants (P < .001), with stronger associations emerging among those of lower income (P < .013) relative to higher income (P < .014).
Conclusions: Additional research with more diverse African American samples is needed, but results supported the potential for the fast food environment to affect BMI among African Americans, particularly among those of lower economic means.
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C.S. Srinivasan
Economics & Human Biology, forthcoming
Abstract:
The facilitation of healthier dietary choices by consumers is a key element of government strategies to combat the rising incidence of obesity in developed and developing countries. Public health campaigns to promote healthier eating often target compliance with recommended dietary guidelines for consumption of individual nutrients such as fats and added sugars. This paper examines the association between improved compliance with dietary guidelines for individual nutrients and excess calorie intake, the most proximate determinant of obesity risk. We apply quantile regressions and counterfactual decompositions to cross-sectional data from the National Diet and Nutrition Survey (2000-01) to assess how excess calorie consumption patterns in the UK are likely to change with improved compliance with dietary guidelines. We find that the effects of compliance vary significantly across different quantiles of calorie consumption. Our results show that compliance with dietary guidelines for individual nutrients, even if successfully achieved, is likely to be associated with only modest shifts in excess calorie consumption patterns. Consequently, public health campaigns that target compliance with dietary guidelines for specific nutrients in isolation are unlikely to have a significant effect on the obesity risk faced by the population.
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Amy Carroll-Scott et al.
Social Science & Medicine, forthcoming
Abstract:
Obesity prevalence among US children and adolescents has tripled in the past three decades. Consequently, dramatic increases in chronic disease incidence are expected, particularly among populations already experiencing health disparities. Recent evidence identifies characteristics of "obesogenic" neighborhood environments that affect weight and weight-related behaviors. This study aimed to examine associations between built, socioeconomic, and social characteristics of a child's residential environment on body mass index (BMI), diet, and physical activity. We focused on pre-adolescent children living in New Haven, Connecticut to better understand neighborhood environments' contribution to persistent health disparities. Participants were 1048 fifth and sixth grade students who completed school-based health surveys and physical measures in fall 2009. Student data were linked to 2000 US Census, parks, retailer, and crime data. Analyses were conducted using multilevel modeling. Property crimes and living further from a grocery store were associated with higher BMI. Students living within a 5-minute walk of a fast food outlet had higher BMI, and those living in a tract with higher density of fast food outlets reported less frequent healthy eating and more frequent unhealthy eating. Students' reported perceptions of access to parks, playgrounds, and gyms were associated with more frequent healthy eating and exercise. Students living in more affluent neighborhoods reported more frequent healthy eating, less unhealthy eating, and less screen time. Neighborhood social ties were positively associated with frequency of exercise. In conclusion, distinct domains of neighborhood environment characteristics are independently related to children's BMI and health behaviors. Findings link healthy behaviors with built, social, and socioeconomic environment assets (access to parks, social ties, affluence), and unhealthy behaviors with built environment inhibitors (access to fast food outlets), suggesting neighborhood environments are an important level at which to intervene to prevent childhood obesity and its adverse consequences.
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Angelina Sutin et al.
Psychosomatic Medicine, forthcoming
Objective: Personality traits related to high neuroticism and low conscientiousness are consistently associated with obesity. Hormones implicated in appetite and metabolism, such as leptin, may also be related to personality and may contribute to the association between these traits and obesity. The present research examined the association between leptin and Five Factor Model personality traits.
Methods: A total of 5214 participants (58% women; mean [standard deviation] age = 44.42 [15.93] years; range, 18-94 years) from the SardiNIA project completed the Revised NEO Personality Inventory, a comprehensive measure of personality traits, and their blood samples were assayed for leptin.
Results: As expected, lower conscientiousness was associated with higher circulating levels of leptin (r = -0.05, p < .001), even after controlling for body mass index, waist circumference, or inflammatory markers (r = -0.05, p < .001). Neuroticism, in contrast, was unrelated to leptin (r = 0.01, p = .31).
Conclusions: Individuals who are impulsive and lack discipline (low conscientiousness) may develop leptin resistance, which could be one factor that contributes to obesity, whereas the relation between a proneness to anxiety and depression (high neuroticism) and obesity may be mediated through other physiological and/or behavioral pathways.
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Childhood maltreatment and obesity: Systematic review and meta-analysis
A. Danese & M. Tan
Molecular Psychiatry, forthcoming
Abstract:
Obesity is a prevalent global-health problem associated with substantial morbidity, impairment and economic burden. Because most readily available forms of treatment are ineffective in the long term, it is essential to advance knowledge of obesity prevention by identifying potentially modifiable risk factors. Findings from experimental studies in non-human primates suggest that adverse childhood experiences may influence obesity risk. However, observations from human studies showed heterogeneous results. To address these inconsistencies, we performed Medline, PsycInfo and Embase searches till 1 August 2012 for articles examining the association between childhood maltreatment and obesity. We then conducted a meta-analysis of the identified studies and explored the effects of various possible sources of bias. A meta-analysis of 41 studies (190 285 participants) revealed that childhood maltreatment was associated with elevated risk of developing obesity over the life-course (odds ratio=1.36; 95% confidence interval=1.26-1.47). Results were not explained by publication bias or undue influence of individual studies. Overall, results were not significantly affected by the measures or definitions used for maltreatment or obesity, nor by confounding by childhood or adult socioeconomic status, current smoking, alcohol intake or physical activity. However, the association was not statistically significant in studies of children and adolescents, focusing on emotional neglect, or adjusting for current depression. Furthermore, the association was stronger in samples including more women and whites, but was not influenced by study quality. Child maltreatment is a potentially modifiable risk factor for obesity. Future research should clarify the mechanisms through which child maltreatment affects obesity risk and explore methods to remediate this effect.
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TV Viewing and BMI by Race/Ethnicity and Socio-Economic Status
Kerem Shuval, Kelley Pettee Gabriel & Tammy Leonard
PLoS ONE, May 2013
Objective: To assess the association between TV viewing and obesity by race/ethnicity and socio-economic status.
Design: Cross-sectional analysis of 5,087 respondents to the Health Information National Trends Survey (HINTS), a nationally representative sample of US adults. Multivariate regression models were computed to assess the association between quartiles of TV viewing and BMI, stratified by race/ethnicity, educational attainment, employment and health insurance status.
Results: Findings indicate that increased TV viewing was associated with higher odds for being overweight/obese in the entire sample, while adjusting for physical activity and other confounders. After stratification by race/ethnicity, increased odds for overweight/obesity in the 3rd and 4th quartiles of TV viewing (e.g., 3rd quartile- cumulative OR = 1.43, 95%CI 1.07-1.92) was observed in non-Hispanic whites, with statistical significance. In non-Hispanic blacks and Hispanics, the odds were similar to whites, but did not reach statistical significance. Significant relations between greater TV viewing and increased BMI were observed in college graduates and non-graduates, those with health insurance and the employed.
Conclusions: This study extends previous research by examining potential inconsistencies in this association between various racial/ethnic groups and some socio-economic variables, which primarily were not found.
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News Coverage of Sugar-Sweetened Beverage Taxes: Pro- and Antitax Arguments in Public Discourse
Jeff Niederdeppe et al.
American Journal of Public Health, June 2013, Pages e92-e98
Objectives: We examined news coverage of public debates about large taxes on sugar-sweetened beverages (SSBs) to illuminate how the news media frames the debate and to inform future efforts to promote obesity-related public policy.
Methods: We conducted a quantitative content analysis in which we assessed how frequently 30 arguments supporting or opposing SSB taxes appeared in national news media and in news outlets serving jurisdictions where SSB taxes were proposed between January 2009 and June 2011.
Results: News coverage included more discrete protax than antitax arguments on average. Supportive arguments about the health consequences and financial benefits of SSB taxes appeared most often. The most frequent opposing arguments focused on how SSB taxes would hurt the economy and how they constituted inappropriate governmental intrusion.
Conclusions: News outlets that covered the debate on SSB taxes in their jurisdictions framed the issue in largely favorable ways. However, because these proposals have not gained passage, it is critical for SSB tax advocates to reach audiences not yet persuaded about the merits of this obesity prevention policy.
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Effect of Skipping Breakfast on Subsequent Energy Intake
David Levitsky & Carly Paconowski
Physiology & Behavior, forthcoming
Abstract:
The objective was to examine the effect of consuming breakfast on subsequent energy intake. Participants who habitually ate breakfast and those who skipped breakfast were recruited for two studies. Using a randomized crossover design , the first study, examined the effect of having participants consume either (a) no breakfast, (b) a high carbohydrate breakfast (335 kcals) or (c) a high fiber breakfast (360) kcals on three occasions and measured ad libitum intake at lunch. The second study again used a randomized crossover design but with a larger, normal carbohydrate, breakfast consumed ad libitum. Intake averaged 624 kcals and subsequent food intake was measured throughout the day. Participants ate only foods served from the Cornell Human Metabolic Research Unit where all foods were weighed before and after consumption. In the first study, neither eating breakfast nor the kind of breakfast consumed had an effect on the amount consumed at lunch despite a reduction in hunger ratings. In the second study, intake at lunch as well as hunger ratings was significantly increased after skipping breakfast, by 144 Kcal, leaving a net caloric deficit of 408 Kcal by the end of the day. These data are consistent with published literature demonstrating that skipping a meal does not result in accurate energy compensation at subsequent meals and suggests that skipping breakfast may be an effective means to reduce daily energy intake in some adults.
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Obesity as a status cue: Perceived social status and the stereotypes of obese individuals
Lenny Vartanian & Keri Silverstein
Journal of Applied Social Psychology, forthcoming
Abstract:
Two studies examined the relationship between social status and obesity stereotypes. In Study 1, obese individuals were seen as having lower status than non-obese individuals, and status ratings were positively correlated with common obesity stereotypes. In Study 2, targets were depicted as overweight or lean, and as having a high-status or low-status job. High-status heavy targets were rated as less lazy and more competent than were their low-status counterparts, but status did not impact ratings of sloppiness or warmth. The findings indicate that obesity can serve as a status cue. Furthermore, the findings provide preliminary evidence that status is related to the attribution of certain stereotypes to obese individuals, while also highlighting the multifaceted nature of obesity stereotypes.
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Sigridur Eidsdóttir et al.
Scandinavian Journal of Public Health, June 2013, Pages 384-391
Aims: To investigate whether the secular trend in the increasing prevalence of overweight and obesity among 16- to 20-year-old adolescents in Iceland varied by levels of parental education and family structure.
Methods: Odds ratios were calculated from repeated population-based, cross-sectional surveys comprising cohorts of 16- to 20-year-old Icelandic adolescents attending junior colleges in 1992 (n=4,922), 2004 (n=11,031), 2007 (n=11,229), and 2010 (n=11,388). Body mass index (BMI) was calculated from self-reported weight and height and categorised as normal weight or overweight and obese, and examined in relation to parental education level and family structure.
Results: The odds of being overweight increased by 2.62 and 1.71 for boys and girls respectively over each of the survey time points. The prevalence of overweight and obesity increased across all three subgroups (low, medium, and high) of parental education level. The probability of overweight across all years were consistently the highest for youths with parents in the low-education category followed by middle-educated and high-educated parental background (p<0.05). The gap in overweight and obesity trends between respondents' parental education backgrounds increased over time and was generally explained more by the fathers' education than by the mothers' education (p<0.05). Family structure was not associated with the prevalence of overweight and obesity in our data.
Conclusions: Differences in parental levels of education are associated with accelerating trends in prevalence of overweight and obesity among 16- to 20-year-old adolescents in Iceland.
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Marcel Bilger et al.
Medical Care, June 2013, Pages 471-477
Objectives: To test whether overweight or obese employees who achieve clinically significant weight loss of ≥5% have reduced medical expenditures, absenteeism, presenteeism, and/or improved Health-Related Quality Of Life (HRQOL).
Methods: The sample analyzed combines data from full-time overweight or obese employees who took part in one of the WAY to Health weight loss studies: 1 that took place in 17 community colleges (935 employees) and another in 12 universities (933), all in North Carolina. The estimations are performed using nonlinear difference-in-difference models where groups are identified by whether the employee achieved a ≥5% weight loss (treated) or not (control) and the treatment variable indicates preweight and postweight loss intervention. The outcomes analyzed are the average quarterly (90 d) amount of medical claims paid by the health insurer, number of days missed at work during the past month, Stanford Presenteeism Scale SPS-6, and the EQ-5D-3L measure of HRQOL.
Results: We find statistical evidence supporting that ≥5% weight loss prevents deterioration in EQ-5D-3L scores by 0.026 points (P-value=0.03) and reduces both absenteeism by 0.258 d/mo (P-value=0.093) and the likelihood of showing low presenteeism (Stanford SPS-6 score between 7 and 9) by 2.9 percentage points (P-value=0.083). No reduction in medical expenditures was observed.
Conclusions: Clinically significant weight loss among overweight or obese employees prevents short-term deterioration in HRQOL and there is some evidence that employee productivity is increased. We find no evidence of a quick return on investment from reduced medical expenditures, although this may occur over longer periods.