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Obesity Beats Adiposity For Cardiovascular Risk

March 16th, 2011 by RyanDuBosar in Better Health Network, Research
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Obesity contributes to cardiovascular risk no matter where a person carries the weight, concluded researchers after looking at outcomes for nearly a quarter-million people worldwide.

Body mass index, (BMI) waist circumference, and waist-to-hip ratio do not predict cardiovascular disease risk any better when physicians recorded systolic blood pressure, history of diabetes and cholesterol levels, researchers reported in The Lancet.

The research group used individual records from 58 prospective studies with at least one year of follow up. In each study, participants were not selected on the basis of having previous vascular disease. Each study provided baseline for weight, height, and waist and hip circumference. Cause-specific mortality or vascular morbidity were recorded according to well defined criteria.

Individual records included 221,934 people in 17 countries. In people with BMI of 20 kg/m2 or higher, hazard ratios for cardiovascular disease were 1.23 (95 percent CI, 1.17 to 1.29) with BMI, 1.27 (95 percent CI, 1.20 to 1.33) with waist circumference, and 1.25 (95 percent CI, 1.19 to 1.31) with waist-to-hip ratio, after adjustment for age, sex, and smoking status. After adjusting for baseline systolic blood pressure, history of diabetes, and total and HDL cholesterol, corresponding hazard rations were 1.07 (95 percent CI, 1.03 to 1.11) with BMI, 1.10 (95 percent CI, 1.05 to 1.14) with waist circumference, and 1.12 (95 percent CI, 1.08 to 1.15) with waist-to-hip ratio.

BMI, waist circumference, or waist-to-hip ratio did not importantly improve risk discrimination or predicted 10-year risk, and the findings remained the same when adiposity — the carrying of adipose tissue (fat) — measures were considered. Read more »

*This blog post was originally published at ACP Internist*

Weight-Loss Counseling: Is Race A Factor?

February 27th, 2011 by Glenn Laffel, M.D., Ph.D. in Better Health Network, Research
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Most people know that the U.S. is struggling to contain a surging epidemic of obesity, and that the problem is most acute among African-Americans. Whereas about 27 percent of all adult Americans are obese (defined as having a body mass index of 30 or more), fully 37 percent of African-American adults are obese, and that number jumps to an appalling 42 percent among African-American women.

Over the years, public health officials have provided evidence that socioeconomic and cultural factors drive this racial disparity. Now, a new study suggests there is another reason as well: Obese African-Americans receive less obesity-related counseling than their white counterparts, and it matters not whether the physicians they see are African-American or white.

To reach these conclusions, Sara Bleich and colleagues from the Johns Hopkins School of Public Health used clinical encounter data from the 2005–2007 National Ambulatory Medical Care Surveys (NAMCS). The sample included 2,231 visits involving African-American and white obese people who were at least 20 years old and who visited family practitioners and internists that were either African-American or white. Asian and Hispanic patients and physicians were excluded from the study because their numbers were too small to permit hypothesis testing.

For each encounter in the study, the scientists determined whether the patient received guidance on weight reduction, diet and nutrition, or exercise from his or her physician. Read more »

*This blog post was originally published at Pizaazz*