Special Issue "Obesity and Public Health"

Guest Editor
Prof. Dr. Peter Clifton
Obesity and Health, Preventative Health Flagship, Affiliate Professor Department of Medicine and Department of Biomedical Science, Adelaide University, SA, Australia
E-Mail:
Interests: Impact of diet and obesity on CVD and type 2 diabetes

Guest Editor
Dr. Rachel Huxley
The George Institute, Level 10, King George V Building, Missenden Road, Camperdown, Sydney, PO Box M201, Missenden Road, Camperdown, Sydney, NSW 2050, Australia
Website: http://www.thegeorgeinstitute.org/
E-Mail:
Interests: Impact of major and modifiable lifestyle risk factors (e.g. obesity, smoking, diabetes etc) on CVD and cancer outcomes

Dear Colleagues,

It is clear that obesity is associated with increased health risks but exactly what proportion of deaths can be directly attributed to obesity is a contentious issue. Whether being overweight adversely affects health outcomes is also the subject of much debate. Another area of considerable debate is whether the obesity epidemic has flattened off in the Western world in countries including the USA, the UK and Australia whilst increasing in developing countries. These caveats aside obesity is a major public health issue but the appropriate responses are not clear and evidence is needed as to the benefits or otherwise of current and proposed public health strategies such as social marketing, banning of advertisements, taxes on high fat foods or subsidies on or provision of free fruit and vegetables and government support of exercise and gym programs.

Prof. Dr. Peter Clifton
Guest Editor

Dr. Rachel Huxley
Guest Editor

Submission

• obesity
• epidemic
• health costs
• mortality
• social marketing
• government regulation

Type of Paper: Article
Title: to be added
Author: S.I. de Vries
Affiliation: TNO Kwaliteit van Leven, Gezondheidsbevordering, Postbus 2215, 2301 CE Leiden, The Netherlands; E-Mail: sanne.devries@tno.nl
Abstract: Objective: To identify built environmental determinants of children's walking and cycling behavior.
Method: In 2004-2005, 448 6- to 11-year-old children from ten Dutch neighborhoods completed a 7-day physical activity diary in which the number of walking and cycling trips for transportation, to school, and for recreation were assessed. Characteristics of the ten neighborhoods were scored with a checklist by two observers. The associations between these characteristics and children's walking and cycling behavior were examined with multivariate linear regression analyses adjusted for the child's age, sex and ethnicity, and for parental education level.
Results: Whereas walking for transportation was strongest associated with the frequency of cycle-tracks, traffic lights, and roundabouts in the neighborhood (R² = 29.9%), determinants of cycling for transportation were the number of recreation facilities, traffic safety, and the frequency of sidewalks, pedestrian crossings, traffic lights, parallel parking spaces, and parking lots in the neighborhood (R² = 33.2%). Comparable results were found for walking and cycling to school. For walking for recreation on the other hand, no significant associations were found with characteristics of the neighborhoods.
Conclusion: Built environmental determinants of children's walking and cycling behavior differ by purpose and by commuting mode implying a behavior-specific approach for interventions and for future, preferably prospective, studies.
Keywords: walking; bicycling; physical activity; environment; child

Type of Paper: Article
Title: The Potential of Parks in Promoting Physical Activity and Addressing Obesity
Author: Judy Kruger; E-Mail: ezk0@cdc.gov
Abstract: There is a lack of information about activity patterns among people who have access to nearby places to recreate. The purpose of this paper is to examine the relationship between mode of travel to a park and physical activity levels by body mass index status (BMI) among local park users. We analyzed data from the Neighborhood Parks and Active Living (NPAL) study of community-dwelling adults aged >18 years in the U.S. Park users (N=247) were interviewed about their mode of travel to the park (walked or drove), and physical activity level (PA). Logistic regression was used to examine the odds of walking versus driving to the park and engaging in >150 minutes/week PA by BMI. Approximately 1/3 of park users (35.6%) who lived within ½ mile of the park reported walking to a park. Walking was more frequent among normal weight persons (48.9%) than overweight (30.7%) or obese persons (24.6%). The prevalence of engaging in >150 minutes/week of PA decreased with increasing BMI (37.4% normal weight; 34.4% overweight; 28.0% obese). The adjusted odds of walking to the park and engaging in >150 minutes/week of PA (OR=0.43 95%CI=0.20-0.91) was significantly different to those who walked to the park and engaged in <150 minutes/week of PA. Given the rising rates of obesity in the population, parks may be a promising community setting to engage in PA by walking in the park or to the park.

Type of Paper: Review
Title: Obesity Among Turkish Migrants in Austria
Author: Sylvia Kirchengast
Affiliation: University of Vienna, Institute for Anthropology, Althanstr. 14,1090 Vienna, Austria; E-Mail: sylvia.kirchengast@univie.ac.at
Abstract: Migration within Europe is an on-going social phenomenon of large scale. Especially people from South-eastern Europe and the near and Middle East migrate to highly industrialized countries of the European Union. This is also true of Austria, where the majority of migrants originated from the countries of Former Yugoslavia and Turkey. Austrians with a background of migration and immigrants have still a lower social and socioeconomic status than Austrians. Migration has also a profound impact on health and the prevalence of obesity. Among the Turkish subpopulation in Austria the prevalence of obesity is extraordinary high. This is true of children, adolescents and adults. Low social status of the migrants, adverse eating habits, and a lack of physical exercise promote obesity and obesity related health problems among Turkish migrants. This review describes the situation of Turkish migrants in Austria.

Type of Paper: Review
Title: The Geography of Fast Food Outlets; A Review to Date
Authors: Fraser L.K.¹, Edwards K.L.², Cade J.³ and Clarke G.P.¹
Affiliations: ¹ Department of Geography, University of Leeds, LS2, UK; E- Mail: l.k.fraser@leeds.ac.uk
² Cancer Epidemiology Group, University of Leeds, LS2, UK
³ Nutritional Epidemiology Group, University of Leeds, LS2, UK
Abstract: The availability of inexpensive unhealthy foods such as Fast Food is implicated in the causal pathway for the obesity epidemic. This review aims to summarise this body of research and highlight areas for future work.
30 studies met the inclusion criteria and were included in the review. These studies were heterogenous in their methodology and analyses. The majority of the studies showed a positive association between availability of FF outlets and increasing deprivation. There are conflicting results in the few studies that included overweight or obesity data.
There is a need for further research which incorporates good quality FF consumption data, physical activity data and more sophisticated analyses.
Keywords: fastfood; obesity; take away

Type of Paper: Article
Title: Obesity in 30-70 year old native Tibetans living at different altitudes under the North- and South face of Everest
Authors: Lhamo Yangchen Sherpa ^1,2, Deji ³, Hein Stigum ^1,4, Virasakdi Chongsuvivatwong ⁵, Dag S. Thelle ⁶, Espen Bjertness ^1,3
Affiliation: ¹Section for Preventive Medicine and Epidemiology, University of Oslo, Oslo, Norway
² Nepal Institute of Health Sciences, Kathmandu, Nepal
³Tibet University Medical College, Lhasa, Tibet, China; ⁴National Institute of Public Health, Oslo, Norway
⁵Epidemiology Unit, Prince of Songkla University, Hat Yai, Thailand
⁶ Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
Abstract: The distribution and effect of traditional risk factors for chronic diseases may be modified in Tibetans as compared with other populations, due to a unique physical environment, including tough climate and exposure to hypobaric hypoxia.
The objectives of our proposed paper are to:
- estimate the prevalence of obesity among Tibetans living at varying altitudes of 1200, 2900 and 3700 meters above sea-level in Tibet and Nepal;
- investigate the effect of altitude on body mass index (BMI) and waist circumference including intermediate pathways like calories, physical activity, smoking and temperature.
We have conducted three cross-sectional studies with simple random sampling, including a total of 617 men and women 30-70 years of age.
We will present descriptive information on socio-demographic and intermediate variables, age-adjusted prevalence of BMI (≥30) and waist circumference (≥102 male & ≥88 female) using WHO criteria. Using regression analyses, we will investigate the effect of altitude on BMI and waist circumference and estimate the effect of intermediate variables as well.

Type of Paper: Review
Title: Obesity and Health Promotion initiatives in the UK: How ‘healthy’ Are They?
Author: Sharon Wray; E-Mail: s.wray@hud.ac.uk
Abstract: This paper explores current obesity and health promotion initiatives and their effect on women’s perceptions of their bodies and experiences of health care services in the UK. Many attempts have been made to examine the medical effects of obesity and construct ways of measuring it. This paper argues that these attempts have tended to be overly dominated by physiological and psychological concerns, and this has led to a neglect of the social and cultural meanings associated with food, exercise and body size. This is evident in recent in public health policy initiatives in the UK where changes to individual lifestyle are promoted as a means of managing obesity. Our paper has two main aims; first to examine current perspectives and policy initiatives on obesity and health promotion in the UK. Second, to consider the extent to which health promotion advice on obesity influences the health and well being of women receiving care within the British National Health Service.
Keywords: obesity, fatness, health promotion, health care services

Type of Paper: Review
Title: Obesity Prevalence in Nepal: Public Health Challenges in a Low-Income Setting of an Alarming Worldwide Trend
Authors: Abhinav Vaidya ^1,2,‡ Suraj Shakya ^1,3,‡ and Alexandra Krettek ¹
Affiliations: ¹ Nordic School of Public Health Box 12133, 402 42 Gothenburg, Sweden; E-Mail: alexandra.krettek@nhv.se
² Dept. of Community Medicine, Kathmandu Medical College, Duwakot, Bhaktapur, Nepal
³ Dept. of Ophthalmology, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal
^‡These Authors contributed equally to the study.
Abstract: The largest future toll of the obesity epidemic is expected in low- and middle-income countries. Ongoing urbanization leads to risk factors such as sedentary lifestyle and a diet with elevated fat and sugar content. Low-income countries like Nepal are experiencing a double disease burden. While infectious diseases are still present, non-communicable diseases with obesity as risk factor, e.g., cardiovascular diseases and diabetes mellitus are rising. Ongoing efforts are directed towards the curative aspect whereas cause reduction through preventive actions is given little attention. This Review highlights the obesity prevalence in Nepal, delineates challenges, and suggests strategies to overcome this trend in a low-income setting.
Keywords: obesity; Nepal; epidemic; diabetes; cardiovascular diseases

Type of Paper: Article
Title: Sitting Time and Body Mass Index, in a Portuguese Sample of Men: Results from the Azorean Physical Activity and Health Study (APAHS)
Authors: Rute Santos, Luísa Soares-Miranda, Susana Vale, Carla Moreira, Ana I. Marques and Jorge Mota
Affiliation: Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; E-Mails: rutemarinasantos@hotmail.com (R.S.); luisasoaresmiranda@hotmail.com (L.S-M.); susanavale@hotmail.com (S.V.); carla_m_moreira@sapo.pt (C.M.); anavalente@netvisao.pt (A.I.M); jmota@fade.up.pt (J.M.)
Abstract: The aim of this study was to verify the relation between body mass index (BMI) and sitting time in a sample of 4091 Azorean men. BMI was calculated from self-reported weight and height. Total physical activity (PA) and sitting time were assessed with the IPAQ (short version). Linear Regression analysis showed that sitting time (hours/day) has positively associated with BMI (B=0.078; p<0.001) after adjustments for age, meal frequency, alcohol and tobacco consumptions, island of residence, education level and total PA. Although the cross sectional design, our findings emphasize the importance of reducing sedentary behavior to decrease the risk of obesity.
Keywords: sitting; Body Mass Index; obesity; sedentary behaviour

Type of Paper: Article
Title: Molecular polymorphisms in Tunisian pomegranate (Punica granatum L.) as revealed by RAPD fingerprints
Authors: Néjib Hasnaoui ^1,2, Messaoud Mars ², Jemni Chibani ³ and Mokhtar Trifi ¹
Affiliations: ¹ U.R. Agro-biodiversity, Higher Agronomic Institute, 4042 Chott Mariem, Sousse, Tunisia; E-Mail: nejibhasnaoui@yahoo.fr
² Laboratory of Molecular Genetics, Immunology & Biotechnology, Faculty of Sciences of Tunis, Campus University, 2092, El Manar, Tunis, Tunisia
³ Laboratory of Biochemistry & Molecular Biology, Faculty of Pharmacy, 5019 Monastir, Tunisia
Abstract: The genetic diversity among Tunisian pomegranate cultivars has been investigated. Using universal primers, the random amplified polymorphic DNA (RAPD) method was designed to generate banding profiles from a set of twelve cultivars. Data was then computed with appropriate programs to construct a dendrogram illustrating the relationships with the cultivars studied. Our data proved the efficiency of the designed method to examine the DNA polymorphism in this crop since the tested primers are characterised by a collective resolving power of 12.83. In addition, the cluster analysis has exhibited a parsimonious tree branching made independently from the geographic origin of the cultivars. In spite of the relatively low number of primers and cultivars, the RAPD constitute an appropriate procedure to assess the genetic diversity and to survey the Phylogenetic relationships in this crop.
Keywords: Pomegranate; Punica granatum L.; diversity; RAPD

Type of Paper: Article
Title: Self-Rated Health Does Not Predict 10-Year Weight Change among Adults
Authors: Margareta Norberg ^1,2,3, Kristina Lindvall ^1,2, Paul L. Jenkins ^4,5, Maria Emmelin ^1,2 and Anne N. Nafziger ⁶
Affiliations: ¹ Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 85 Umeå, Sweden; E-Mails: margareta.norberg@epiph.umu.se (M.N.); kristina.lindvall@epiph.umu.se (K.L.); maria.emmelin@epiph.umu.se (M.E.)
² Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, S-901 85 Umeå, Sweden
³ Centre for Population Studies, Ageing and Living Conditions Programme, Umeå University, S-901 87 Umeå, Sweden
⁴ The Research Institute, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326, USA; E-Mail: paul.jenkins@bassett.org (P.J.)
⁵ New York Center for Agricultural Medicine and Health, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326, USA
⁶ Bertino Consulting, 3078 New Williamsburg Drive, Schenectady, NY 12303, USA; E-Mail: nafziger@ix.netcom.com (A.N.)
Abstract: Ten-year percent weight change and self-rated health were evaluated to determine if self-rated health would predict weight change. From 1990 to 2008, adults aged 30-60 years were invited to health surveys that included self-rated health and measured weight and height. ANOVA was used to evaluate the relationship of 10-year percent weight change and self-rated health. 29207 participants (46.5% men) were included. There was no relationship between self-rated health at baseline and 10-year percent weight change for men or women. Self-rated health is not able to predict weight change over a 10-year period.
Keywords: obesity/epidemiology; body weight changes; self-rated health; health surveys; weight maintenance; cohort studies; population based

Type of Paper: Article
Title: Parenthood—a Contributing Factor to Childhood Obesity?
Authors: Fatma G. Huffman, Sankarabharan Kanikireddy and Manthan Patel
Affiliation: Florida International University, Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, 11200 SW 8th St., HLS1-435, Miami FL 33199, USA; E-Mails: huffmanf@fiu.edu (F.H.); Skani@fiu.edu (S.K.); Manthan.Patel@fiu.edu (M.P.)
Abstract: Prevalence of childhood obesity and its complications have increased world-wide. Parental status may be associated with children’s eating habits. NHANES III data, 1988-1994, of 219 households with single-parents and 780 dual-parent households were analyzed using variables Body Mass Index (BMI) and selected dietary nutrient intakes. Children of single-parent households were significantly (p < 0.01) more overweight than children of dual-parent households. Total calorie and saturated fatty acid intakes were higher among children of single-parent households (p < 0.05) than dual-parent households. Black children were more overweight (p < 0.04) than children of other race. The study result implies a strong relationship of single-parent status and overweight in children. Further studies are needed to explore the dynamics of single-parent households and its influence on childhood overweight.
Keywords: marital status; childhood Overweight; NHANES; single-parent households; dual-parent households

Type of Paper: Review
Title: Obesity Prevention: A Review of The Interactions and Interventions, and Some Policy Implications
Authors: Anura Amarasinghe ¹ and Gerard D’Souza ²
Affiliations: ¹ Centre for the Built Environment and Health, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009; E-Mail: AAmarasinghe@meddent.uwa.edu.au
² Division of Resource Management, West Virginia University, P.O. Box 6108, Morgantown, WV 26505-6108, USA; E-Mail: gdsouza@wvu.edu
Abstract: Obesity is reaching epidemic proportions especially in the developed and, more recently, in the developing world where the problem is compounded by myriad socio-economic, demographic, built and natural environmental factors. This review examines the possible causes, consequences and policy implications using a multilevel, multispectral framework. The causes of obesity clearly are multifaceted and involve numerous interactions. Together with economic incentives, allocation of physical and financial resources to community intervention strategies through educational programs as well as better land use planning would be helpful in promoting healthier and sustainable communities. Towards this goal, we proposed a dynamic and integrated Individual, Social, Economic and Environmental Model (ISEEM) for obesity prevention. The use of an ISEEM framework, involving a strategic combinations of strategies and targeted to the specific circumstances of individual communities and localities could be helpful for obesity prevention in the years to come.
Keywords: health promotion; obesity prevention; dynamic, integrated system, economic incentives

Type of Paper: Article
Title: Trends in Body Mass Index among Icelandic Adolescents and Young Adults from 1992 to 2007
Authors: Sigríður Þ. Eiðsdóttir ¹, Álfgeir L. Kristjánsson ², Inga D. Sigfúsdóttir ², Carol E. Garber ³, and John P. Allegrante ^1,2,4
Affiliations: ¹ Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA; E-Mail: ste2105@columbia.edu
² Icelandic Centre for Social Research and Analysis, School of Health and Education, Reykjavik University, Ofanleiti 2, 103 Reykjavík, Iceland; E-Mail: alfgeir@ru.is
³ Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA; E-Mail: ceg@2140columbia.edu
⁴ Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, West 168th Street, New York, NY 10032, USA; E-Mail: jpa1@columbia.edu
Abstract: Trends in BMI among 51,889 14- to 20-year-old Icelandic adolescents and young adults were examined using data from cross-sectional population surveys conducted from 1992 to 2007. Being overweight and obese increased for both genders across all age groups (except for a slight decline among 16-year-old obese girls) and was more pronounced in boys than girls and among older age groups for both genders. The largest increase occurred in the oldest group, 13% and 7.7% respectively among boys and 7.1% and 3.7% among girls. Within four weight categories, the most profound change in average BMI occurred in the obese group.
Keywords: adolescents; BMI; Iceland; obesity; overweight; trends