A Pooled Analysis of Body Mass Index and Mortality among African Americans

Pooled analyses among whites and East Asians have demonstrated positive associations between all-cause mortality and body mass index (BMI), but studies of African Americans have yielded less consistent results. We examined the association between BMI and all-cause mortality in a sample of African Americans pooled from seven prospective cohort studies: NIH-AARP, 1995–2009; Adventist Health Study 2, 2002–2008; Black Women's Health Study, 1995–2009; Cancer Prevention Study II, 1982–2008; Multiethnic Cohort Study, 1993–2007; Prostate, Lung, Colorectal and Ovarian Screening Trial, 1993–2009; Southern Community Cohort Study, 2002–2009. 239,526 African Americans (including 100,175 never smokers without baseline heart disease, stroke, or cancer), age 30–104 (mean 52) and 71% female, were followed up to 26.5 years (mean 11.7). Hazard ratios (HR) and 95% confidence intervals (CI) for mortality were derived from multivariate Cox proportional hazards models. Among healthy, never smokers (11,386 deaths), HRs (CI) for BMI 25–27.4, 27.5–29.9, 30–34.9, 35–39.9, 40–49.9, and 50–60 kg/m2 were 1.02 (0.92–1.12), 1.06 (0.95–1.18), 1.32 (1.18–1.47), 1.54 (1.29–1.83), 1.93 (1.46–2.56), and 1.93 (0.80–4.69), respectively among men and 1.06 (0.99–1.15), 1.15 (1.06–1.25), 1.24 (1.15–1.34), 1.58 (1.43–1.74), 1.80 (1.60–2.02), and 2.31 (1.74–3.07) respectively among women (reference category 22.5–24.9). HRs were highest among those with the highest educational attainment, longest follow-up, and for cardiovascular disease mortality. Obesity was associated with a higher risk of mortality in African Americans, similar to that observed in pooled analyses of whites and East Asians. This study provides compelling evidence to support public health efforts to prevent excess weight gain and obesity in African Americans

Adaptive Wavelet Fusion based Color Image Enhancement by Scaling the DC Coefficients

Abstract-Usually the images taken by digital cameras are different from the original true color image in terms of color and brightness of the scene captured. Various factors like non uniform illumination, color of ambient light, low or high contrast, and over exposure or under exposure of some specific regions may leads to poor contrast which is annoying to human visual system. Thus, enhancement methods are required for color images. In this paper An image fusion is used to improve the performance of DC coefficient scaling method in the compressed DCT domain for enhancing the contrast of colour images. Using the multi resolution wavelet fusion preserves the brightness of the enhanced image. This improves the entropy of standard DCT based DC coefficient scaling method. For comparing the performance along with SNR and the absolute standard deviation difference is also used as parameters. The methods are tested on various true colour images from different environmen

Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies

Background: The prevalence of class III obesity (body mass index [BMI]≥40 kg/m2) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity. Methods and Findings: In a pooled analysis of 20 prospective studies from the United States, Sweden, and Australia, we estimated sex- and age-adjusted total and cause-specific mortality rates (deaths per 100,000 persons per year) and multivariable-adjusted hazard ratios for adults, aged 19–83 y at baseline, classified as obese class III (BMI 40.0–59.9 kg/m2) compared with those classified as normal weight (BMI 18.5–24.9 kg/m2). Participants reporting ever smoking cigarettes or a history of chronic disease (heart disease, cancer, stroke, or emphysema) on baseline questionnaires were excluded. Among 9,564 class III obesity participants, mortality rates were 856.0 in men and 663.0 in women during the study period (1976–2009). Among 304,011 normal-weight participants, rates were 346.7 and 280.5 in men and women, respectively. Deaths from heart disease contributed largely to the excess rates in the class III obesity group (rate differences = 238.9 and 132.8 in men and women, respectively), followed by deaths from cancer (rate differences = 36.7 and 62.3 in men and women, respectively) and diabetes (rate differences = 51.2 and 29.2 in men and women, respectively). Within the class III obesity range, multivariable-adjusted hazard ratios for total deaths and deaths due to heart disease, cancer, diabetes, nephritis/nephrotic syndrome/nephrosis, chronic lower respiratory disease, and influenza/pneumonia increased with increasing BMI. Compared with normal-weight BMI, a BMI of 40–44.9, 45–49.9, 50–54.9, and 55–59.9 kg/m2 was associated with an estimated 6.5 (95% CI: 5.7–7.3), 8.9 (95% CI: 7.4–10.4), 9.8 (95% CI: 7.4–12.2), and 13.7 (95% CI: 10.5–16.9) y of life lost. A limitation was that BMI was mainly ascertained by self-report. Conclusions: Class III obesity is associated with substantially elevated rates of total mortality, with most of the excess deaths due to heart disease, cancer, and diabetes, and major reductions in life expectancy compared with normal weight. Please see later in the article for the Editors' Summar

Exploring Demographic and Substance Use Correlates of Hookah Use in a Sample of Southern California Community College Students

Background and Purpose: Hookah smoking is a growing young adult phenomenon, particularly among college students. Many users feel that it is safer than other tobacco products, although its health threats are well documented. Little is known about hookah use rates in community colleges that are attended by nearly half of all US college students. This study examined hookah use in a diverse convenience sample of students attending two southern California community colleges. Methods: In fall 2011, a crosssectional, in-classroom survey was administered to 1,207 students. A series of fully adjusted multivariate logistic regressions were conducted to explore demographic, other substance use, and attitudinal correlates of lifetime and current hookah use. Results: Lifetime hookah use (56%) was higher than lifetime cigarette use (49%). Gender and personal socioeconomic status were not related to hookah use. Current use (10.8%) was associated with current use of alcohol, cigars, and cigarettes. Compared to African-Americans, Whites were 2.9 times more likely to be current users, and students who perceive hookah to be more socially acceptable were 21 times more likely to currently use. Conclusion: Since hookah use rates are high, colleges should offer health education programs to inform incoming students about the health risks of hookah and cessation programs

Evaluating Smoking Cessation Counseling Bundle Behavioral Intervention for Mongolian Adults Who Use Nicotine Patches

Objectives: The objective of this study is to evaluate the effectiveness of a behavioral intervention based on the World Health Organization (WHO) 5A and 5R guidelines in Mongolia who use the Nicotine Replacement Therapy (NRT) patch. The study aims to assess the impact of the intervention on smoking cessation rate. The finding of this study will contribute to the existing literature on smoking cessation interventions and provide valuable insights into the effectiveness of a behavioral approach in a Mongolian population. Methods: In the intervention study, out of total of 806 people interested in the part of this study. The study team excluded their eligibility criteria of the study participant. A sample of 625 people who fulfilled study inclusion criteria received advice about the negative consequences of tobacco. After that, 479 people decided to quit smoking and 41 people were excluded due to health contraindications, and the final sample 454 people began nicotine replacement therapy to quit smoking. Participants in the treatment group received nicotine replacement patches for 28 days, while those in the counseling group received four sessions of behavioral change counseling (5A, 5R). Results: 454 were found to be eligible to take part in the study and were subsequently assigned to one of two groups, with 230 and 224 participants assigned to each group, respectively. In the second month of follow-up, 90 (39.1%) of participants who received NRT patches quit smoking. The group that received NRT + Behavioral intervention was 1.02 times as successful, or 0.7% more effective, than the group that did not receive behavioral intervention (P=0.872). Conclusion: WHO 5A, 5R brief counselling were more effective than group without behavioral intervention for smoking cessation, but difference was insignificant

Cigarette smoking and tuberculosis in Cambodia: findings from a national sample

Background Cambodia has very high rates of tuberculosis and smoked tobacco use among adults. Efforts to control both tobacco use and tuberculosis in Cambodia need to be informed by nationally representative data. Our objective is to examine the relation between daily cigarette smoking and lifetime tuberculosis (TB) history in a national sample of adults in Cambodia. Methods In 2011, a multi-stage, cluster sample of 15,615 adults (ages 15 years and older) from all regions of Cambodia were administered the Global Adult Tobacco Survey by interviewers from the National Institute of Statistics of Cambodia. Results Our findings include: 1) among daily smokers, a significant positive relation between TB and number of cigarettes smoked per day (OR = 1.70 [95% CI 1.01, 2.87]) and pack-years of smoking (OR = 1.53 [95% CI 1.05, 2.25]) 2) a non-significant 58% increase in odds of ever having being diagnosed with TB among men who smoked manufactured cigarettes (OR = 1.58 [95% CI 0.97, 2.58]). Conclusions In Cambodia, manufactured cigarette smoking was associated with lifetime TB infection and the association was most evident among the heaviest smokers (> 1 pack per day, > 30 pack years)

Plant-Based Diets Are Associated With Lower Adiposity Levels Among Hispanic/Latino Adults in the Adventist Multi-Ethnic Nutrition (AMEN) Study

Background: The Hispanic/Latino population in the US is experiencing high rates of obesity and cardio-metabolic disease that may be attributable to a nutrition transition away from traditional diets emphasizing whole plant foods. In the US, plant-based diets have been shown to be effective in preventing and controlling obesity and cardio-metabolic disease in large samples of primarily non-Hispanic subjects. Studying this association in US Hispanic/Latinos could inform culturally tailored interventions.Objective: To examine whether the plant-based diet pattern that is frequently followed by Hispanic/Latino Seventh-day Adventists is associated with lower levels of adiposity and adiposity-related biomarkers.Methods: The Adventist Multiethnic Nutrition Study (AMEN) enrolled 74 Seventh-day Adventists from five Hispanic/Latino churches within a 20 mile radius of Loma Linda, CA into a cross-sectional study of diet (24 h recalls, surveys) and health (anthropometrics and biomarkers).Results: Vegetarian diet patterns (Vegan, Lacto-ovo vegetarian, Pesco-vegetarian) were associated with significantly lower BMI (24.5 kg/m2 vs. 27.9 kg/m2, p = 0.006), waist circumference (34.8 in vs. 37.5 in, p = 0.01), and fat mass (18.3 kg vs. 23.9 kg, p = 0.007), as compared to non-vegetarians. Adiposity was positively associated with pro-inflammatory cytokines (Interleukin-6) in this sample, but adjusting for this effect did not alter the associations with vegetarian diet.Conclusions: Plant-based eating as practiced by US-based Hispanic/Latino Seventh-day Adventists is associated with BMI in the recommended range. Further work is needed to characterize this type of diet for use in obesity-related interventions among Hispanic/Latinos in the US

Socioeconomic Factors Related to Nicotine Dependence in Mongolia

Objectives: This study is aimed to investigate potential socio-economic risk factors associated with Nicotine Dependence among UB residents. It is important to identify and understand the various elements that may make people more susceptible to the negative health effects of smoking. Methods: We applied a cross-sectional study design to define the level of nicotine dependence on 875 participants. In addition, risk factors associated with nicotine dependence were assessed through a questionnaire survey. Results: Higher nicotine dependence in this study was associated with being a female (OR=1.208), older age groups (OR=1.5-2.9), divorced (OR=1.091), living in a house (OR=1.602), having a high school education level (OR=1.794), not having a regular job (OR=1.137), having a higher alcohol consumption level (OR=1.18-1.62), and age at initiation of smoking at 18 or younger (OR=1.796). Conclusion: According to the results of our research, countries with low and moderate levels of income, such as Mongolia, have a significant problem with high levels of nicotine dependence. In addition to this, it underscores the importance of developing smoking cessation programs that consider the extent of nicotine dependence while placing a greater emphasis on early interventions of the linked factors