Weight underestimation linked to anxiety and depression in a cross-sectional study of overweight individuals in a Sami and non-Sami Norwegian population: the SAMINOR Study

Source at http://dx.doi.org/10.1136/bmjopen-2019-031810. Objectives: Underestimation of overweight/obesity may prevent weight loss attempts, resulting in further weight gain and maintenance of overweight. Mental health benefits may nevertheless surpass negative consequences. Our main objective was to study the association between underestimation of overweight/obesity and symptoms of anxiety and depression in Sami and non-Sami populations. Design: Population-based cross-sectional study. Setting: The SAMINOR 2 Clinical Study with participants from 10 municipalities in Northern Norway enrolled between 2012 and 2014. Participants: The study included 3266 adults of multiethnic rural origin with overweight/obesity (body mass index (BMI) ≥25 kg/m2) whereof 1384 underestimated their weight (42%). Primary and secondary outcome measures: Primary outcome measure was symptoms of anxiety and depression and secondary outcome measures were BMI and the demographic variables: sex, age, education and marital status. Results: A higher proportion of Sami men compared with non-Sami men were obese, and reported more symptoms of anxiety and depression. More men than women, and a higher proportion of Sami women compared with non-Sami women, underestimated their weight. Multivariable-adjusted analyses showed that women were less likely to underestimate their weight compared with men (OR 0.43, 95% CI 0.33 to 0.55 in Sami and OR 0.33, 95% CI 0.26 to 0.42 in non-Sami), higher BMI was protective against weight underestimation (OR 0.72, 95% CI 0.69 to 0.75 in Sami and OR 0.63, 95% CI 0.60 to 0.67 in non-Sami), slightly higher odds of weight underestimation were observed with increasing age in both ethnic groups (OR 1.03, 95% CI 1.01 to 1.05 in Sami and OR 1.02, 95% CI 1.00 to 1.03 in non-Sami), while higher education lowered the odds in non-Sami (OR 0.69, 95% CI 0.55 to 0.87). Weight underestimation was protectively associated with anxiety and depression in Sami men (OR 0.48, 95% CI 0.27 to 0.84) and in non-Sami women (OR 0.44, 95% CI 0.25 to 0.78) adjusted for age, BMI, education and marital status. Conclusions: Independent of ethnicity, more men than women underestimated their weight. Underestimation of weight was protectively associated with anxiety and depression in Sami men and non-Sami women

Sex-specific height-correction of weight in a population with ethnic groups that differ in stature - the SAMINOR 1 Survey: a cross-sectional study

Source at https://socialmedicinsktidskrift.se/index.php/smt/article/view/2609Background: Body mass index (BMI, weight/height2) is a common proxy for body fatness, but it is negatively correlated with height. In Norway, the ethnic Sami people have had higher BMI and lower height than their non-Sami peers. This article aimed to examine if previous findings of higher obesity measures in Sami compared to non-Sami persist when applying an adequately height-corrected weight index. Methods: We estimated a sex-specific height-corrected weight index—the Benn index—that is, weight/heightp where p is estimated from log(weight)-log(height) regression. We used data on 15 717 men and women aged 30 and 36–79 years who participated in the SAMINOR 1 Survey (2003–2004). Correlations between height and weight and the indices BMI and Benn index were calculated using Pearson’s correlation coefficient. Results: BMI and height had a modest, negative correlation. Analyses were stratified by sex due to a statistically significant interaction (sex * log(height), p Conclusion: Previous findings of higher obesity measures in Sami than in non-Sami may be biased. Future studies should take into account the marked height differences between these groups when comparing obesity indices

HUNT for better public health

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Depression, anxiety, and psychosocial stressors across BMI classes: A Norwegian population study - The HUNT Study

Background: Obesity is a global issue with detrimental health impacts. Recent research has highlighted the complexity of obesity due to its psychological correlates. The purpose of the present study was to explore the relationship between body mass index (BMI) and depression, anxiety, and psychosocial stress. Methods: Data, including demographic, height, and weight information from 23 557 adult participants was obtained from the fourth survey of the Norwegian population based Trøndelag Health Study (HUNT4, 2017-2019). The Hospital Anxiety and Depression Scale (HADS) was used to measure self-reported depression and anxiety. We also collected data on 10 domains of psychosocial stress (violence, mental violence, unwanted sex, cyber bullying, school bullying, history of own life-threatening disease, life-threatening disease in family, relationship problems, divorce, and sudden family death), which were aggregated into a cumulative measure of psychosocial stress. Results: Multinomial logistic regression was utilized for statistical analysis. In the full model, the relationship between depression, anxiety, and psychosocial stress were explored controlling for age, sex, income, marital status, and educational attainment. After adjustments, a significant relationship was found between depression and obesity I (OR = 1.05, 95% CI 1.03-1.06, p <.001) and II and III (OR = 1.10, 95% CI 1.06-1.14, p <.001). After the same adjustments, significant relationship between anxiety and overweight and obesity class I was found among elderly participants (≥65 years old). Psychosocial stress significantly and positively related to all levels of BMI, with or without considering anxiety and depression, after controlling for sex, age, educational attainment, marital status, and income in all age groups. Conclusions: Obesity is a multifaceted health problem, significantly related to psychological factors including depression and psychosocial stress, which supports the need for a multifaceted, targeted approach to obesity treatment

Underestimation of Overweight and Health Beneficial Outcomes in Two Adolescent Cohorts in Norway - The HUNT Study

Purpose: Underestimating overweight may prevent efforts toward reducing weight, but simultaneously benefit mental health and well-being. The magnitude of underestimation of overweight and obesity in adolescents is largely unknown, and so is to what extent this underestimation is associated with dieting behaviors, mental distress, and life satisfaction. As overweight has become more common during the past decades, associations between body size underestimation and mental health may have changed. Methods: Overweight (iso–body mass index, iso-BMI ≥25) adolescents (aged 13–19 years) who participated in The Young-HUNT1 (1995–97, n = 1,338) or The Young-HUNT3 (2006–08, n = 1,833) surveys were included. Being overweight, but perceiving oneself as average-weighted or underweighted was defined as underestimation. Results were based on clinical examinations and self-report questionnaires. Multivariable logistic regression models were used to examine associations between body size underestimation, dieting behaviors, and symptoms of anxiety, depression, and life satisfaction. Results: Among adolescents with overweight and obesity (iso-BMI ≥25), the prevalence of obesity (iso-BMI ≥30), body size underestimation, and having symptoms of anxiety and depression had increased from the first survey to the next. At both time points, body size underestimation was more common among boys than girls. In 2006–08, body size underestimation was negatively associated with symptoms of anxiety and depression in both sexes, and overall associated with higher life satisfaction equally over time. Dieting behavior was negatively associated with underestimation of body size. Conclusions: Body size underestimation in adolescents with overweight/obesity has become more prevalent and a phenomenon associated with less dieting, better life satisfaction and mental health in both boys and girls.publishedVersionPaid Open Acces

Being Normal Weight but Feeling Overweight in Adolescence May Affect Weight Development into Young Adulthood—An 11-Year Followup: The HUNT Study, Norway

Objectives. To explore if self-perceived overweight in normal weight adolescents influence their weight development into young adulthood and if so, whether physical activity moderates this association. Methods. A longitudinal study of 1196 normal weight adolescents (13–19 yrs) who were followed up as young adults (24–30 yrs) in the HUNT study. Lifestyle and health issues were assessed employing questionnaires, and standardized anthropometric measurements were taken. Chi square calculations and regression analyses were performed to investigate the associations between self-perceived overweight and change in BMI or waist circumference (WC) adjusted for age, age squared, sex, and other relevant cofactors. Results. Adolescents, defined as being normal weight, but who perceived themselves as overweight had a larger weight gain into young adulthood than adolescents who perceived themselves as normal weight (difference in BMI: 0.66 units [CI95%: 0.1, 1.2] and in WC: 3.46 cm [CI95%: 1.8, 5.1]). Level of physical activity was not found to moderate this association. Conclusions. This study reveals that self-perceived overweight during adolescence may affect development of weight from adolescence into young adulthood. This highlights the importance of also focusing on body image in public health interventions against obesity, favouring a “healthy” body weight taking into account natural differences in body shapes

Suicidal ideation in relation to disordered eating, body size and weight perception: a cross-sectional study of a Norwegian adolescent population: the HUNT study

Objective We conducted a population-based study on a sample of more than 7000 adolescents where we examined the associations between suicidal ideation (SI) and disordered eating (DE) and its related traits. Design Cross-sectional. Settings Data were derived from two Norwegian population-based cohorts, the Young-HUNT1 (1995–1997) and Young-HUNT3 (2006–2008) from the county of Nord-Trøndelag, Norway. Participants A total of 7268 adolescents (15–19 years) who had completed self-reported questionnaires including items on SI, DE, body size and weight perception were included. Primary outcome measures ORs for SI given DE, body size or weight perception. Analyses were performed in multivariate logistic regression models. Results The prevalence of SI was 23.1% in total population. Both girls and boys who reported DE, evaluated their body size as not ‘about the same as others’ or were ‘unhappy about their weight’ had between twofold to fivefold increase in odds for SI; these incremental risks were observed independent of sex, age, body mass index and socioeconomic status. We observed higher odds for SI among boys. Conclusions Our findings suggest a clear association between SI and DE and its associated traits, in both genders but especially in males. Special attention should be paid on early detection of DE traits among adolescents.publishedVersio

Symptovmh byöpmedimssturremidie jïh madtjelesvoetese jïjtse kråahpine

I dagens samfunn er overvekt og fedme hyppig forekommende og har derfor blitt mer akseptert i store deler av befolkningen. Samtidig fokuseres det i media på at idealet er å være slank, sunn og i god fysisk form. I to studier av deltakere i SAMINOR 2 – den kliniske undersøkelsen (2012–2014), var vi interessert i å studere symptomer på spiseforstyrrelser (Studie 1) og om underestimering av overvekt hadde sammenheng med lavere grad av symptomer på angst og depresjon (Studie 2). Vi fant at kvinner gjennomsnittlig hadde høyere totalskår med hensyn til symptomer på spiseforstyrrelse enn menn. De som rapporterte symptomer på spiseforstyrrelse, var nesten alle overvektige og hadde også høyere sannsynlighet for å rapportere angst og depresjon. Det var ingen betydelige forskjeller mellom samisk og ikke-samisk befolkning når det gjelder disse sammenhengene, men samer rapporterte mer trøstespising. Blant samiske menn og ikke-samiske kvinner var det lavere forekomst av symptomer på angst og depresjon blant de som var overvektige, men som selv enten synes de var normalvektige eller tynne. For samiske kvinner og ikke-samiske menn fant vi ingen slik sammenheng.Daan beajjetje seabradahkesne bijjieleavloe jïh buajtehksvoete daamtaj gååvnesieh jïh leah dan åvteste vielie jååhkesjamme sjïdteme stoerre bieline årroejijstie. Seamma tïjjen medija jarngesne åtna åvteguvvie lea skaejlies, aejlies jïh vervesne årrodh. Göökte goerehtimmine dejstie mah lin meatan SAMINOR 2 – klinihkeles goerehtimmesne (2012–2014), ïedtjem utnimh symptovmh goerehtidh byöpmedimssturremasse (Goerehtimmie 1) jïh mejtie fer vuelege aarvehtse bijjieleavloste naan såarhts ektiedimmiem utni viesjiehtåbpoe symptovmigujmie asvese jïh depresjovnese (Goerehtimmie 2). Mijjieh gaavnimh nyjsenæjjah gaskemedtien jienebh symptovmh byöpmedimssturremidie utnin goh ålmah. Mahte gaajhkesh dovnesh mah symptovmh byöpmedimssturremidie reektin, bijjieleavloem utnin jïh dah sån aaj stuerebe aarvehtsem utnin asvem jïh depresjovnem reektedh. Ij lij naan stoerre joekehtsh saemien jïh daaroen årroji gaskem gosse lea daej ektiedimmiej bïjre, men saemieh vielie soelkehtsbyöpmedimmien bïjre reektin. Saemien ålmaj jïh daaroen nyjsenæjjaj gaskem lij vaenebh symptovmh asveste jïh depresjovnese dej gaskem mah bijjieleavloem utnin, men mah jïjtjh vïenhtin dah iemie leavloem utnin jallh lin siegkie. Saemien nyjsenæjjide jïh daaroen ålmide idtjimh dagkeres ektiedimmiem gaavnh

Adiposity and asthma in adults: a bidirectional Mendelian randomization analysis of the HUNT Study

This article has been accepted for publication in Thorax, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/thoraxjnl-2019-213678. © Authors (or their employer(s))Background - We aimed to investigate the potential causal associations of adiposity with asthma overall, asthma by atopic status or by levels of symptom control in a large adult population and stratified by sex. We also investigated the potential for reverse causation between asthma and risk of adiposity. Methods - We performed a bidirectional one-sample Mendelian randomisation (MR) study using the Norwegian Nord-Trøndelag Health Study population including 56 105 adults. 73 and 47 genetic variants were included as instrumental variables for body mass index (BMI) and waist-to-hip ratio (WHR), respectively. Asthma was defined as ever asthma, doctor-diagnosed asthma and doctor-diagnosed active asthma, and was further classified by atopic status or levels of symptom control. Causal OR was calculated with the Wald method. Results - The ORs per 1 SD (4.1 kg/m2) increase in genetically determined BMI were ranged from 1.36 to 1.49 for the three asthma definitions and similar for women and men. The corresponding ORs for non-atopic asthma (range 1.42–1.72) appeared stronger than those for the atopic asthma (range 1.18–1.26), but they were similar for controlled versus partly controlled doctor-diagnosed active asthma (1.43 vs 1.44). There was no clear association between genetically predicted WHR and asthma risk or between genetically predicted asthma and the adiposity markers. Conclusions - Our MR study provided evidence of a causal association of BMI with asthma in adults, particularly with non-atopic asthma. There was no clear evidence of a causal link between WHR and asthma or of reverse causation

Obesity measures, metabolic health and their association with 15-year all-cause and cardiovascular mortality in the SAMINOR 1 Survey:a population-based cohort study

Background - The mortality of metabolic-obesity phenotypes has been thoroughly studied, but it is not known if or how the association between mortality and body mass index (BMI), waist circumference or a body shape index (ABSI) differ in strata of cardiometabolic health status. Methods - We linked data on 12,815 men and women aged 36–79 years from the SAMINOR 1 Survey with mortality data from the Norwegian Cause of Death Registry. We defined metabolically healthy and unhealthy as having zero and ≥ 1, respectively, of the following: MetS, pre-existing diabetes or cardiovascular disease (CVD), or prescribed drugs for high blood pressure, hyperglycaemia or dyslipidaemia. We defined general and abdominal obesity as BMI ≥ 30 kg/m2 and waist circumference ≥ 88 cm (women) or 102 cm (men), respectively, and cross-classified these categories with metabolic status to create metabolically healthy non-obese and obese (MHNO and MHO) and metabolically unhealthy non-obese and obese (MUNO and MUO) phenotypes. We used Cox regression to estimate the hazard ratio (HR) for all-cause and CVD mortality for 1) the four phenotypes and 2) BMI, waist circumference and ABSI fitted with restricted cubic splines. We adjusted for age and lifestyle, and tested for interactions with sex and metabolic status (only continuous measures). Results - The MHO phenotype was present in 7.8% of women and 5.8% of men. During a median follow-up of 15.3/15.2 years, 596/938 women/men had died, respectively. The MUNO and MUO groups had higher mortality than the MHNO group. Sex and phenotypes interacted with respect to CVD mortality: relative to the MHNO group, the MHO group had an adjusted HR (95% confidence interval) for CVD mortality of 1.05 (0.38–2.88) in women and 2.92 (1.71–5.01) in men. We found curvilinear associations between BMI/waist circumference and all-cause mortality irrespective of metabolic status. Corresponding relationships with CVD mortality were linear and the slope differed by sex and metabolic status. ABSI was linearly and positively associated with all-cause and CVD mortality in men. Conclusion - The relationships between BMI, waist circumference or ABSI and mortality differed by sex, metabolic status and cause of death. Poor metabolic health substantially increases mortality regardless of obesity status