Objective: To investigate the association between body mass index (BMI) and oral anticoagulant (OAC) prescription in atrial fibrillation (AF).Methods: Patients with newly diagnosed non-valvular AF ... Show moreObjective: To investigate the association between body mass index (BMI) and oral anticoagulant (OAC) prescription in atrial fibrillation (AF).Methods: Patients with newly diagnosed non-valvular AF (< 3 months) with >= 1 stroke risk factors enrolled in the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) in Asia, Europe and North America were evaluated.Results: The cohort (n = 13,793) comprised patients from all BMI categories (kg/m(2)): 1.4% were underweight (<18.5), 27.3% had a normal BMI (18.5 to <25), 37.9% were overweight (25 to <30), 19.3% were moderately obese (30 to < 35), and 12.7% were morbidly obese (>= 35). The highest proportion of Asians had a BMI of 18.5 to <25 kg/m(2), while the highest proportion of patients from Europe and North America were overweight and a substantial proportion of North Americans morbidly obese. In the multivariable analysis, the probability ratio of non-prescription of OAC, as compared to normal BMI, decreased for overweight (RR = 0.907), moderately obese (RR = 0.802) and severe very severe obese patients (RR = 0.659). Moreover, the probability ratio of non-prescription of OACs was increased in the Asia or North America regions, as compared with Europe, in patients aged <65 years or female patients, as well as in patients with prior bleeding or vascular disease.Conclusions: The distribution of BMI differed among the continents. An increased BMI was associated with a lower probability of non-prescription of OACs, as compared with a normal BMI. The probability of non-prescription of OACs was increased in the Asia or North America regions, as compared with Europe. Show less
Velde, L.A. van der; Nyns, C.J.; Engel, M.D.; Neter, J.E.; Meer, I.M. van der; Numans, M.E.; Kiefte-de Jong, J.C. 2020
BackgroundFood insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. This study aimed to assess the... Show moreBackgroundFood insecurity is related to risk of adverse health outcomes such as obesity, but the explanatory factors underlying this association are still unclear. This study aimed to assess the association between food insecurity and obesity, and to explore potential mediation by sociodemographic and lifestyle factors.MethodsThis cross-sectional study was conducted among 250 participants in a deprived urban area in the Netherlands. Data on sociodemographic and lifestyle factors, food insecurity status and diet quality were collected using questionnaires. Diet quality was determined based on current national dietary guidelines. BMI was calculated from self-reported height and weight. Regression analyses were performed to explore the association between food insecurity and BMI status. Mediation analyses were performed to estimate the total-, direct-, and indirect effect and proportion of total effect mediated of the food insecurity-obesity association.ResultsThe overall prevalence of food insecurity was 26%. Food insecurity was associated with obesity (OR=2.49, 95%CI=1.16, 5.33), but not with overweight (OR=1.15, 95%CI=0.54, 2.45) in the unadjusted model. The food insecurity-obesity association was partially mediated by living situation (proportion mediated: 15.4%), diet quality (-18.6%), and smoking status (-15.8%) after adjustment for other covariates.ConclusionsThe findings of this study suggest an association between food insecurity and obesity. Living situation, diet quality and smoking status explained part, but not all, of the total association between food insecurity and obesity. Future longitudinal studies are warranted to examine the temporal order of the food insecurity-obesity association and potential mediators in this relationship. In addition, food insecurity and its potential consequences need to be taken into account in obesity prevention programs and policies. Show less
Abramovitch, A.; Anholt, G.E.; Cooperman, A.; Balkom, A.J.L.M. van; Giltay, E.J.; Penninx, B.W.; Oppen, P. van 2019
Background: : Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder(OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally,... Show moreBackground: : Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder(OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally, depression isassociated with elevated BMI, but effects of comorbid secondary depression are unknown. The aim of the presentstudy was to assess BMI and risk for overweight/obesity in OCD and to assess the effect of comorbid depressionon BMI.Methods: : BMI, demographics, and clinical status were assessed in large samples of individuals with OCD,anxiety disorders, depressive disorders, comorbid anxiety/depressive disorders, and non-clinical controls (NCC).Results: : Although no initial differences were found between the samples on BMI, the non-depressed OCDsubsample had significantly lower BMI and risk for overweight/obesity compared to all other clinical samples.NCC were nearly twice as likely to be overweight compared to non-depressed OCD.Limitations: : Eating disorders were excluded in the OCD sample, but BMI < 17 was used as an exclusion cri-terion in the clinical control groups in lieu of screening for Anorexia. Group differences on demographics werecontrolled for. Recruitment methodology differed between samples.Conclusions: : OCD is associated with significantly lower rates of obesity and overweight, but this relationshipwas not found when comorbid depression was present. This suggests that the purer the phenotype of OCD, themore substantial protective factor against overweight/obesity emerges compared to other clinical samples andNCC. An OCD-specific reward/anhedonia model, previously offered to elucidate lower smoking rates in OCD,may account for lower BMI in OCD. These results warrant careful clinical attention to the negative impact ofcomorbid depression on OCD that spans from increasing risk for obesity and cigarette smoking, to hinderingtreatment response. Show less
