@article {13181, title = {Longitudinal body weight dynamics in relation to cognitive decline over two decades: A prospective cohort study.}, journal = {Obesity (Silver Spring)}, volume = {31}, year = {2023}, month = {2023 Mar}, pages = {852-860}, abstract = {

OBJECTIVE: The aim of this study was to investigate the associations of body weight change (BWC) and body weight variability (BWV) with changes in cognitive function.

METHODS: In 10,340 Health and Retirement Study participants (mean age: 68.0 years), body weight was reported biennially from 1993/1994 to 2016, and cognitive function was measured biennially from 1998 to 2016. We calculated BWC and BWV as the slope and root-mean-square error by regressing body weight on time for each individual. BWC was categorized by quintiles (Q): stable weight (Q2 to Q4), weight loss (Q1), and weight gain (Q5). BWV was categorized by tertiles. We used linear mixed regression models to assess associations with cognitive change.

RESULTS: Compared with stable weight (median: 0~kg/y), weight loss (median: -1.3~kg/y) predicted faster cognitive decline as demonstrated by mean difference of -0.023 (95\% CI: -0.027 to -0.019) in cognitive change z score per year, whereas weight gain (median: 1~kg/y) was related to slower cognitive decline (β~=~0.006; 95\% CI: 0.003 to 0.009). Larger BWV was also associated with faster cognitive decline (β comparing the top with bottom tertile~=~-0.003; 95\% CI: -0.006 to -0.0002). Similar associations were observed for episodic and working memory.

CONCLUSIONS: Weight loss and large BWV over a long time independently predicted faster cognitive decline in middle-aged and older adults, underscoring the importance of long-term dynamic body weight monitoring.

}, keywords = {Aged, Body Weight, Cognitive Dysfunction, Humans, Longitudinal Studies, Middle Aged, Prospective Studies, Weight Gain, Weight Loss}, issn = {1930-739X}, doi = {10.1002/oby.23671}, author = {Zhou, Tianjing and Chen, Hui and Huang, Yuhui and Wang, Binghan and Zheng, Yan and Wang, Liang and Rong, Shuang and Ma, Yuan and Yuan, Changzheng} } @article {13155, title = {Obesity Stigma: Causes, Consequences, and Potential Solutions.}, journal = {Curr Obes Rep}, volume = {12}, year = {2023}, month = {2023 Mar}, pages = {10-23}, abstract = {

PURPOSE OF REVIEW: This review aims to examine (i) the aetiology of obesity; (ii) how and why a perception of personal responsibility for obesity so dominantly frames this condition and how this mindset leads to stigma; (iii) the consequences of obesity stigma for people living with obesity, and for the public support for interventions to prevent and manage this condition; and (iv) potential strategies to diminish our focus on personal responsibility for the development of obesity, to enable a reduction of obesity stigma, and to move towards effective interventions to prevent and manage obesity within the population.

RECENT FINDINGS: We summarise literature which shows that obesity stems from a complex interplay of genetic and environment factors most of which are outside an individual{\textquoteright}s control. Despite this, evidence of obesity stigmatisation remains abundant throughout areas of media, entertainment, social media and the internet, advertising, news outlets, and the political and public health landscape. This has damaging consequences including psychological, physical, and socioeconomic harm. Obesity stigma does not prevent obesity. A combined, concerted, and sustained effort from multiple stakeholders and key decision-makers within society is required to dispel myths around personal responsibility for body weight, and to foster more empathy for people living in larger bodies. This also sets the scene for more effective policies and interventions, targeting the social and environmental drivers of health, to ultimately improve population health.

}, keywords = {Body Weight, Humans, Obesity, Social Behavior, Social Stigma, Stereotyping}, issn = {2162-4968}, doi = {10.1007/s13679-023-00495-3}, author = {Westbury, Susannah and Oyebode, Oyinlola and van Rens, Thijs and Barber, Thomas M} } @article {13465, title = {Psychological pathways explaining the prospective association between obesity and physiological dysregulation.}, journal = {Health Psychol}, volume = {42}, year = {2023}, pages = {472-484}, abstract = {

OBJECTIVE: Obesity is associated with a range of negative psychological conditions that may also affect physiological health. Across two studies, we tested whether a range of psychological measures explain why obesity is prospectively associated with physiological dysregulation, measured via clinical indicators of cardiovascular, immune system, and metabolic function.

METHOD: We used comparable 4-year follow-up representative longitudinal data of U.K. and U.S. older adults (>=50 years) from the English Longitudinal Study of Ageing (2008/2009-2012/2013; Study 1; n = 6,250) and the Health and Retirement Study (2008/2010-2012/2014; Study 2; n = 9,664). A diverse range of psychological measures (e.g., depressive symptoms, life satisfaction, weight stigma, positive affect) were tested as candidate mediators in Studies 1 (n = 14) and 2 (n = 21).

RESULTS: Obesity predicted physiological dysregulation at follow-up across both studies. In Study 1, only weight stigma (measured between baseline and follow-up) explained 37\% of the association between obesity and physiological dysregulation. In Study 2, only changes in weight stigma from baseline to follow-up (not baseline weight stigma) explained 13\% of the effect of obesity on future physiological dysregulation. Mediation by weight stigma in both studies was partially attenuated when changes in body mass index from baseline to follow-up were controlled for. No other psychological measures explained the association between obesity and physiological dysregulation in either study.

CONCLUSIONS: The prospective association between obesity and physiological dysregulation was largely not explained by psychological factors. However, experiencing weight stigma is associated with increased weight gain and this process may explain obesity-related declines in physiological health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

}, keywords = {Aged, Body Mass Index, Body Weight, Humans, Longitudinal Studies, Obesity, Social Stigma, Weight Gain}, issn = {1930-7810}, doi = {10.1037/hea0001284}, author = {Putra, I Gusti Ngurah Edi and Daly, Michael and Sutin, Angelina and Steptoe, Andrew and Robinson, Eric} } @article {12980, title = {Weight Loss, Body Weight Variability Associated With Faster Cognitive Decline}, year = {2023}, publisher = {Endocrinology Advisor}, keywords = {Body Weight, Cognitive decline, Weight Loss}, url = {https://www.endocrinologyadvisor.com/home/topics/general-endocrinology/weight-loss-body-weight-variability-associated-with-faster-cognitive-decline/}, author = {Wei, Sophie} } @article {12788, title = {Association of Long-Term Body Weight Variability With Dementia: A Prospective Study.}, journal = {The Journals of Gerontology, Series A }, volume = {77}, year = {2022}, pages = {2116-2122}, abstract = {

BACKGROUND: Body weight variability (BWV) refers to intraindividual weight loss and gain over a period. The association of long-term BWV with dementia remains unclear and whether this association is beyond body weight change is undetermined.

METHODS: In the Health and Retirement Study, a total of 5 547 dementia-free participants (56.7\% women; mean [SD] age, 71.1 [3.2] years) at baseline (2008) were followed up to 8 years (mean = 6.8 years) to detect incident dementia. Body weight was self-reported biennially from 1992 to 2008. BWV was measured as the coefficient of variation utilizing the body weight reported 9 times across 16 years before baseline. Cox-proportional hazard model was used to estimate the hazard ratio (HR) and 95\% confidence interval (CI).

RESULTS: Among the 5 547 participants, a total of 427 incident dementia cases were identified during follow-up. Greater long-term BWV was significantly associated with a higher risk of dementia (HR comparing extreme quartiles: 2.01, 95\% CI: 1.48-2.72; HR of each SD increment: 1.21, 95\% CI: 1.10-1.32; p-trend < .001) independent of mean body weight and body weight change. This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95\% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis.

CONCLUSION: Our prospective study suggested that greater BWV may be a novel risk factor for dementia.

}, keywords = {Body Weight, Proportional Hazards Models, Prospective Studies, Risk Factors, Weight Loss}, issn = {1758-535X}, doi = {10.1093/gerona/glab372}, author = {Chen, Hui and Zhou, Tianjing and Guo, Jie and Ji, John S and Huang, Liyan and Xu, Weili and Zuo, Guangmin and Lv, Xiaozhen and Zheng, Yan and Hofman, Albert and Ma, Yuan and Yuan, Changzheng} } @article {11069, title = {Middle-aged Americans report more pain than the elderly}, journal = {Research News}, year = {2020}, publisher = {EurekAlert/AAAS}, address = {Washington, D.C.}, abstract = {As people age, they tend to report more acute or chronic pain -- a common sign of getting older. Yet, in the United States, middle-aged adults are now reporting more pain than the elderly, according to a paper published in the Proceedings of the National Academy of Sciences (PNAS).}, keywords = {Aging, Body Weight, Death \& Dying, Gerontology, Longevity, pain, Public Health}, url = {https://www.eurekalert.org/pub_releases/2020-09/puww-mar091720.php}, author = {Huber, B. Rose} } @article {10917, title = {Sense of purpose in life and five health behaviors in older adults}, journal = {Preventive Medicine}, volume = {139}, year = {2020}, abstract = {Accumulating evidence shows that a higher sense of purpose in life is associated with lower risk of chronic conditions and premature mortality. Health behaviors might partially explain these findings, however, the prospective association between sense of purpose and health behaviors is understudied. We tested whether a higher sense of purpose at baseline was associated with lower likelihood of developing unhealthy behaviors over time. Prospective data were from the Health and Retirement Study, a national sample of U.S. older adults. Our sample included 13,770 adults assessed up to five times across eight years. Among people who met recommended guidelines for a given health behavior outcome at baseline, those in the top versus lowest quartile of purpose in life had 24\% lower likelihood of becoming physically inactive (95\% CI: 0.68{\textendash}0.85), 33\% lower likelihood of developing sleep problems (95\% CI: 0.58{\textendash}0.79), and 22\% lower likelihood of developing unhealthy body mass index (BMI) (95\% CI: 0.69{\textendash}0.87) in sociodemographic-adjusted models. Further there was a marginal reduction in smoking relapse (HR = 0.65, 95\% CI: 0.41{\textendash}1.03) and no association with heavy alcohol use (HR = 1.02, 95\% CI: 0.81{\textendash}1.29). Findings for physical inactivity, sleep problems, and unhealthy BMI remained evident after further adjusting for baseline health status and depression. Our results, suggest that a sense of purpose in life might emerge (with further research) as a valuable target to consider for interventions aimed at helping older adults maintain some health behaviors.}, keywords = {Alcohol Consumption, Body Weight, Epidemiology, Health behaviors, Health psychology, Physical activity, psychological well-being, Purpose in life, Sleep, Smoking}, isbn = {0091-7435}, doi = {10.1016/j.ypmed.2020.106172}, author = {Eric S Kim and Shiba, Koichiro and Boehm, Julia K. and Laura D Kubzansky} } @article {6522, title = {Body weight status and telomere length in U.S. middle-aged and older adults.}, journal = {Obes Res Clin Pract}, volume = {11}, year = {2017}, month = {2017 Jan-Feb}, pages = {51-62}, abstract = {

OBJECTIVE: Telomere length has been proposed as a biomarker of biological aging. This study examined the relationship between body weight status and telomere length in U.S. middle-aged and older adults.

METHODS: Nationally representative data (N=2749) came from the Health and Retirement Study. Linear regressions were performed to examine the relationship between baseline body weight status reported in 1992 and telomere length measured in 2008 in the overall sample and by sex and racial/ethnic groups, adjusted for individual characteristics.

RESULTS: Baseline overweight (25kg/m<=body mass index [BMI]<30kg/m) and obesity (BMI>=30kg/m) status positively predicted telomere length 17 years later. Compared with their normal weight counterparts, telomere length ratio was on average 0.062 (95\% confidence interval=0.016, 0.109) and 0.125 (0.048, 0.202) larger among overweight and obese adults, respectively. In comparison to women and racial/ethnic minorities, the estimated positive associations between overweight and obesity status and telomere length were more salient among men and non-Hispanic whites, respectively.

CONCLUSIONS: The positive association between body weight status and telomere length found in this study was opposite to what existing biological model predicts, and could partially relate to the nonlinear relationship between body weight status and telomere length across age cohorts, and/or the lack of reliability of BMI as an indicator for adiposity in the older population. Large-scale longitudinal studies with baseline telomere length measures are warranted to replicate this study finding and explore the potential heterogeneous relationship between body weight status and telomere length.

}, keywords = {Aged, Aging, Body Mass Index, Body Weight, ethnicity, Female, Humans, Linear Models, Male, Middle Aged, Obesity, Overweight, Racial Groups, Risk Factors, Sex Factors, Telomere, Telomere Shortening, United States, White People}, issn = {1871-403X}, doi = {10.1016/j.orcp.2016.01.003}, author = {An, Ruopeng and Yan, Hai} } @article {8700, title = {Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. adults.}, journal = {Health Psychol}, volume = {36}, year = {2017}, month = {2017 Feb}, pages = {112-121}, abstract = {

OBJECTIVE: Obesity has been shown to increase risk of depression. Persons with obesity experience discrimination because of their body weight. Across 3 studies, we tested for the first time whether experiencing (perceived) weight-based discrimination explains why obesity is prospectively associated with increases in depressive symptoms.

METHOD: Data from 3 studies, including the English Longitudinal Study of Ageing (2008/2009-2012/2013), the Health and Retirement Study (2006/2008-2010/2012), and Midlife in the United States (1995/1996-2004/2005), were used to examine associations between obesity, perceived weight discrimination, and depressive symptoms among 20,286 U.S. and U.K. adults.

RESULTS: Across all 3 studies, Class II and III obesity were reliably associated with increases in depressive symptoms from baseline to follow-up. Perceived weight-based discrimination predicted increases in depressive symptoms over time and mediated the prospective association between obesity and depressive symptoms in all 3 studies. Persons with Class II and III obesity were more likely to report experiencing weight-based discrimination, and this explained approximately 31\% of the obesity-related increase in depressive symptoms on average across the 3 studies.

CONCLUSION: In U.S. and U.K. samples, the prospective association between obesity (defined using body mass index) and increases in depressive symptoms in adulthood may in part be explained by perceived weight discrimination. (PsycINFO Database Record

}, keywords = {Adult, Aged, Body Weight, depression, Female, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, Prejudice, Prospective Studies, United Kingdom, United States, Young Adult}, issn = {1930-7810}, doi = {10.1037/hea0000426}, author = {Robinson, Eric and Angelina R Sutin and Daly, Michael} } @article {8510, title = {Trajectories of body mass indices and development of frailty: Evidence from the health and retirement study.}, journal = {Obesity (Silver Spring)}, volume = {24}, year = {2016}, month = {2016 08}, pages = {1643-7}, abstract = {

OBJECTIVE: To estimate trajectories of body mass index (BMI) and determine their association with incident frailty in later life.

METHODS: Data come from the 2004 to 2012 waves of the Health and Retirement Study, a longitudinal survey of older adults. Analysis was restricted to respondents who were not frail at baseline (n = 10,827). BMI (kg/m(2) ) was calculated from self-reported weight and height. Incident frailty was assessed using the Frailty Index. Longitudinal growth mixture modeling was used to estimate the relationship between BMI trajectories and incident frailty over a 10-year period.

RESULTS: Four trajectory classes were identified: weight gain (n = 162 [1.4\%], mean final BMI = 42 kg/m(2) ), weight loss (n = 171 [1.7\%], mean final BMI = 25.0 kg/m(2) ), consistent obesity (n = 640 [6.8\%], mean final BMI = 34.7 kg/m(2) ), and consistent overweight (n = 9,864 [90.1\%] mean final BMI = 26.0 kg/m(2) ). Cumulative incidence of frailty was 19.9\%. Relative to the consistent overweight class, the weight gain class had the highest likelihood of incident frailty (odds ratio, OR: 3.61, 95\% confidence interval, CI: 2.39-5.46). The consistent obesity (OR: 2.72, 95\% CI: 2.06-3.58) and weight loss (OR: 2.81, 95\% CI: 1.84-4.30) classes had similarly elevated risk of frailty.

CONCLUSIONS: Weight change and obesity are associated with risk of frailty.

}, keywords = {Aged, Aged, 80 and over, Body Mass Index, Body Weight, Female, Frail Elderly, Geriatric Assessment, Health Status, Humans, Incidence, Longitudinal Studies, Male, Obesity, Retirement, Risk Factors, Weight Gain}, issn = {1930-739X}, doi = {10.1002/oby.21572}, url = {http://www.ncbi.nlm.nih.gov/pubmed/27355440}, author = {Briana Mezuk and Matthew C. Lohman and Rock, Andrew K and Payne, Martha E} } @article {8812, title = {Validating a summary measure of weight history for modeling the health consequences of obesity.}, journal = {Ann Epidemiol}, volume = {26}, year = {2016}, month = {2016 12}, pages = {821-826.e2}, abstract = {

PURPOSE: Data on weight history may enhance the predictive validity of epidemiologic models of the health risks of obesity, but collecting such data is often not feasible. In this study, we investigate the validity of a summary measure of weight history.

METHODS: We evaluated the quality of reporting of maximum weight in a sample of adults aged 50-84~years using data from the Health and Retirement Study. Recalled max body mass index (BMI, measured in kilogram per square meter) based on recalled weight in 2004 was compared with calculated max BMI based on self-reported weight collected biennially between 1992 and 2004. Logistic regression was used to assess similarity between the measures in predicting prevalent conditions.

RESULTS: The correlation coefficient between recalled and calculated max weight in the overall sample was 0.95. Recalled max BMI value was within three BMI units of the calculated value 91.4\% of the time. The proportions of individuals with obese I (BMI: 30.0-34.9), obese II (BMI: 35.0-39.9), and obese III (BMI: 40.0 and above) were 28.8\%, 12.7\%, and 6.6\% using recalled values compared with 27.1\%, 10.5\%, and 4.9\% using calculated values. In multivariate analyses, the two BMI measures similarly predicted disease prevalence across a number of chronic conditions.

CONCLUSIONS: Recalled max BMI was strongly correlated with max BMI calculated over the 12-year period before recall, suggesting that this measure can serve as a reliable summary measure of recent weight status.

}, keywords = {Aged, Aged, 80 and over, Body Mass Index, Body Weight, Chronic disease, Female, Health Surveys, Humans, Logistic Models, Longitudinal Studies, Male, Middle Aged, Obesity, Self Report, United States}, issn = {1873-2585}, doi = {10.1016/j.annepidem.2016.10.005}, url = {http://linkinghub.elsevier.com/retrieve/pii/S1047279716304070http://api.elsevier.com/content/article/PII:S1047279716304070?httpAccept=text/xmlhttp://api.elsevier.com/content/article/PII:S1047279716304070?httpAccept=text/plain}, author = {Andrew C. Stokes and Ni, Yu} } @article {8220, title = {Estimating the Effects of Obesity and Weight Change on Mortality Using a Dynamic Causal Model.}, journal = {PLoS One}, volume = {10}, year = {2015}, note = {Times Cited: 0 0}, month = {2015}, pages = {e0129946}, publisher = {10}, abstract = {

BACKGROUND: A well-known challenge in estimating the mortality risks of obesity is reverse causality attributable to illness-associated and smoking-associated weight loss. Given that the likelihood of chronic and acute illnesses rises with age, reverse causality is most threatening to estimates derived from elderly populations.

METHODS: I analyzed data from 12,523 respondents over 50 years old from a nationally representative longitudinal dataset, the Health and Retirement Study (HRS). The effects of both baseline body weight and time-varying weight change on mortality are estimated, adjusting for demographic and socio-economic variables, as well as time-varying confounders including illness and smoking. Body weight is measured by body mass index (BMI). In survival models for mortality, illness and smoking were lagged to minimize bias from reverse causality in estimates of the effect of weight change. Furthermore, because illness both causes and is caused by changes in BMI, I used a marginal structural model (MSM) rather than standard adjustment to control confounding by this and other time-dependent factors.

RESULTS: Overall, relative to normal weight, underweight and Class II/III at baseline are associated with hazard ratios that are 2.07 (95\% confidence interval (CI): 1.28-3.37) and 1.82 (1.54-2.16) respectively, whereas overweight and Class I obesity do not significantly lower or raise the mortality risks. Furthermore, relative to stable weight change, all types of weight change lead to significantly increased risk of mortality. Specifically, large weight loss results in a mortality risk that is nearly 3.86 (3.26-4.58) times of staying in the stable weight range and small weight loss is about 1.81 (1.55-2.11 ) times riskier. In contrast, large weight gain and small weight gain are associated with hazard ratios that are 1.98 (1.67-2.35) and 1.20 (1.02-1.41) respectively.

CONCLUSIONS: Being underweight or severe obese at baseline is associated with excess mortality risk, and weight change tend to raise mortality risk. Both the confounding by illness and by smoking lead to overestimates of the effects of being underweight at baseline and of weight loss, but underestimates the effect of being obese at baseline.

}, keywords = {Aged, Aged, 80 and over, Body Mass Index, Body Weight, Female, Humans, Male, Middle Aged, Models, Theoretical, Obesity, Overweight, Risk Factors, Thinness, Weight Gain, Weight Loss}, issn = {1932-6203}, doi = {10.1371/journal.pone.0129946}, author = {Cao, Bochen} } @article {8236, title = {Variation in the effects of family background and birth region on adult obesity: results of a prospective cohort study of a Great Depression-era American cohort.}, journal = {BMC Public Health}, volume = {15}, year = {2015}, note = {Export Date: 9 September 2015}, month = {2015 Jun 05}, pages = {535}, publisher = {15}, abstract = {

BACKGROUND: Studies have identified prenatal and early childhood conditions as important contributors to weight status in later life. To date, however, few studies have considered how weight status in adulthood is shaped by regional variation in early-life conditions, rather than the characteristics of the individual or their family. Furthermore, gender and life course differences in the salience of early life conditions to weight status remain unclear. This study investigates whether the effect of family background and birth region on adult obesity status varies by gender and over the life course.

METHODS: We used data from a population-based cohort of 6,453 adults from the Health and Retirement Study, 1992-2008. Early life conditions were measured retrospectively at and after the baseline. Obesity was calculated from self-reported height and weight. Logistic models were used to estimate the net effects of family background and birth region on adulthood obesity risk after adjusting for socioeconomic factors and health behaviors measured in adulthood. Four economic and demographic data sets were used to further test the birthplace effect.

RESULTS: At ages 50-61, mother{\textquoteright}s education and birth region were associated with women{\textquoteright}s obesity risk, but not men{\textquoteright}s. Each year{\textquoteright}s increase in mother{\textquoteright}s education significantly reduces the odds of being obese by 6\% (OR = 0.94; 95\% CI: 0.92, 0.97) among women, and this pattern persisted at ages 66-77. Women born in the Mountain region were least likely to be obese in late-middle age and late-life. Measures of per capita income and infant mortality rate in the birth region were also associated with the odds of obesity among women.

CONCLUSIONS: Women{\textquoteright}s obesity status in adulthood is influenced by early childhood conditions, including regional conditions, while adulthood health risk factors may be more important for men{\textquoteright}s obesity risk. Biological and social mechanisms may account for the gender difference.

}, keywords = {Aged, Aged, 80 and over, Body Weight, Cohort Studies, ethnicity, Family Characteristics, Female, Health Behavior, Humans, Interviews as Topic, Logistic Models, Male, Middle Aged, Obesity, Prospective Studies, Qualitative Research, Retirement, Risk Factors, Socioeconomic factors, United States}, issn = {1471-2458}, doi = {10.1186/s12889-015-1870-7}, url = {http://www.scopus.com/inward/record.url?eid=2-s2.0-84934903370andpartnerID=40andmd5=b19c15d412d4437881f0111906f49570}, author = {Hui Zheng and Dmitry Tumin} } @article {7993, title = {Testing the key assumption of heritability estimates based on genome-wide genetic relatedness.}, journal = {J Hum Genet}, volume = {59}, year = {2014}, month = {2014 Jun}, pages = {342-5}, publisher = {59}, abstract = {

Comparing genetic and phenotypic similarity among unrelated individuals seems a promising way to quantify the genetic component of traits while avoiding the problematic assumptions plaguing twin- and other kin-based estimates of heritability. One approach uses a Genetic Relatedness Estimation through Maximum Likelihood (GREML) model for individuals who are related at less than 0.025 to predict their phenotypic similarity by their genetic similarity. Here we test the key underlying assumption of this approach: that genetic relatedness is orthogonal to environmental similarity. Using data from the Health and Retirement Study (and two other surveys), we show two unrelated individuals may be more likely to have been reared in a similar environment (urban versus nonurban setting) if they are genetically similar. This effect is not eliminated by controls for population structure. However, when we include this environmental confound in GREML models, heritabilities do not change substantially and thus potential bias in estimates of most biological phenotypes is probably minimal.

}, keywords = {Body Height, Body Weight, Educational Status, Gene-Environment Interaction, Genome, Human, Humans, Likelihood Functions, Models, Genetic, Phenotype, Quantitative Trait, Heritable, Urban Population}, issn = {1435-232X}, doi = {10.1038/jhg.2014.14}, author = {Dalton C Conley and Mark L Siegal and Benjamin W Domingue and Kathleen Mullan Harris and Matthew B McQueen and Jason D Boardman} } @article {7717, title = {Health investment decisions in response to diabetes information in older Americans.}, journal = {J Health Econ}, volume = {31}, year = {2012}, month = {2012 May}, pages = {502-20}, publisher = {31}, abstract = {

Diabetes is a very common and serious chronic disease, and one of the fastest growing disease burdens in the United States. Further, health behaviors, such as exercise, smoking, drinking, as well as weight status, are instrumental to diabetes management and the reduction of its medical consequences. Nine waves of the Health and Retirement Study are used to model the role of a recent diabetes diagnosis and medication on present and subsequent weight status, exercise, drinking and smoking activity. Several non-linear dynamic population average probit models are estimated. Results suggest that compared to non-diagnosed individuals at risk for high blood sugar, diagnosed diabetics respond initially in terms of increasing exercise, losing weight, and curbing smoking and drinking behavior, but the effect diminishes after diagnosis. Evidence of recidivism is also found in these outcomes, especially weight status and physical activity, suggesting that some behavioral responses to diabetes may be short-lived.

}, keywords = {Adult, Age Factors, Aged, Aged, 80 and over, Alcohol Drinking, Body Weight, Decision making, Diabetes Mellitus, Empirical Research, Exercise, Female, Health Behavior, Health Surveys, Humans, Male, Middle Aged, Models, Psychological, Smoking, United States}, issn = {1879-1646}, doi = {10.1016/j.jhealeco.2012.04.001}, author = {Alexander N Slade} } @article {7751, title = {The relationship between body weight, frailty, and the disablement process.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {67}, year = {2012}, month = {2012 Sep}, pages = {618-26}, publisher = {67}, abstract = {

OBJECTIVES: To prospectively examine the relationship between body weight, frailty, and the disablement process.

METHOD: Longitudinal data from the Health and Retirement Study (1998-2006) were used to examine the relationship between being underweight, overweight, or obese (compared with normal weight) and the onset and progression of functional limitations and disabilities in instrumental activities of daily living (IADL) and activities of daily living (ADL) among a nationally representative sample of community-dwelling older adults (aged 50 and older) with characteristics of frailty (n= 11,491). Nonlinear multilevel models additionally adjusted for demographic characteristics and intra-individual changes in body weight, socioeconomic status, health behaviors, and health conditions over the course of 8 years.

RESULTS: Compared with their nonfrail normal weight counterparts, prefrail obese respondents have a 16\% (p <= 0.001) reduction in the expected functional limitations rate and frail overweight and obese respondents have a 10\% (p <= 0.01) and 36\% (p <= 0.001) reduction in the expected functional limitations rate, respectively. In addition, frail obese respondents have a 27\% (p <= 0.05) reduction in the expected ADL disability rate.

DISCUSSION: This study{\textquoteright}s findings suggest that underweight, overweight, and obese status differentially affect the risk for functional limitations and disabilities in IADL and ADL. Among prefrail and frail adults, some excess body weight in later life may be beneficial, reducing the rate of functional limitations and disability.

}, keywords = {Activities of Daily Living, Aged, Body Weight, Cross-Sectional Studies, Disability Evaluation, Disabled Persons, Female, Frail Elderly, Geriatric Assessment, Health Behavior, Health Surveys, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Overweight, Physical Fitness, Prospective Studies, sarcopenia, Socioeconomic factors, Thinness, United States}, issn = {1758-5368}, doi = {10.1093/geronb/gbs067}, author = {Mary E Bowen} } @article {7517, title = {Can racial disparity in health between black and white Americans be attributed to racial disparities in body weight and socioeconomic status?}, journal = {Health Soc Work}, volume = {35}, year = {2010}, month = {2010 Nov}, pages = {257-66}, publisher = {35}, abstract = {

Few studies have examined to what extent racial disparities in chronic health conditions (CHCs) are attributable to racial differences in body weight (measured as body mass index [BMI]) and socioeconomic status (SES) among older adults. To address this gap, using longitudinal data from the Health and Retirement Study, the current study examined risk factors of CHC trajectory including race, BMI, and SES. The sample consists of 22,560 in 1998, 20,825 in 2000, and 19,004 in 2002. Data analysis was done through latent growth curve modeling. As expected, older adults presented an increasing trajectory of CHCs over time. Black Americans presented a significantly more negative CHC trajectory than did their white counterparts, confirming racial disparity in health over time. Consequent hierarchical analyses revealed that racial disparity in CHC trajectory can be explained by racial disparity in BMI and that racial disparity in BMI can be attributed to racial disparity in SES. Because low SES is closely related to unhealthy diet and negative health behaviors that may subsequently lead to obesity and chronic health conditions, the findings suggest that to address racial disparity in CHCs, it is important for social workers to continuously try to mitigate racial inequality in SES.

}, keywords = {Aged, Black or African American, Body Mass Index, Body Weight, Female, Health Surveys, Healthcare Disparities, Humans, Male, Middle Aged, Social Class, United States, White People}, issn = {0360-7283}, doi = {10.1093/hsw/35.4.257}, author = {Kahng, Sang Kyoung} } @article {7437, title = {The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.}, journal = {Soc Psychiatry Psychiatr Epidemiol}, volume = {45}, year = {2010}, month = {2010 Jan}, pages = {67-76}, publisher = {45}, abstract = {

OBJECTIVES: We investigated the longitudinal association between depressive symptoms and glycemic control (HbA1c) in adults with type 2 diabetes, and the extent to which that association was explained by health behaviors.

METHODS: This study assessed data on 998 adults (aged 51 and above) with type 2 diabetes in the US nationally representative Health and Retirement Study and its diabetes-specific mail survey. Participants{\textquoteright} depressive symptoms and baseline health behaviors (exercise, body weight control, and smoking status) were collected in 1998. Follow-up health behaviors and the glycemic control outcome were measured at a 2- and 5-year intervals, respectively.

RESULTS: Nearly one in four of participants (23\%) reported moderate or high levels of depressive symptoms at baseline (CES-D score >or=3). Adults with higher levels of depressive symptoms at baseline showed lower scores on baseline and follow-up health behaviors as well as higher HbA1c levels at a 5-year follow-up. Structural equation models (SEM) reveal that health behaviors accounted for 13\% of the link between depressive symptoms and glycemic control.

CONCLUSIONS: The long-term relationship between depressive symptoms and glycemic control was supported in the present study. Health behaviors, including exercise, body weight control, and smoking status, explained a sizable amount of the association between depressive symptoms and glycemic control. More comprehensive diabetes self-care behaviors should be examined with available data. Other competing explicators for the link, such as endocrinological process and antidepressant effects, also warrant further examination.

}, keywords = {Adult, Aged, Blood Glucose, Body Weight, Comorbidity, depression, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glycated Hemoglobin, Glycemic Index, Health Behavior, Health Surveys, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Self Care, Smoking, United States}, issn = {1433-9285}, doi = {10.1007/s00127-009-0043-3}, author = {Chiu, Ching-Ju and Linda A. Wray and Elizabeth A Beverly and Oralia G Dominic} } @article {7442, title = {Self-reported versus measured height and weight in the health and retirement study.}, journal = {J Am Geriatr Soc}, volume = {58}, year = {2010}, month = {2010 Feb}, pages = {412-3}, publisher = {58}, keywords = {Aged, Body Height, Body Weight, Female, Humans, Male, Middle Aged, Obesity, Population Surveillance, Prevalence, Reproducibility of Results, Sensitivity and Specificity, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2009.02713.x}, author = {Meng, Hongdao and Xiaoxing He and Dixon, Denise} } @article {7239, title = {Retirement and weight changes among men and women in the health and retirement study.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {63}, year = {2008}, month = {2008 May}, pages = {S146-53}, publisher = {63B}, abstract = {

OBJECTIVES: Older adults may experience weight changes upon retirement for a number of reasons, such as being less physically active; having less structured meal times; and consuming food in response to losing personal identity, the potential for social interactions, or the sense of accomplishment derived from working. The purpose of this study was to determine whether retirement was associated with either weight gain or weight loss.

METHODS: We used the 1994-2002 Health and Retirement Study to determine whether retirement between biennial interviews was associated with weight change, separately for men (n = 1,966) and women (n = 1,759). We defined weight change as a 5\% increase or decrease in body mass index between interviews.

RESULT: . We did not find a significant association between retirement and weight change among men. Women who retired were more likely to gain weight than women who continued to work at least 20 hr per week (odds ratio [OR] = 1.24, 95\% confidence interval [CI] = 1.04-1.48). We found a significant relationship between retirement and weight gain only for women who were normal weight upon retiring (OR = 1.30, 95\% CI = 1.01-1.69) and who retired from blue-collar jobs (OR = 1.58, 95\% CI = 1.13-2.21).

DISCUSSION: Public health interventions may be indicated for women, particularly those working in blue-collar occupations, in order to prevent weight gain upon retirement.

}, keywords = {Aged, Aging, Body Mass Index, Body Weight, Demography, depression, Female, Health Behavior, Health Status, Humans, Interviews as Topic, Male, Middle Aged, Obesity, Retirement}, issn = {1079-5014}, doi = {10.1093/geronb/63.3.s146}, author = {Valerie L Forman-Hoffman and Kelly K Richardson and Jon W. Yankey and Stephen L Hillis and Robert B Wallace and Frederic D Wolinsky} } @article {7140, title = {Informal caregiving and Body Mass Index among older adults.}, journal = {J Gerontol Nurs}, volume = {33}, year = {2007}, month = {2007 Apr}, pages = {42-51}, publisher = {33}, abstract = {

The authors sought to obtain nationally representative estimates of the time of informal caregiving provided to older adults classified into the four standard Body Mass Index (BMI) classifications. They estimated multivariate regression models using data from the 2000 Health and Retirement Study to determine the weekly hours of informal caregiving for older adults classified into the four standard BMI classifications. In the fully adjusted models, being underweight was associated with receiving significantly more informal care, however, obesity was not associated with more informal care. The implications of these findings are discussed in terms of nursing practice and research to prevent weight loss and frailty.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Body Mass Index, Body Weight, Caregivers, Female, Geriatric Assessment, Humans, Male, Social Class}, issn = {0098-9134}, doi = {10.3928/00989134-20070401-06}, author = {Kristi Rahrig Jenkins and Mohammed U Kabeto and Fultz, Nancy H. and Kenneth M. Langa} } @article {7042, title = {Social status and risky health behaviors: results from the health and retirement study.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {60 Spec No 2}, year = {2005}, month = {2005 Oct}, pages = {85-92}, publisher = {60B}, abstract = {

OBJECTIVES: We focus on a hypothesized mechanism that may underlie the well-documented link between social status and health-behavioral health risks.

METHODS: We use longitudinal data from representative samples of 6,106 middle-aged and 3,636 older adults from the Health and Retirement Study to examine the relationships between social status-including early life social status (e.g., parental schooling), ascribed social status (e.g., sex, race-ethnicity), and achieved social status (e.g., schooling, economic resources)-and behavioral health risks (e.g., weight, smoking, drinking, physical activity) to (1) assess how early life and ascribed social statuses are linked to behavioral health risks, (2) investigate the role of achieved factors in behavioral health risks, (3) test whether achieved status explains the contributions of early life and ascribed status, and (4) examine whether the social status and health risk relationships differ at midlife and older age.

RESULTS: We find that early life, achieved, and ascribed social statuses strongly predict behavioral health risks, although the effects are stronger in midlife than they are in older age.

DISCUSSION: Ascribed social statuses (and interactions of sex and race-ethnicity), which are important predictors of behavioral health risks even net of early life and achieved social status, should be explored in future research.

}, keywords = {Aged, Aging, Alcohol Drinking, Body Weight, Exercise, Female, Health Behavior, Humans, Life Style, Likelihood Functions, Logistic Models, Longitudinal Studies, Male, Middle Aged, Smoking, Social Class, United States}, issn = {1079-5014}, doi = {10.1093/geronb/60.special_issue_2.s85}, author = {Linda A. Wray and Duane F. Alwin and Ryan J McCammon} } @article {7013, title = {Survival expectations of the obese: Is excess mortality reflected in perceptions?}, journal = {Obes Res}, volume = {13}, year = {2005}, month = {2005 Apr}, pages = {754-61}, publisher = {13}, abstract = {

OBJECTIVE: This study compared self-reported subjective life expectancy (i.e., probability of living to age 75) for normal-weight, overweight, and obese weight groups to examine whether individuals are internalizing information about the health risks due to excessive weight.

RESEARCH METHODS AND PROCEDURES: Using data from the Health and Retirement Study, a total of 9035 individuals 51 to 61 years old were analyzed by BMI category. The primary outcome measure was individuals{\textquoteright} reports about their own expectations of survival to age 75. Absolute and relative risks of survival were compared with published estimates of survival to age 75.

RESULTS: Consistently, higher levels of BMI were associated with lower self-estimated survival probabilities. Differences relative to normal weight ranged from 4.9\% (p < 0.01) for male nonsmokers to 8.8\% (p < 0.001) for female nonsmokers. However, these differences were substantially less than those obtained from published survival curve estimates, suggesting that obese individuals tended to underestimate mortality risks.

DISCUSSION: Individuals appeared to underestimate the mortality risks of excessive weight; thus, knowledge campaigns about the risks of obesity should remain a top priority.

}, keywords = {Aged, Body Mass Index, Body Weight, Diabetes Mellitus, Female, Health Surveys, Humans, Hypertension, Male, Obesity, Perception, Retirement, Smoking, Surveys and Questionnaires, Survival Rate}, issn = {1071-7323}, doi = {10.1038/oby.2005.85}, author = {Tracy Falba and Susan H. Busch} } @article {6940, title = {Body-weight change and physical functioning among young old adults.}, journal = {J Aging Health}, volume = {16}, year = {2004}, month = {2004}, pages = {248-66}, publisher = {16}, abstract = {

OBJECTIVES: The main purpose of this study is to examine if body weight change is a potential risk factor for the onset of functional impairment across time among various functional domains.

METHODS: Using longitudinal data from the Health and Retirement Study, logistic regression models on the onset of functional impairment over three time points are estimated for young old adults.

RESULTS: Results indicate that weight gain is associated with greater risk of lower body mobility impairment. An increase in body mass index of greater than 5\% increases the likelihood of the onset of lower body mobility functional impairment.

DISCUSSION: Study findings support the promotion of healthy weight management. Future studies in this area may want to investigate effective interventions that contribute to healthy weight maintenance among this cohort.

}, keywords = {Activities of Daily Living, Aged, Body Weight, Demography, Exercise, Health Behavior, Humans, Movement Disorders, Socioeconomic factors}, issn = {0898-2643}, doi = {10.1177/0898264303262626}, author = {Kristi Rahrig Jenkins} } @article {6962, title = {Changes in weight among a nationally representative cohort of adults aged 51 to 61, 1992 to 2000.}, journal = {Am J Prev Med}, volume = {27}, year = {2004}, month = {2004 Jul}, pages = {8-15}, publisher = {27}, abstract = {

BACKGROUND: Few studies have examined patterns and predictors of changes in body weight among adults in late middle age.

METHODS: Prospective cohort study of 7391 community-dwelling U.S. adults aged 51 to 61 years at baseline (1992), using publicly available data files from the 1992, 1994, 1996, 1998, and 2000 Health and Retirement Survey interviews. Changes in weight and body mass index (BMI) were examined for different racial/ethnic groups of men and women. The predictors of changes in body weight and BMI were determined using gender-specific linear regression.

RESULTS: Mean body weight and BMI increased in both genders and all ethnic groups. The mean weight gain was higher for women (1.67 kg, 95\% confidence interval [CI]=1.34-1.99) than for men (1.43 kg, 95\% CI=1.17-1.68). White men and women had the lowest baseline BMI but tended to gain more weight than other racial/ethnic groups. In multivariate analyses, individuals who were older or had higher baseline weight showed less weight gain. Men were less likely to gain weight if their self-reported overall health at baseline was poor compared to those in excellent health. Regular light or vigorous recreational activities and work-related activities were not associated with less weight gain. Race, education, and income were not associated with weight gain in multivariate analyses.

CONCLUSIONS: All population subgroups are at risk for weight gain. Public health messages should target diverse populations. The current levels of physical activity attained by this population do not appear to protect against weight gain.

}, keywords = {Body Mass Index, Body Weight, Female, Health Surveys, Humans, Linear Models, Longitudinal Studies, Male, Middle Aged, Motor Activity, Multivariate Analysis, Prospective Studies, Racial Groups, Sex Factors, United States}, issn = {0749-3797}, doi = {10.1016/j.amepre.2004.03.016}, author = {Xiaoxing He and David W. Baker} } @article {6977, title = {Moderate and severe obesity have large differences in health care costs.}, journal = {Obes Res}, volume = {12}, year = {2004}, month = {2004 Dec}, pages = {1936-43}, publisher = {12}, abstract = {

OBJECTIVE: To analyze health care use and expenditures associated with varying degrees of obesity for a nationally representative sample of individuals 54 to 69 years old.

RESEARCH METHODS AND PROCEDURES: Data from the Health and Retirement Study, a nationwide biennial longitudinal survey of Americans in their 50s, were used to estimate multivariate regression models of the effect of weight class on health care use and costs. The main outcomes were total health care expenditures, the number of outpatient visits, the probability of any inpatient stay, and the number of inpatient days.

RESULTS: The results indicated that there were large differences in obesity-related health care costs by degree of obesity. Overall, a BMI of 35 to 40 was associated with twice the increase in health care expenditures above normal weight (about a 50\% increase) than a BMI of 30 to 35 (about a 25\% increase); a BMI of over 40 doubled health care costs (approximately 100\% higher costs above those of normal weight). There was a difference by gender in how health care use and costs changed with obesity class. The primary effect of increasing weight class on health care use appeared to be through elevated use of outpatient health care services.

DISCUSSION: Obesity imposes an increasing burden on the health care system, and that burden grows disproportionately large for the most obese segment of the U.S. population. Because the prevalence of severe obesity is increasing much faster than that of moderate obesity, average estimates of obesity effects obscure real consequences for individuals, physician practices, hospitals, and health plans.

}, keywords = {Aged, Ambulatory Care, Body Mass Index, Body Weight, Female, Health Care Costs, Hospitalization, Humans, Male, Middle Aged, Obesity, Sex Characteristics}, issn = {1071-7323}, doi = {10.1038/oby.2004.243}, author = {Andreyeva, Tatiana and Sturm, Roland and Ringel, Jeanne S.} } @article {6915, title = {Obesity{\textquoteright}s effects on the onset of functional impairment among older adults.}, journal = {Gerontologist}, volume = {44}, year = {2004}, month = {2004 Apr}, pages = {206-16}, publisher = {44}, abstract = {

PURPOSE: This study has two purposes. First, it determines if there is a relationship between body weight and the onset of functional impairment across time among this sample of older adults. More specifically, it examines if obese older adults are more likely to experience the onset of functional impairment. Second, it explores how health behaviors and health conditions may explain the relationship between body weight and the onset of functional impairment.

DESIGN AND METHODS: With the use of longitudinal data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, logistic regression models on the onset of functional impairment over two time points are estimated for older adults.

RESULTS: Results indicate that body weight (more specifically being overweight or obese) makes one more likely to experience the onset of functional impairment across various domains of impairment. Outside of health behaviors and health conditions, obesity has an independent effect on the onset of impairment in strength, lower body mobility, and activities of daily living.

IMPLICATIONS: Study findings support the active treatment of weight problems in older adults. Future directions for research in this area should address effective weight management interventions targeting issues related to older individuals.

}, keywords = {Activities of Daily Living, Aged, Aged, 80 and over, Body Weight, Chronic disease, Disabled Persons, Exercise, Female, Humans, Longitudinal Studies, Male, Motor Activity, Movement, Obesity, Risk-Taking, United States}, issn = {0016-9013}, doi = {10.1093/geront/44.2.206}, author = {Kristi Rahrig Jenkins} }