Guest guest Posted January 19, 2005 Report Share Posted January 19, 2005 The numbers were sent to me to show there were those over 75 who were obese, So, I looked more into it last nite and this is what I found out.. The post I was sent, (and my reply) said... " " There are very sigificant numbers of overweight and obese people who do live into their 70's and 80's. and not doing very well at all. The information is based on telephone surveys and self reported data. Form the actual report... http://www.publichealthreports.org/userfiles/119_3/119356.pdf " We analyzed data from the BRFSS for all 50 states and the District of Columbia. The BRFSS is a cross-sectional telephone survey conducted by state health departments with assistance from the Centers for Disease Control and Prevention (CDC). Questions on the BRFSS questionnaire are used primarily to monitor personal behaviors that increase risk of death. The BRFSS uses a multistage cluster design based on random-digit dialing to select a representative sample from each state's adult noninstitutionalized civilian residents aged 18 years or older. State data are pooled to produce nationally representative estimates. The report actually concluded... " Although older Americans appear to be living more healthfully now, their higher rates of obesity, high blood pressure, and diabetes are not good signs; perhaps these rates can be tied to the higher rates we found for days of poor physical and mental health.7 So, I next looked up the actual questionairres they used which you can find here to see how they asked the questions... http://www.cdc.gov/brfss/questionnaires/pdf-ques/2000brfss.pdf To determine BMI, the phone survey asked ... 10.13. About how much do you weigh without shoes? Weight pounds Don't know/Not sure Refused 10.14. About how tall are you without shoes? (166-168) Height /ft/inches Don't know/Not sure Refused I next went to reference 7 which was referenced for the above comment about the higher rates of obesity not being a good sign ... 7. Ford ES, Moriarty DG, Zack MM, Mokdad AH, Chapman DP. Self-reported body mass index and healthrelated quality of life: findings from the Behavioral Risk Factor Surveillance System. Obes Res 2001;9:21-31. we all can read the full text here http://www.obesityresearch.org/cgi/content/full/9/1/21 Instead of highlighting one or two sentences, I though the information was valuable, so I am copying the final discussion. All mentioned references can be found at the above link. Discussion: In the largest study yet to examine the relationship between self-reported BMI and health-related quality of life, our results are consistent with findings from previous studies that have shown that overweight and obese persons have a worse health-related quality of life (2) (6) (7) (8) (9) (10) (11) (12) (13) . Our results extend previous findings by showing that the direct associations between excess weight and worse health-related quality of life include all adult age groups, both sexes, and whites, African Americans, and Hispanics. Because we combined representative samples from each of the 50 states, the results of our investigation are generalizable to the U.S. population (31) . In the Swedish Obese Subjects Intervention study, 1743 obese participants had diminished mental well-being and psychosocial functioning compared with 89 healthy reference participants (6) . Overweight and obesity were positively associated with physical impairment (defined as an inability to run a short distance, enter a bus without problems, or take a short walk), reduced mobility, back pain, and severe pain in hands and legs in a representative sample of 12,988 men and 13,414 women from Sweden (7) . Using the SF-36 questionnaire, other investigators have found that health and health-related quality of life worsened as BMI or waist circumference increased (8) (9) (11) (12) (13) . Data from the Monitoring Cardiovascular Health (MORGEN) study in the Netherlands showed that physical functioning and bodily pain were significantly associated with increased BMI among 1885 men and 2156 women (11) . In a reanalysis of these data, these associations were similar using BMI categories adopted by the National Institutes of Health and the World Health Organization (13) . Among 56,510 participants of the Nurses' Health Study, four scales of a modified version of the SF-36 questionnaire (i.e., physical functioning, vitality, bodily pain, and role functioning) were significantly and inversely related to self-reported BMI (8) . In the Whitehall II study, poor physical functioning increased monotonically as BMI increased in 2412 women, whereas poor physical functioning was increased only in 5449 men whose BMI was >=27 kg/m2 (12) . In our study, the number of poor physical health days during the previous 30 days (physical functioning) appeared more strongly related to self-reported BMI than the number of days of poor mental health during the previous 30 days (mental functioning). Although the MORGEN researchers found no association between BMI and the mental health components of the SF-36 (9) , we did find a significant association between BMI and the risk of having >=14 unhealthy mental days during the previous 30 days. That many obese persons experience a diminished health-related quality of life is not surprising. Obese persons are more likely than persons who are not obese to suffer from low self-esteem and depression and to experience poor peer relationships (2) (10) . Prejudice and discrimination directed at obese persons are ubiquitous in U.S. society (32) . Many conditions for which obesity increases risk, such as type 2 diabetes and cardiovascular disease, also decrease health-related quality of life (33) (34) . Furthermore, in at least two prospective studies, overweight persons had an increased risk of disability (35) (36) . The increase in unhealthy days among lean respondents is more difficult to explain. Health-related quality of life among very lean persons has not been studied extensively (7) . The increased mean number of unhealthy days in such respondents agrees with numerous studies showing increased all-cause mortality at lower BMIs (5) . Consistent with previous findings (37) , we found low self-reported BMI to be significantly associated with female gender, a risk factor for anorexia nervosa (38) , and linked to greater weight loss goals when dieting (39) . Lean respondents are likely to be very heterogeneous and include healthy persons who either diet or exercise a lot, persons with eating disorders, and clinically or subclinically sick persons. Such respondents are also more likely to smoke than others. The shape of the relationship between self-reported BMI and the number of unhealthy days (physical or mental) among persons who had never smoked resembled that for the entire analytic sample (data not shown). Unfortunately, the BRFSS does not include information needed to distinguish subgroups (except for current smokers) within lean respondents. Similar to many previous studies, our study was cross-sectional. Such a design provides a snapshot of the burden of adverse effects experienced by obese or very lean persons but does not allow conclusions about cause and effect. Thus, although obesity may reduce quality of life, poor quality of life may be due to other factors that led to weight gain. Because weight and height were self-reported in our study, misclassification may have affected our results. Obese persons are more likely to underreport their weights and over-report their heights than are persons who are not obese (thus decreasing calculated BMI), and men are more likely to over-report their heights than are women (4) . Reliability studies of the BRFSS questionnaires in various settings have reported {kappa} coefficients of 0.77 to 0.96 for BMI and categories of overweight or obese (41) (42) (43) and correlation coefficients of 0.84 to 0.94 for height, weight, and BMI (44) . Validity studies of the BRFSS have shown sensitivities of 0.74 to 0.77 and a specificity of 0.99 for obesity (45) (46) . Correlation coefficients for self-reported height and BMI were 0.94 and 0.96, respectively (45) . The prevalence of obesity from a BRFSS survey was ~45% less than that from the Five-City Project Survey (47) . If little or no misclassification of the reference category occurred, the likely result of misclassification would be relatively accurate ORs for the lowest and highest BMI classes but increased ORs for the intermediate classes. Telephone coverage bias is not likely to have affected these results, because a high proportion of U.S. residents own telephones. The mean BMI for participants with a telephone in the Third National Health and Nutrition Examination Survey resembled that of those without a telephone (48) . However, for subgroups of the U.S. population with low telephone coverage, the associations between BMI and quality of life measurements may differ from those described in this article. In conclusion, this is the largest study to have examined health-related quality of life measures related to self-reported BMI. Our results agree with previous studies and show that health-related quality of life diminishes as BMI increases or decreases from the normal range. With the increasing prevalence of obesity becoming recognized as a public health crisis (49) , our results may be useful in better monitoring the full impact of this health condition and its economic consequences. Health-related quality of life measures from population-based studies such as the BRFSS may provide insights into health perceptions that may affect the efforts of individuals to maintain or change their weight. Regards Jeff Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 19, 2005 Report Share Posted January 19, 2005 Hi Jeff: Most of the charts in the study you linked show that the number of unhealthy days per month is minimized at a BMI of around 24. Both higher **and lower** BMIs are associated with more unhealthy days per month. As regards the rise in unhealthy days at low BMIs, of course sickness may in many cases be the cause of the low BMI. Rather than the low BMI being the cause of the sickness. So if we have a low BMI and are not sick ............ But they didn't have a chart to show the number of unhealthy days per month for wackos eating 800 calories a day. A serious omission, you might agree ; ^ ))) Rodney. --- In , " Jeff Novick " <jnovick@p...> wrote: > The numbers were sent to me to show there were those over 75 who were obese, > > So, I looked more into it last nite and this is what I found out.. > > The post I was sent, (and my reply) said... > > " " There are very sigificant numbers of overweight and obese people who do live into their > 70's and 80's. > > and not doing very well at all. > > The information is based on telephone surveys and self reported data. > > Form the actual report... > > http://www.publichealthreports.org/userfiles/119_3/119356.pdf > > " We analyzed data from the BRFSS for all 50 states and the District of Columbia. The BRFSS is a cross-sectional telephone survey conducted by state health departments with assistance from the Centers for Disease Control and Prevention (CDC). Questions on the BRFSS questionnaire are used primarily to monitor personal behaviors that increase risk of death. The BRFSS uses a multistage cluster design based on random-digit dialing to select a representative sample from each state's adult noninstitutionalized civilian residents aged 18 years or older. State data are pooled to produce nationally representative estimates. > > The report actually concluded... > > " Although older Americans appear to be living more healthfully now, their higher rates of obesity, high blood pressure, and diabetes are not good signs; perhaps these rates can be tied to the higher rates we found for days of poor physical and mental health.7 > > So, I next looked up the actual questionairres they used which you can find here to see how they asked the questions... > > http://www.cdc.gov/brfss/questionnaires/pdf-ques/2000brfss.pdf > > To determine BMI, the phone survey asked ... > > 10.13. About how much do you weigh without shoes? > > Weight > > pounds > > Don't know/Not sure > > Refused > > 10.14. About how tall are you without shoes? (166-168) > > Height /ft/inches > > Don't know/Not sure > > Refused > > > I next went to reference 7 which was referenced for the above comment about the higher rates of obesity not being a good sign > .. > 7. Ford ES, Moriarty DG, Zack MM, Mokdad AH, Chapman DP. Self- reported body mass index and healthrelated quality of life: findings from the Behavioral Risk Factor Surveillance System. Obes Res 2001;9:21-31. > > we all can read the full text here > > http://www.obesityresearch.org/cgi/content/full/9/1/21 > > Instead of highlighting one or two sentences, I though the information was valuable, so I am copying the final discussion. All mentioned references can be found at the above link. > > Discussion: In the largest study yet to examine the relationship between self-reported BMI and health-related quality of life, our results are consistent with findings from previous studies that have shown that overweight and obese persons have a worse health-related quality of life (2) (6) (7) (8) (9) (10) (11) (12) (13) . Our results extend previous findings by showing that the direct associations between excess weight and worse health-related quality of life include all adult age groups, both sexes, and whites, African Americans, and Hispanics. Because we combined representative samples from each of the 50 states, the results of our investigation are generalizable to the U.S. population (31) . > > In the Swedish Obese Subjects Intervention study, 1743 obese participants had diminished mental well-being and psychosocial functioning compared with 89 healthy reference participants (6) . Overweight and obesity were positively associated with physical impairment (defined as an inability to run a short distance, enter a bus without problems, or take a short walk), reduced mobility, back pain, and severe pain in hands and legs in a representative sample of 12,988 men and 13,414 women from Sweden (7) . > > Using the SF-36 questionnaire, other investigators have found that health and health-related quality of life worsened as BMI or waist circumference increased (8) (9) (11) (12) (13) . Data from the Monitoring Cardiovascular Health (MORGEN) study in the Netherlands showed that physical functioning and bodily pain were significantly associated with increased BMI among 1885 men and 2156 women (11) . In a reanalysis of these data, these associations were similar using BMI categories adopted by the National Institutes of Health and the World Health Organization (13) . Among 56,510 participants of the Nurses' Health Study, four scales of a modified version of the SF-36 questionnaire (i.e., physical functioning, vitality, bodily pain, and role functioning) were significantly and inversely related to self- reported BMI (8) . In the Whitehall II study, poor physical functioning increased monotonically as BMI increased in 2412 women, whereas poor physical functioning was increased only in 5449 men whose BMI was >=27 kg/m2 (12) . > > In our study, the number of poor physical health days during the previous 30 days (physical functioning) appeared more strongly related to self-reported BMI than the number of days of poor mental health during the previous 30 days (mental functioning). Although the MORGEN researchers found no association between BMI and the mental health components of the SF-36 (9) , we did find a significant association between BMI and the risk of having >=14 unhealthy mental days during the previous 30 days. > > That many obese persons experience a diminished health-related quality of life is not surprising. Obese persons are more likely than persons who are not obese to suffer from low self-esteem and depression and to experience poor peer relationships (2) (10) . Prejudice and discrimination directed at obese persons are ubiquitous in U.S. society (32) . Many conditions for which obesity increases risk, such as type 2 diabetes and cardiovascular disease, also decrease health-related quality of life (33) (34) . Furthermore, in at least two prospective studies, overweight persons had an increased risk of disability (35) (36) . > > The increase in unhealthy days among lean respondents is more difficult to explain. Health-related quality of life among very lean persons has not been studied extensively (7) . The increased mean number of unhealthy days in such respondents agrees with numerous studies showing increased all-cause mortality at lower BMIs (5) . Consistent with previous findings (37) , we found low self-reported BMI to be significantly associated with female gender, a risk factor for anorexia nervosa (38) , and linked to greater weight loss goals when dieting (39) . Lean respondents are likely to be very heterogeneous and include healthy persons who either diet or exercise a lot, persons with eating disorders, and clinically or subclinically sick persons. Such respondents are also more likely to smoke than others. The shape of the relationship between self-reported BMI and the number of unhealthy days (physical or mental) among persons who had never smoked resembled that for the entire analytic sample (data not shown). Unfortunately, the BRFSS does not include information needed to distinguish subgroups (except for current smokers) within lean respondents. > > Similar to many previous studies, our study was cross-sectional. Such a design provides a snapshot of the burden of adverse effects experienced by obese or very lean persons but does not allow conclusions about cause and effect. Thus, although obesity may reduce quality of life, poor quality of life may be due to other factors that led to weight gain. Because weight and height were self-reported in our study, misclassification may have affected our results. Obese persons are more likely to underreport their weights and over-report their heights than are persons who are not obese (thus decreasing calculated BMI), and men are more likely to over-report their heights than are women (4) . Reliability studies of the BRFSS questionnaires in various settings have reported {kappa} coefficients of 0.77 to 0.96 for BMI and categories of overweight or obese (41) (42) (43) and correlation coefficients of 0.84 to 0.94 for height, weight, and BMI (44) . Validity studies of the BRFSS have shown sensitivities of 0.74 to 0.77 and a specificity of 0.99 for obesity (45) (46) . Correlation coefficients for self-reported height and BMI were 0.94 and 0.96, respectively (45) . The prevalence of obesity from a BRFSS survey was ~45% less than that from the Five-City Project Survey (47) . If little or no misclassification of the reference category occurred, the likely result of misclassification would be relatively accurate ORs for the lowest and highest BMI classes but increased ORs for the intermediate classes. Telephone coverage bias is not likely to have affected these results, because a high proportion of U.S. residents own telephones. The mean BMI for participants with a telephone in the Third National Health and Nutrition Examination Survey resembled that of those without a telephone (48) . However, for subgroups of the U.S. population with low telephone coverage, the associations between BMI and quality of life measurements may differ from those described in this article. > > In conclusion, this is the largest study to have examined health- related quality of life measures related to self-reported BMI. Our results agree with previous studies and show that health-related quality of life diminishes as BMI increases or decreases from the normal range. With the increasing prevalence of obesity becoming recognized as a public health crisis (49) , our results may be useful in better monitoring the full impact of this health condition and its economic consequences. Health-related quality of life measures from population-based studies such as the BRFSS may provide insights into health perceptions that may affect the efforts of individuals to maintain or change their weight. > > > Regards > Jeff Quote Link to comment Share on other sites More sharing options...
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