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Biomedical subjects

J C Seidell

Publications and source records attributed to J C Seidell.

At least 73 records · Page 4Linked to original sources
PubMed1999

Waist and hip circumferences, and waist-hip ratio in 19 populations of the WHO MONICA Project.

OBJECTIVE: To assess differences in waist and hip circumferences and waist-to-hip ratio (WHR) measured using a standard protocol among populations with different prevalences of overweight. In addition, to quantify the associations of these anthropometric measures with age and degree of overweight. DESIGN: Cross-sectional study of random population samples. SUBJECTS: More than 32000 men and women aged 25-64y from 19 (18 in women) populations participating in the second MONItoring trends and determinants in CArdiovascular disease (MONICA) survey from 1987-1992. RESULTS: Age standardized mean waist circumference range between populations from 83-98 cm in men and from 78-91cm in women. Mean hip circumference ranged from 94-105cm and from 97-108cm in men and women, respectively, and mean WHR from 0.87-0.99 and from 0.76-0.84, respectively. Together, height, body mass index (BMI), age group and population explained about 80% of the variance in waist circumference. BMI was the predominant determinant (77% in men, 75% women). Similar results were obtained for hip circumference. However, height, BMI, age group and population, accounted only for 49% (men) and 30% (women) the variation in WHR. CONCLUSION: Considerable variation in waist and hip circumferences and WHR were observed among the study populations. Waist circumference and WHR, both of which are used as indicators of abdominal obesity, seem to measure different aspects of the human body: waist circumference reflects mainly the degree of overweight whereas WHR does not.

Adult↗
PubMed1999

Perception of weight status and dieting behaviour in Dutch men and women.

OBJECTIVE: To study the perception of weight status, the accuracy of self-assessment of weight status and weight control practices relative to the degree of adiposity in Dutch men and women. DESIGN: A cross-sectional study. SUBJECTS: 2155 men and 2446 women, aged 20-65y, of mostly caucasian origin, non-diabetic, not pregnant or with cancer. MEASUREMENTS: Body weight, height, waist and hip, total cholesterol, high density lipoprotein (HDL) cholesterol, blood pressure, self-administered questionnaire (including questions concerning demographic variables), weight loss practices, dietary intake, participation in sport as part of Dutch Monitoring Project on Risk Factors for Chronic Diseases (MORGEN). RESULTS: In the study population, 53% of men and 39% of women were overweight or obese. An association was shown between degree of adiposity and participation in sport for both men and women, and dietary fat intake in men. Of the subjects studied 56% of men and 52% of women described their weight as appropriate. A degree of inaccuracy in the estimation of relative body weight was observed. While dieting was prevalent, particularly among women, there was a lack of weight control action on the part of many overweight or obese individuals. This effect was most marked in men. Body Mass Index (BMI) was the strongest determinant of weight perception and dieting behaviours with some effect of educational level in men. Physical activity was not widely used as a method of weight control. CONCLUSION: These results point to a need for regular assessment of an individual's relative weight and health risk, gender specific obesity treatments and prevention strategies, and an emphasis in treatment and prevention of obesity on physical activity.

Adult↗
PubMed1999

The prevalence of subclinical hypothyroidism at different total plasma cholesterol levels in middle aged men and women: a need for case-finding?

OBJECTIVE: In order to determine whether screening of thyroid function is justified in patients with hypercholesterolaemia, we determined the prevalence of subclinical hypothyroidism at different levels of total plasma cholesterol in middle-aged men and women. DESIGN AND METHODS: 1200 participants were selected from a population based cross sectional study on risk factors for cardiovascular diseases. The participants were divided into three groups: total plasma cholesterol < 5 mmol/l, total plasma cholesterol 5-8 mmol/l, total plasma cholesterol > 8 mmol/l. Each group was comparable in size and sex distribution. Subclinical hypothyroidism was defined as plasma TSH levels higher than 4 mU/l, in the presence of normal free thyroxine (FT4(4)) concentration. RESULTS: Plasma samples of a total of 1191 participants were analyzed. The overall prevalence of subclinical hypothyroidism was 1.9% in men and 7.6% in women of middle age. In women the prevalence of subclinical hypothyroidism increased from 4.0 percent in the lowest, to 10.3 percent in the highest cholesterol stratum (P = 0.02). In men, the mean prevalence was 1.8 percent and roughly similar in the various strata. After age correction, an increase of 1 mU/l TSH in women was associated with an increase of 0.09 mmol/l total plasma cholesterol (95% confidence interval (CI) 0.02-0.16 mmol/l). A similar trend was found in men (0.16 mmol/l, 95% CI -0.02-0.34 mmol/l). CONCLUSIONS: In the population, the prevalence of subclinical hypothyroidism is up to 10 percent in middle aged women with high levels of total plasma cholesterol and may justify case-finding. In these women approximately 0.5 mmol/l of total plasma cholesterol can be attributed to the subclinical thyroid dysfunction. In men a similar correlation between thyroid dysfunction and total plasma cholesterol is seen, but the prevalence of thyroid dysfunction is considerably lower.

Cholesterol↗
PubMed1999

Overweight and obesity in the mortality rate data: current evidence and research issues.

PURPOSE: The relation between indicators of overweight (body mass index (BMI)) and all-cause mortality and factors that potentially affect such a relationship were reviewed. METHODS: The literature was reviewed. RESULTS: Although there are many reports on the relationship between indicators of overweight (such as BMI) and all-cause mortality, there are no two studies that have been analyzed identically. It is now usually assumed that there is a U- or J-shaped association between BMI and mortality, but there are many issues that remain unsolved until today. These issues include the effects of: adequate control for cigarette smoking; adequate control for (sub)clinical disease at baseline; adequate control for intermediate risk factors; adequate measures for exposure to obesity; age, period, and cohort effects; adequate control for underlying lifestyle factors; adequate control or stratification for ethnicity and socioeconomic status; effects of sample size and duration of follow-up; and reliance on self-reported body weight and height. CONCLUSION: The literature is dominated by studies in young adult and middle-aged white inhabitants of North America and Europe. In those populations, it seems well accepted that lowest mortality is in the range of BMI between 18.5 and 25 kg.m(-2). When BMI reached values of 30 kg x m(-2) or more, mortality is substantially elevated by about 50-150%. These results may not be generalizable to other populations, and more studies are needed. All evidence is of category C (observational studies).

Adult↗
PubMed1999

Obesity: a growing problem.

Obesity, defined as a body mass index (BMI) of 30 kg/m2 or more, is common in many parts of the world, especially in the established market economies, the former socialist economies of Europe, Latin America, the Caribbean and the Middle Eastern Crescent. As many as 250 million people worldwide may be obese (7% of the adult population) and two to three times as many may be considered overweight. The prevalence of obesity seems to be increasing in most parts of the world, even where it used to be rare. Increased fatness, measured by a high BMI, a large waist circumference or a high waist/hip circumference ratio, is associated with many chronic diseases as well as with poor physical functioning. Assessments of the prevalence of obesity, and trends in this prevalence over time, are more difficult in children than adults, due to the lack of international criteria for classifying individuals as overweight or obese. The World Health Organization has now recommended the use of BMI-for-age percentiles, but the reference curves are still under development. France. The Netherlands, the UK and the USA are among the countries that have reported recent increases in the prevalence of obesity in children and adolescents. Although there are no accurate estimates of the components of energy balance and their changes over time, the available evidence suggests that the trends in obesity rates are related more to a reduction in energy expenditure than to an increase in caloric intake. Prevention of obesity through the promotion of a healthy lifestyle is among the important challenges for the new millennium, and should start in childhood.

Adolescent↗
PubMed1999

Effects of sex steroid hormones on regional fat depots as assessed by magnetic resonance imaging in transsexuals.

We investigated prospectively the effect of sex steroids on regional fat depots and thigh muscle mass in adult transsexuals. Ethinyl estradiol in combination with cyproterone acetate, a progestational antiandrogen, was given to 20 male-to-female (M-F) transsexuals, and parenteral testosterone esters were given to 17 female-to-male (F-M) transsexuals. Before and after 12 mo of cross-sex hormone administration, several anthropometric measurements (weight, skinfolds, body circumferences, and bioimpedance) were performed, and transverse magnetic resonance images were obtained at the level of the abdomen, hip, and thigh to quantify fat depots (subcutaneous and visceral) and muscle areas. We observed that treatment with ethinyl estradiol in M-F transsexuals induced a significant increase in all subcutaneous fat depots, with a lesser but proportional and significant increase in the visceral fat depot and a decrease in thigh muscle area. Testosterone administration in F-M transsexuals markedly increased thigh muscle area, reduced subcutaneous fat deposition at all levels measured, but slightly increased the visceral fat area. We conclude that sex steroid hormones are important determinants of the sex-specific localization of body fat.

Adipose Tissue↗
PubMed1999

Excess stroke among hypertensive men and women attributable to undertreatment of hypertension.

BACKGROUND AND PURPOSE: Most population-based studies indicate that a considerable proportion of hypertensive subjects are undertreated and that undertreatment is more prevalent among hypertensive men than among hypertensive women. The aim of our study was to investigate the consequences of undertreatment of hypertension for women and men in terms of stroke occurrence. METHODS: Approximately 45 000 men and women aged >/=20 years were examined in 2 population-based studies in the Netherlands. A cohort of 2616 hypertensive subjects (pharmacologically treated hypertensives and untreated hypertensives who needed pharmacological treatment according to the severity of their hypertension and the coexistence of additional cardiovascular risk factors) was selected for a follow-up study. Follow-up (mean duration, 4.6 years) was complete for 2369 (91%) of the enrolled hypertensive subjects. RESULTS: Compared with treated and controlled hypertensives, the relative risks of stroke for treated and uncontrolled hypertensives and for untreated hypertensives who needed treatment were 1.30 (95% CI, 0.70 to 2.44) and 1.76 (95% CI, 1.05 to 2.94), respectively. These relative risks and the prevalence of (undertreated) hypertension in the total population of 45 000 subjects were used to estimate the number of strokes in the Netherlands attributable to undertreatment. Among hypertensive men and women aged >/=20 years in the Netherlands, the proportions of strokes attributable to treated but uncontrolled blood pressure were 3.1% (95% CI, -5.2% to 18.7%) and 4.1% (95% CI, -7.2% to 20.7%), respectively. For untreated hypertensive men and women who should have been treated, these proportions were 22.8% (95% CI, 0.8% to 38.4%) and 25.4% (95% CI, 0. 5% to 42.5%), respectively. CONCLUSIONS: Increasing the detection of hypertension and improving adherence to current guidelines might prevent a considerable proportion of the incident strokes among hypertensives. The potential impact of achieving control of blood pressure in patients already being treated on the reduction of strokes requires further investigation.

Adult↗
PubMed1999

The joint impact of family history of myocardial infarction and other risk factors on 12-year coronary heart disease mortality.

We investigated the impact of family history of myocardial infarction on 12-year coronary heart disease mortality. Men and women with a family history had an increased risk for coronary heart disease death, irrespective of other risk factors (RR = 1.58; 95% CI = 1.17-2.13 and RR = 2.12; 95% CI = 1.11-4.05, respectively). Women with a family history seemed to be more susceptible to the detrimental effects of smoking; not to the effects of other risk factors. We found no effect modification by family history in men.

Adult↗
PubMed1999

Prevention of obesity: the role of the food industry.

The food industry is a critical factor in any potentially successful long-term strategy to prevent obesity. By producing new products low in energy density and improving the nutritional quality (and reducing the energy content) of existing products, as well as through advances in responsible marketing and labeling, the food industry can provide foods that enable consumers to achieve lower energy intakes without going short of essential nutrients. The food industry is not the sole factor and government policies regarding agriculture, prices and subsidies are equally essential. Caterers and retailers are yet another important cog in the wheel for progress in obesity prevention. Intensive collaboration between all these players will only be attained if obesity prevention is given the priority it deserves in future public health planning.

Female↗
PubMed1998

Determinants of obesity-related underreporting of energy intake.

Data from an ongoing Dutch health examination monitoring project carried out in 1995 (n = 2,079 men and 2,467 women, aged 20-65 years) were used to study whether various determinants of underreporting of energy intake influenced the association between underreporting and body mass index. Further, the authors examined whether these determinants were mutually independent predictors of underreporting. As a measure for the degree of underreporting, they calculated energy ratios of reported daily energy intake divided by the estimated basal metabolic rate. They observed that underreporting occurred more with increasing degrees of overweight in men and women. Each increase in body mass index by 1 kg/m2 was associated with a decrease in reported energy intake/basal metabolic rate (in men, beta = -0.0364; standard error, 0.0024; in women, beta = -0.0262; standard error, 0.0018). After adjustment for age, education, smoking habits, physical activity, dieting behavior, and dieting frequency during the last year, the slopes were reduced by 29% in men and 17% in women but remained negative and highly statistically significant. Adjustment for current dieting behavior particularly decreased the association between body mass index and underreporting. Age was another independent determinant of underreporting in men and women and, in men only, so were smoking habits and education level. In conclusion, overweight individuals give biased dietary information, and this may distort the relations between self-reported dietary intake and diseases related to body mass index.

Adult↗
PubMed1998

Impairment of health and quality of life in people with large waist circumference.

BACKGROUND: Symptoms and secondary disorders associated with excess central fat distribution are being increasingly recognised. We aimed to define the symptoms and assess risks of chronic disorders in people with large waist circumferences. METHODS: We did a cross-sectional study of 5887 men and 7018 women aged 20-59 years from the general population of Maastricht, Amsterdam, and Doetinchem, Netherlands. We assessed in health centres respiratory insufficiency, low back pain, degree of physical function, presence of non-insulin-dependent diabetes, and cardiovascular risk factors. We measured bodyweight, body-mass index, and waist circumference by action levels (men: less than action level 1 <94.0 cm, action levels 1-2 94.0-101.9 cm, more than action level 2 > or =102.0 cm; women: less than action level 1 <80.0 cm, action levels 1-2 80.0-87.9 cm) more than action level 2 > or =88.0 cm). The reference group were people with waist circumferences lower than action level 1. FINDINGS: All symptoms and risks increased among participants higher than action level 2, after adjustment for age and lifestyle, by 3.1 (95% CI 2.5-3.7) in men and 2.7 (2.3-3.1) in women for shortness of breath when walking upstairs; 4.5 (2.5-7.8) and 3.8 (1.9-7.3) for non-insulin-dependent diabetes; and 4.2 (3.6-5.0) and 2.8 (2.4-3.2) for at least one major cardiovascular risk factor. Above action level 2, compared with the reference group, men and women were at twice the risk of difficulties in everyday activities, women were 1.5 times more likely to have low back pain or symptoms of intervertebral disc herniation, with secondary problems including hindrance to daily activities. INTERPRETATION: People with large waist circumferences have excess burden of ill health. Waist action levels could be useful for health promotion to raise awareness of the need for weight management.

Abdomen↗
PubMed1998

Associations of body composition with type 2 diabetes mellitus.

The aims of this study were to establish the associations of stature, body mass index, waist to hip ratio, and waist circumference with Type 2 (non-insulin-dependent) diabetes mellitus in a random sample of 5887 men and 7018 women aged 20-59 years in a cross-sectional study set in The Netherlands. The crude prevalence of Type 2 diabetes (overall 1.58% in men, 0.94% in women) was significantly (p < 0.01) higher in shorter subjects and those with high body mass index, high waist to hip ratio, and larger waist circumference. Odds ratios and 95% confidence intervals (95% CI) were adjusted for age, cigarette smoking, alcohol consumption, physical activity, and education. Compared to the tallest tertile of height, odds ratios for Type 2 diabetes were 4.4 (95% CI: 1.3 to 11.5) in men and 1.6 (95% CI: 0.8 to 3.2) in women whose height was in the shortest tertile. Compared to the lowest tertile, odds ratios for Type 2 diabetes were 18.4 (95% CI: 4.3 to 78.5) in men and 5.3 (95% CI: 2.0 to 14.0) in women with waist to hip ratio in the highest tertile, 4.1 (95% CI: 2.0 to 8.4) in men and 2.1 (95% CI: 1.0 to 4.2) in women with body mass index in the highest tertile, and 4.9 (95% CI: 2.1 to 11.7) in men and 2.7 (95% CI: 1.2 to 5.9) in women with waist circumference in the highest tertile. In conclusion, although in longitudinal studies waist is a powerful predictor of diabetes incidence, Type 2 diabetes in a cross-sectional survey is associated with shortness in stature, as well as large waist circumference and high body mass index, and particularly strongly with high waist to hip ratio, suggesting that the development of Type 2 diabetes may modify hip circumference independently of body fat.

Adult↗
PubMed1998

Lipid profiles reflecting high and low risk for coronary heart disease: contribution of apolipoprotein E polymorphism and lifestyle.

To elucidate the role of modifiable factors and the apolipoprotein E polymorphism in explaining lipid profiles reflecting low, average and high risk for coronary heart disease, we selected subjects from a large population-based study. Subjects with low total cholesterol (TC) (< 15th percentile) and high HDL-cholesterol levels (> 85th percentile) were randomly selected (n = 99) and represent subjects with a low risk lipid profile. Additionally, 95 subjects with total and HDL-cholesterol levels in the 15% around the population-median (median risk lipid profile) and 100 subjects with high TC (> 85th percentile) and low HDL-cholesterol levels (< 15th percentile) (high risk lipid profile) were selected. Compared with E3/3 subjects, the likelihood for a low risk lipid profile was considerably higher (odds ratio 14.3; 2.6-79) in female, but not in male E2-carriers (1.5; 0.3-6.7). Smoking and alcohol consumption were independently associated with a low risk lipid profile in both genders, physical inactivity only in women. The odds ratio for a high risk lipid profile was elevated in male E4-carriers (4.9; 1.1-23) only. In addition to the E4 isoform, smoking and physical inactivity, overweight was the main determinant for a high risk lipid profile (odds ratio 16.8; 3.4-82). Male overweight E4-carriers had a 50 times higher likelihood of a high risk lipid profile than E3/3 men of normal weight. In women, only overweight was independently associated with a high risk lipid profile. Our results suggest that both modifiable factors and the apolipoprotein E polymorphism contribute to a lipid profile, reflecting low, average and high risk for coronary heart disease, but effects may be gender-specific.

Adult↗
PubMed1998

The Asn9 variant of lipoprotein lipase is associated with the -93G promoter mutation and an increased risk of coronary artery disease. The Regress Study Group.

Two mutations in the lipoprotein lipase (LPL) gene, a T to G transition at position -93 of the proximal promoter region and an Asp9Asn substitution in exon 2, were examined in 762 Dutch males with angiographically-diagnosed coronary artery disease (CAD) and 296 healthy normolipidemic Dutch males. The two mutations exhibited strong linkage disequilibrium (D' = 0.975). A significantly higher proportion of cases (4.86%) than controls (1.37%) carried the -93G/Asn9 allele (p = 0.008). In the combined sample of cases and controls, adjusted mean plasma total cholesterol (TC) levels were significantly higher in -93G/Asn9 carriers (6.20+/-0.13 mmol/l) than in non-carriers (5.93+/-0.03 mmol/l; p = 0.048), while mean high-density lipoprotein cholesterol (HDL-C) levels were lower in carriers (0.88+/-0.03 mmol/l) than in non-carriers (0.98+/-0.01 mmol/l; p = 0.002). There was a trend towards higher triglyceride (TG) levels in carriers (1.96+/-0.14 mmol/l) compared with non-carriers (1.73+/-0.03 mmol/l) (p = 0.08). Additionally, carrier frequencies in tertiles of TC, HDL-C, TG, and LPL activity, suggested an association of the -93G/Asn9 variant with higher TC and TG levels, and with lower HDL-C and LPL activity levels. Logistic regression revealed a significant odds ratio (OR) for the combined -93G/Asn9 genotype in CAD cases relative to controls (OR: 5.36; 95% CI: 1.57-18.24), with age, body mass index (BMI), smoking, and plasma total- and HDL-cholesterol levels included in the model. In conclusion, we show that the LPL Asp9Asn mutation is in non-random association with a T G substitution at position -93 of the proximal promoter region and that the combined -93G/Asn9 genotype predisposes to decreased HDL-C levels and an increased risk of CAD.

Asparagine↗
PubMed1998

Selection of anthropometric indicators for classification of abdominal fatness--a critical review.

In the literature, a variety of anthropometric indicators for abdominal obesity have been suggested. The criteria for their selection vary, and they have been justified mainly on the basis of being correlated with other risk factors, with morbidity and mortality, or to be predictors of the amount of visceral fat. Many of the studies, however, suffer from methodological limitations: they are based on a small number of subjects, often derived from cross-sectional data, based on indirect measurement of risk, or the indicators are complicated to interpret biologically or difficult to use in a public health context. The literature lacks a systematic evaluation of the proposed indicators taking into account possible differences between genders, age categories and ethnic groups and different diseases and mortality. Similar considerations relate to the cut-off points based on the indicators of abdominal obesity. The suggested cut-off points for waist-hip ratio have been based on rather arbitrary criteria, and the studies where cut-off points for waist circumference have been suggested have methodological shortcomings as well, such as being based on cross-sectional data and arbitrary cut-off points for other variables. It is also a reason for concern that so far all suggested cut-off points for abdominal obesity have been based on results obtained in Caucasian populations. Moreover, they are based on assessment of risk and their appropriateness in the use of intervention has not been evaluated. Therefore, no consensus about the appropriateness of the different cut-off points has been reached. We conclude that there is an apparent lack of consistency in the field and therefore a more scientifically and theoretically solid basis for the selection and use of anthropometric indicators of abdominal obesity and cut-off points based on them should be a high priority in this research field in the near future.

Anthropometry↗
PubMed1998

Societal and personal costs of obesity.

The economic costs of obesity can be broken down into three levels: 1. DIRECT COSTS: Costs to the community, related to the diversion of resources to the diagnosis and treatment of diseases directly related to obesity, as well as the treatment of obesity itself. These costs have been estimated to vary between 1-5% of total healthcare costs for various countries. Usually, the cost of obesity alone has been calculated, although it is known that the costs associated with being overweight [body mass index (BMI) 25-30 kg/m2] are also substantial because of the large proportion of individuals involved. These constitute costs to the health service (visits to general practitioners, consultations with medical specialists, hospital admissions and medication). 2. SOCIETAL OR INDIRECT COSTS: These costs are related to the loss of productivity caused by absenteeism, disability pensions and premature death. There is a lack of good economic analysis on this subject, although research from Sweden, Finland and the Netherlands has clearly shown that obesity is associated with increased sick leave and disability pensions. 3. PERSONAL COSTS: Obese subjects may earn less than their lean counterparts because of job discrimination (related to the stigma associated with obesity, or due to diseases and disabilities caused by obesity). Many insurance companies (particularly life insurance) charge higher premiums with increasing degrees of overweight. Obesity is further related to poor physical functioning and limitations in daily life. Some of these require assistance or adaptations which may be costly for an individual. In conclusion, there is much indirect information that obesity and overweight contribute substantially to healthcare-related costs. Data on aspects such as societal costs and personal costs are too fragmentary to allow calculation of the expenses involved. An appropriate analysis of all costs associated with obesity is important in order to persuade responsible bodies to develop strategies towards the prevention and long-term management of obesity.

Absenteeism↗