ArticleLiterature Review

Cigarette Smoking, Nicotine, and Body Weight

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Abstract

Smokers generally gain weight when they quit smoking; this weight gain can lessen some of the health benefits of quitting smoking. We review the effectiveness of behavioral and pharmacological approaches to mitigating weight gain in the context of quitting smoking and consider mechanisms that could potentially account for the effects of smoking and nicotine on body weight. Understanding how nicotine affects body weight may lead to novel pharmacological and behavioral interventions for obesity as well as concurrent obesity and nicotine dependence.Clinical Pharmacology & Therapeutics (2011) 90 1, 164-168. doi:10.1038/clpt.2011.105

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... Moreover, adolescents who regularly smoke cigarettes or drink alcohol have a higher BMI than those who do not [27]. In addition, it was widely accepted that nicotine influences hunger to the point that nicotine is also used for controlling weight [28,29]. Additionally, literature suggests that the consequences of behavioral disorders due to the consumption of alcohol and tobacco may be dependent on genetic factors, by inducing, for instance, plasticity in the brain circuits involved in reward and learning [30]. ...
... Our study also shows that controlling for confounding variables, cigarette smoking is not associated with the BMI categories, in contrast with other literature results [28,29]. Nevertheless, it generally confirms the positive association between overweight and unhealthy habits (such as sedentary life and frequent alcohol consumption) in a national representative sample of adolescent boys. ...
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The literature about the relationship between extreme BMI and at-risk behaviors is quite inconsistent, and few articles focus on the underweight male population. This study aimed to analyze BMI level and its association with risky behavior, such as psychoactive substances use, gaming, and gambling, in a representative sample of the male adolescent population. Psychosocial variables were considered to better describe the possible at-risk profiles. This study used data from the 2018 ESPAD®Italia cross-sectional study, a survey using a self-administered anonymous questionnaire. For the purpose of the paper, males only were included in the analysis, with a total sample of 6938 students aged 15–19 years. Multinomial logistic regression showed that being overweight is positively associated with the gambler profile, the perception of a low financial family situation, and dissatisfaction with health conditions. Furthermore, being underweight was positively associated with gaming. Both extremes of BMI were associated with a frequent alcohol consumption and a sedentary lifestyle. This study provides important information regarding both extremes of BMI conditions, underling the presence of at-risk behavior and self-related perceptions with shared factors between underweight and overweight.
... Individuals at higher body weights comprise 70% of those seeking treatment for smoking ( LaRowe et al., 2009 ). They gain the most weight after quitting, are the least accepting of that weight gain ( Bush et al., 2008 ; M. D. Levine et al., 2013 ), and are more likely to relapse as a result ( Audrain -McGovern and Benowitz, 2011 ). Despite public health significance, little research has focused on understanding what motivates smoking among individuals with excess body weight. ...
... D. Levine et al., 2013 ). As a result, individuals who smoke are more likely to return to smoking when they have overweight and obesity than those who are lean ( Audrain -McGovern and Benowitz, 2011 ;Borrelli et al., 1999 ). ...
Article
Objective: Cigarette smoking and obesity are the leading causes of premature morbidity and mortality and increase the risk of all-cause mortality four-fold when comorbid. Although research suggests that smoking motives may differ based on body mass index (BMI), it is unclear how these differences translate to smoking behavior. Method: Three groups of adults who smoke cigarettes (N=79; obese n=25, overweight n=30, and lean n=24) completed measures of smoking and the Smoking Motivations Questionnaire. Groups did not differ on age, education, cigarettes per day (CPD), pack-years, or nicotine dependence, as measured by the Fagerström Test for Cigarette Dependence (FTCD). Results: Analyses revealed different associations between reasons for smoking and smoking behavior depending on lean, overweight, or obesity status. Participants (N=37 female, average age 39.8 years) self-reported smoking was positively associated with Addictive, and Automatic subscale scores among lean participants, with only the Addictive subscale score among those with overweight, and only the Automatic subscale score among those with obesity. Post hoc MANCOVA analysis revealed a significant interaction effect of Group x Automatic Smoking on Pack-years (F(2, 79)=3.34, p = 0.04). Conclusion: Findings suggest smoking motives are differentially associated with smoking behavior in adults who smoke depending on weight status. The daily smoking rate of participants with obesity may be less related to the addictive quality of smoking, and automaticity may be less associated with smoking history in those with overweight. Additional research on the influence of BMI on cigarette smoking is necessary to fully elucidate how obesity may impact treatment outcomes to optimize smoking cessation treatment among those with excess body weight.
... This research showed that smokers declared they derived less pleasure from eating milk soups than non-smokers (Table 3). It is difficult to explain why lower declared pleasure from eating milk soups is associated with an increase in the habit intensity, but it is known that smoking negatively influences the sense of taste and the gastrointestinal tract function (Audrain-McGovern & Benowitz, 2011). ...
... Furthermore, Audrain- McGovern & Benowitz (2011), showed that smokers generally weigh 4-5 kilograms less than non-smokers, and that smoking reduces appetite and increases satiety. Interestingly, studies by Palaniappan et al. (2001), showed that smokers consume more fat and calories than non-smokers. ...
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Background Food choices made by most people mainly depend on food preferences. Knowing how certain factors affect food preferences can help dietitians working with women to understand the relationship between individual factors and the challenges faced by the women in changing eating habits. The aim of the study was to examine the food preferences of women and to assess the impact of the sense of smell, age, body mass index (BMI), smoking and hormonal status (phase of the menstrual cycle, hormonal contraception) on the declared pleasure derived from eating various types of food. Methods A total of 190 women living in the Górnośląsko-Zagłębiowska Metropolis in Poland aged 18–75 (19.29–26.71 RNO) years participated in the study. The collected survey data included age, BMI, smoking, phase of the menstrual cycle and hormonal contraception. Olfactory sensitivity was measured by T08 olfactometer. Additionally, food preferences were assessed, using 24 different food types, which were presented as pictures. To evaluate food preferences 10 cm visual analogue scale was used. Results The most liked foods were: fruits (M = 8.81, SD = 1.67), sweet desserts (M = 8.44, SD = 2.30), vegetables and salads (M = 8.08, SD = 2.24), chocolate (M = 7.84, SD = 2.76), and poultry (M = 7.30, SD = 2.47). The least liked foods were: salty products (M = 4.98, SD = 3.03), milk soup (M = 3.30, SD = 3.13), and seafood (M = 2.99, SD = 3.28). The influence of the analyzed factors on the degree of liking six food types was shown. Women with better ability to name scents preferred sausages/ham and beef/pork. Women with a higher BMI had lower preference for jellybeans and broth. Women who were heavier smokers had lower preference for milk soup. In women using hormonal contraception, pleasure from eating sausages and ham was higher than compared to women in all phases of the monthly cycle. In women in the follicular phase the pleasure from eating pasta was lower when compared to women in the ovulatory phase, the luteal phase and those using hormonal contraception. In women in the ovulatory phase the pleasure from eating candies and jellybeans was lower when compared to women in the follicular phase, the luteal phase and those using hormonal contraception. In women in the ovulatory phase, also pleasure from eating broth was lower when compared to women in the luteal phase and those using hormonal contraception. Conclusions Among women in Poland, the top five preferred food types are fruits, sweet desserts, vegetables/salads, chocolate and poultry. To confirm the extent to which the declared pleasure derived from eating these food types translates into health condition, further research on the consumption of these food types is necessary. The impact of the sense of smell, BMI, smoking, or menstrual cycle phase and hormonal contraception on the declared pleasure derived from eating was observed for six out of twenty-four food types. The hormonal status was the factor most significantly influencing food preferences.
... The study aimed to investigate differences in anti-S1-RBD antibody profiles in sera samples collected from equal numbers of gender and age-matched individuals pre-pandemic and during the pandemic in 2020 to discern differences in trends. Along with demographic data, it is essential to study various clinical characteristics such as fever, cough, myalgia, fatigue, FBG, and BMR levels that may affect disease prognosis (23)(24)(25)(26). High FBG and HbA1c levels were detected in older age groups (>60 years), which is a normal pattern in the elderly (17). ...
... However, participants reporting symptoms of moderate fever, fatigue, cough, and myalgia had a significantly (p < 0.05) higher BMR, with the trend most apparent in men with a history of smoking. They increased smoking duration (23,24). ...
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Background: Two years into the pandemic, yet the threat of new SARS-CoV-2 variants continues to loom large. Sustained efforts are required to fully understand the infection in asymptomatic individuals and those with complications. Identification, containment, care, and preventative strategies rely on understanding the varied humoral immune responses. Methods: An in-house ELISA was developed and standardized to screen for serum IgG antibodies against the SARS-CoV-2 S1-RBD protein as an antigen. This study aims to investigate the seroprevalence of serum antibodies against S1-RBD antigen in pre-pandemic (n = 120) and during the early pandemic period (n = 120) in subjects from the Hail region, KSA and to correlate it with clinical and demographic factors. Results: Samples collected from both male (n = 60) and female (n = 60) subjects during the pandemic in the age groups of 20-40 (0.31 ± 0.029 and 0.29 ± 0.024, respectively) and 41-60 years (0.35 ± 0.026 and 0.30 ± 0.025, respectively) showed significantly higher levels of serum antibodies against S-RBD antigen than the age-matched pre-pandemic samples [male (n = 60) and female (n = 60)]. Pandemic subjects exhibited significantly (p < 0.01) higher inhibition (80-88%) than age-matched pre-pandemic subjects (32-39%). Antibodies against S1-RBD antigen were detected in approximately 10% of the total pre-pandemic population (males and females). However, subjects > 60 years did not show antibodies. Conclusion: Antibody levels increased in samples collected during the pandemic, even though these subjects were not clinically COVID-19 positive. A small number of pre-pandemic subjects showed serum antibodies, suggesting prior exposure to other coronaviruses in the region. With dwindling neutralizing antibody levels and reduced vaccine efficacy against newer variants, it remains crucial to develop better assays for surveillance, management, and future research.
... The lower body weight among smokers may be mediated by nicotine, which increases energy expenditure. However, smoking can also serve as a behavioural alternative to eating, resulting in decreased food intake [38]. Finally, with respect to family history, Harvie et al. also observed a significantly greater waist and waist/hip ratio among women with family BC history, possibly due to the genetic predisposition to central obesity of these women [39]. ...
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Breast cancer (BC) survivors are advised to follow the WCRF/AICR cancer prevention recommendations, given their high risk of developing a second tumour. We aimed to explore compliance with these recommendations in BC survivors and to identify potentially associated clinical and sociodemographic factors. A total of 420 BC survivors, aged 31–80, was recruited from 16 Spanish hospitals. Epidemiological, dietary and physical activity information was collected through questionnaires. A 7-item score to measure compliance with the recommendations was built according to the 2018 WCRF/AICR scoring criteria. Standardized prevalences and standardized prevalence ratios of moderate and high compliance across participant characteristics were estimated using multinomial and binary logistic regression models. The mean score was 3.9 (SD: 1.0) out of 7 points. Recommendations with the worst adherence were those of limiting consumption of red/processed meats (12% of compliance, 95%CI:8.2–15.0) and high fibre intake (22% of compliance, 95%CI:17.6–27.0), while the best compliance was observed for the consumption of fruits and vegetables (73% of compliance, 95%CI:69.2–77.7). Overall, adherence was worse in women with university education and in those with first-degree relatives with BC. This information may be of interest to design and implement personalized preventive measures adapted to the characteristics of these patients.
... Body weight was also a significant score compo-nent for all except current smokers. The lack of association in current smokers may be explained by the association often seen between current smoking status and lower BMI (35,36). Meeting the alcohol recommendation was associated with reduced risk of mortality in male former and current smokers, and cancer mortality in female current smokers. ...
Article
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Background The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) published Cancer Prevention Recommendations in 2018 focused on modifiable lifestyle factors. Objectives To examine how adherence to WCRF/AICR Recommendations via the 2018 WCRF/AICR Score was associated with risk for all-cause, cancer, and CVD mortality outcomes among older US adults. Design Baseline and follow-up questionnaire data (N = 177,410) were used to calculate weight, physical activity, and diet components of the 2018 WCRF/AICR Score (0–7 total points). Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated, stratified by sex and smoking status. Results There were 16,055 deaths during a mean 14.2 person-years. Each one-point Score increase was associated with a 9–26% reduced mortality risk for all outcomes, except for current male smokers’ cancer mortality risk. When the Score was categorized comparing highest (5–7 points) vs. lowest (0–2 points) Scores, associations with reduced all-cause mortality risk were strongest in former smokers (HRmales: 0.51, 95%CI: 0.43–0.61; HRfemales: 0.38, 95%CI: 0.31–0.46), followed by current smokers (HRmales: 0.55, 95%CI: 0.34–0.89; HRfemales: 0.44, 95%CI: 0.32–0.59) and never smokers (HRmales: 0.57, 95%CI: 0.47–0.70; HRfemales: 0.50, 95%CI: 0.41–0.60). An association with cancer mortality risk was also seen in former smokers (HRmales: 0.59, 95%CI: 0.43–0.81; HRfemales: 0.52, 95%CI: 0.37–0.73) and female current (HRfemales: 0.55, 95%CI:0.32–0.96) and never smokers (HRfemales: 0.57, 95%CI: 0.40–0.80); findings were not statistically significant in other strata. For CVD mortality, highest vs. lowest Scores were associated with a 49–73% risk reduction, except in male never and current smokers. In exploratory analysis, physical activity, body weight, alcohol, and plant-based foods were found to be predominant components in the Score. Conclusions Greater 2018 WCRF/AICR Scores were associated with lower mortality risk among older adults. Future research can explore how smoking modifies these relationships, and further examine different populations and other cancer-relevant outcomes.
... Tobacco has a long history of being used for weight management due to nicotine's ability to suppress appetite, increase metabolism, and act as a behavioral replacement to eating (Audrain-McGovern & Benowitz, 2011;Glover, Breier, & Bauld, 2016). Previous research reports higher rates of nicotine dependence and cigarette use among people who use tobacco products with an intention to suppress hunger, control weight, prevent overeating, diet, and after overeating (compensatory) (Anzengruber et al., 2006;White, 2012). ...
Article
Introduction Emerging research has found that some young adults report vaping nicotine to control appetite and lose weight. Yet, there is little research on how young adults use vaping to manage weight, where they learn about weight-motivated vaping, and the role that food and weight motivations play in decisions to vape. Methods We conducted one-on-one qualitative interviews with young adults aged 18–25 years old in Los Angeles, California (N = 62) from June 2018 to June 2019, who self-reported using e-cigarettes on a weekly basis or more for at least 5 months prior to study enrollment. Interviews examined participants’ thoughts, feelings, and experiences related to e-cigarette use, including their understanding of the relation of vaping with eating behaviors and weight management. We analyzed the interviews using the rigorous and accelerated data reduction (RADaR) technique. Results Participants reported pairing nicotine vaping with caffeinated beverages like coffee, pop/soda, tea, and after every meal (like patterns of combustible cigarette use). Participants also reported vaping nicotine as a tool to avoid binge eating and increase concentration while studying. Reports of vaping effecting appetite and eating behaviors also emerged. Vaping nicotine to suppress appetite and/or achieve weight loss was often reported in conjunction with an eating disorder. Participants reported learning about weight-motivated vaping from peers or deducing from cigarette effects and their own experiences with nicotine. Others mentioned controlling food cravings by vaping a similar e-liquid flavor. Conclusion Nicotine vaping was used as a tool to control weight and suppress appetite, paralleling food- and weight-related behaviors associated with cigarette use. Findings suggest a need for targeted interventions that address the role of nicotine vaping in eating/weight-related behaviors.
... Multiple regression analysis was used to assess important factors related to the change in postpartum weight. Method of breastfeeding, weight gain during pregnancy, pre-pregnancy BMI, age, primiparous, smoking during lactation, alcohol consumption during lactation, and years of education, all of which have been considered to affect weight change in previous studies [15][16][17][18][19], were explanatory variables. IBM1 SPSS1 Statistics for Windows, version 22 (IBM Corp. Armonk, N.Y., USA) was used for all statistical analyses. ...
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Aim The aim of this study was to examine the relationship between breastfeeding and postpartum maternal weight change. Method This study used data from the Japan Environment and Children’s Study (JECS), an ongoing nationwide birth cohort study. Participants were categorized into two groups: full breastfeeding (FB) and non-full breastfeeding (NFB) groups. Postpartum weight changes between the FB (n = 26,340) and NFB (n = 38,129) groups were compared. Results At 6 months postpartum, mean weight retention was significantly lower in the FB group than in the NFB group (0.2 vs 0.8 kg, respectively, p<0.001). Weight retention differed by pre-pregnancy body mass index (BMI), with postpartum weights of overweight (pre-pregnancy BMI 25.0–29.9) and obese (pre-pregnancy BMI ≥30.0) participants being lower than pre-pregnancy weight; this trend was more pronounced in the FB group than in the NFB group (overweight: −2.2 vs −0.7 kg, respectively; obese: −4.8 vs −3.4 kg, respectively). Factors affecting weight retention at 6 months postpartum were weight gain during pregnancy (β = 0.43; p<0.001), pre-pregnancy BMI (β = −0.147; p<0.001) and feeding method. FB resulted in lower weight retention than NFB (β = −0.107; p<0.001). Conclusion Breastfeeding reduced maternal weight retention, which was greater in mothers who were obese before pregnancy. For obese women, active breastfeeding may improve their health.
... The more common the dieting habit becomes, the greater the risk of initiating the smoking habit. Young adults who are trying to lose weight are 40% more likely to smoke cigarettes [52] [53]. Another study demonstrate weight gain associated with smoking cessation among women prisoners, and the authors suggest smoking cessation interventions that address postcessation weight gain, as a preventative measure may be beneficial in improving health and reducing the high prevalence of smoking in prisoner populations [54]. ...
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Abstract Purpose of the review A search of scientific papers has been carried out to investigate sex differences in drug abuse and to understand the underlying biological and psychosocial causes of these differences. Based on the anatomical and neurochemical differences of the male and female brain, the difference in skills, and the possible importance of evolutionary factors, the reasons for the differential characteristics of addictions in men and women as well as the sex bias in the concurrent neuropsychiatric disorders are reviewed. The importance of sex hormones in these differences is also reviewed, as well as the influence of psychosocial conditioning factors associated with gender in addiction. Finally, the main features that differentiate the treatment of drug abuse in men and women are reviewed. Recent findings The results obtained indicate that there is a close link between the differential biological characteristics of the male and female brain and sex hormones, which explain the specific characteristics of drug abuse according to sex. Summary These differences exist in the reward circuit, in metabolism, and in the different phases of the addictive process— acquisition, escalation of consumption, abstinence, and relapse—as well as in the associated neuropsychiatric disorders; all of them are modulated by psychosocial gender particularities. Finally, the need for separate sex-specific treatments, especially indicated in the presence of coexisting psychological or psychiatric disorders, is assessed. Keywords Gender differences · Neuropsychiatric disorders · Sex hormones · Sex differences · Therapeutic approach
... There was, however, a significant sex  WC interaction (P interaction ¼ 0.03) for overall cancer (HR: 36,37 We explored this inverse association by stratifying lung cancer analyses by smoking status, as smoking is a known risk factor for lung cancer and is associated with lower average BMI. 38 Our findings support a previous prospective cohort study of about 450,000 individuals, 39 demonstrating reduced risk among current smoking but no association among former and never smoking. Although this might suggest that the "obesity paradox" may be explained by smoking, analyses of never smoking were likely underpowered, with other studies supporting an association across all smoking statuses including never smoking. ...
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Background Obesity and cardiometabolic dysfunction have been associated with cancer risk and severity. Underlying mechanisms remain unclear. Objectives The aim of this study was to examine associations of obesity and related cardiometabolic traits with incident cancer. Methods FHS (Framingham Heart Study) and PREVEND (Prevention of Renal and Vascular End-Stage Disease) study participants without prevalent cancer were studied, examining associations of obesity, body mass index (BMI), waist circumference, visceral adipose tissue (VAT) and subcutaneous adipose tissue depots, and C-reactive protein (CRP) with future cancer in Cox models. Results Among 20,667 participants (mean age 50 years, 53% women), 2,619 cancer events were observed over a median follow-up duration of 15 years. Obesity was associated with increased risk for future gastrointestinal (HR: 1.30; 95% CI: 1.05-1.60), gynecologic (HR: 1.62; 95% CI: 1.08-2.45), and breast (HR: 1.32; 95% CI: 1.05-1.66) cancer and lower risk for lung cancer (HR: 0.62; 95% CI: 0.44-0.87). Similarly, waist circumference was associated with increased risk for overall, gastrointestinal, and gynecologic but not lung cancer. VAT but not subcutaneous adipose tissue was associated with risk for overall cancer (HR: 1.22; 95% CI: 1.05-1.43), lung cancer (HR: 1.92; 95% CI: 1.01-3.66), and melanoma (HR: 1.56; 95% CI: 1.02-2.38) independent of BMI. Last, higher CRP levels were associated with higher risk for overall, colorectal, and lung cancer (P < 0.05 for all). Conclusions Obesity and abdominal adiposity are associated with future risk for specific cancers (eg, gastrointestinal, gynecologic). Although obesity was associated with lower risk for lung cancer, greater VAT and CRP were associated with higher lung cancer risk after adjusting for BMI.
... Although a dose-response pattern was found between maternal pre-pregnancy BMI and placental abruption, underweight as a risk factor and overweight and obesity as protective factors, respectively [4]; however, a correct decision about the association between pre-pregnancy BMI and placental abruption requires considering confounders in the causal pathway of the two aforementioned variables. For example, previous studies have suggested variables including micronutrient deficiencies [33], lifestyle, underlying medical conditions, and smoking during pregnancy [34][35][36] can be considered as confounders in the pathway. Nearly 70% of individual studies included in the meta-analysis by Adane et al. [33] that address the association between pre-pregnancy BMI and placental abruption did not adequately address the confounder's adjustment. ...
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Background The present umbrella review evaluated risk factors prior to conception associated with placental abruption based on meta-analyses and systematic reviews. Methods We searched PubMed, Scopus, and Web of Science until June 25, 2021. All meta-analyses that had focused on assessing the risk factors associated with placental abruption were included. We calculated summary effect estimates, 95% CI, heterogeneity I ² , 95% prediction interval, small-study effects, excess significance biases, and sensitive analysis. The quality of the meta-analyses was evaluated with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Results There was no risk factor in the present umbrella review with the high level of evidence (class I or II). Eight risk factors including maternal asthma (RR 1.29 95% CI 1.14, 1.47), prior cesarean section (RR 1.38, 95% CI 1.35–1.42), cocaine using (RR 4.55, 95% CI 1.78–6.50), endometriosis (OR 1.40, 95% CI 1.12–1.76), chronic hypertension (OR 3.13, 95% CI 2.04–4.80), advanced maternal age (OR 1.44, 95% CI 1.35–1.54), maternal smoking (OR 1.80, 95% CI 1.75–1.85) (RR 1.65, 95% CI 1.51–1.80), and use of assisted reproductive techniques (ART) (OR 1.87, 95% CI 1.70–2.06) were graded as suggestive evidence (class III). The other four risk factors including pre-pregnancy underweight (OR 1.38, 95% CI 1.12–1.70), preeclampsia (OR 1.73, 95% CI 1.47–2.04), uterine leiomyoma (OR 2.63, 95% CI 1.38–3.88), and marijuana use (OR 1.78, 95% CI 1.32–2.40) were graded as risk factors with weak evidence (class IV). Conclusion Maternal asthma, prior cesarean section, cocaine use, endometriosis, chronic hypertension, advanced maternal age, maternal smoking, and use of ART, pre-pregnancy underweight, preeclampsia, uterine leiomyoma, and marijuana use were risk factors associated with placental abruption. Although factors associated with placental abruption have been investigated, the current meta-analytic associations cannot disentangle the complex etiology of placental abruption mainly due to their low quality of evidence.
... One possible explanation for the discrepancy found between former and current users is different exposure in terms of the duration and intensity of smoking, with former smokers possibly being previously long-term heavy smokers (data unavailable). The body weight-lowering effect of tobacco smoking [91] and the weight-gaining effect of quitting tobacco [92] may also explain the opposite tendencies which former and current use had on hypertension [93]. ...
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People living with chronic hepatitis B virus (HBV) infection are at high risk of liver disease progression, which is positively associated with metabolic disorders, but inversely associated with dyslipidemia. Diet, including dietary antioxidants, is a lever of metabolic disorder management. In particular, elevated coffee consumption is associated with different metabolic outcomes in the general population. We aimed to test whether such associations occur in HBV-infected people. Based on cross-sectional data from the ANRS CO22 Hepather cohort, we performed logistic regression models with (i) dyslipidemia, (ii) hypertension, and (iii) diabetes as outcomes, and with demographic, clinical, and socio-behavioral (including coffee consumption) data as explanatory variables. Among 4746 HBV-infected patients, drinking ≥3 cups of coffee per day was associated with a higher risk of dyslipidemia (adjusted odds ratio [95% confidence interval] 1.49 [1.10–2.00], p = 0.009) and a lower risk of hypertension (0.64 [0.50–0.82], p = 0.001). It was not associated with diabetes. Elevated coffee consumption was associated with a higher risk of dyslipidemia and a lower risk of hypertension in HBV-infected patients, two effects expected to be associated with favorable clinical outcomes. Further studies should test whether such metabolic benefits translate into reduced mortality risk in this population.
... Although cigarette smoking and tobacco use have been primarily reported to occur because of the psychoactive properties of nicotine, robust evidence suggests that tobacco is also used for its effects on body weight. Smokers exhibit lower body weight gain compared with nonsmokers, and smoking cessation leads to a robust weight gain that contributes to relapse (Audrain-McGovern & Benowitz 2011;Filozof et al. 2004;Komiyama et al. 2013). ...
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Rationale Nicotine consumption in both human and animal studies has been strongly associated with changes in feeding-related behaviors and metabolism. The current dogma is that nicotine is an anorexic agent that decreases food intake and increases metabolism, leading to decreased body weight gain. However, there are conflicting reports about the acute effects of nicotine on hunger in humans. No study has reported nicotine-induced decreases in food intake within minutes of consumption, suggesting that our understanding of the pharmacological effects of nicotine on appetite and feeding may be incorrect. Objectives The aim of this study was to elucidate effects of acute nicotine intake on feeding and drinking behavior. Methods Adult male Wistar rats were trained to intravenously self-administer nicotine. Microstructural and macrostructural behavioral analyses were employed to look at changes in food and water intake at different timescales. Results At the macrostructural level (hours to days), nicotine decreased body weight gain, decreased feeding, and was associated with increases in feeding and body weight gain during abstinence. At the microstructural level (seconds to minutes), nicotine increased feeding and drinking behavior during the first 5 min after nicotine self-administration. This effect was also observed in animals that passively received nicotine, but the effect was not observed in animals that self-administered saline or passively received saline. Conclusions These results challenge the notion that the initial pharmacological effect of nicotine is anorexigenic and paradoxically suggest that an acute increase in food intake minutes after exposure to nicotine may contribute to the long-term anorexigenic effects of nicotine.
... Minor tobacco alkaloids are naturally occurring compounds [5] that are structurally [6] and functionally [7][8][9] analogous to nicotine, the primary psychoactive component in cigarettes, and have been the subject of research on novel therapeutics for smoking cessation [10], cognitive disorders including Alzheimer's disease [11][12][13] and Parkinson's disease [14], traumatic brain injury [15], inflammatory bowel disease [16] and psoriasis (Rock Creek Pharmaceuticals), as well as a novel strategy for pain management [17]. Previous research investigating the role of nicotine on body weight has repeatedly demonstrated that cigarette smoking and/or nicotine administration produces sustained weight loss and reduced food intake [18][19][20][21][22]. The similarities between the alkaloids and nicotine indicate there may be potential for the MTAs to reduce body weight, making them prime candidates for novel obesity pharmacotherapies. ...
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Obesity is a leading cause of preventable death in the United States. Currently approved pharmacotherapies for the treatment of obesity are associated with rebound weight gain, negative side effects, and the potential for abuse. There is a need for new treatments with fewer side effects. Minor tobacco alkaloids (MTAs) are potential candidates for novel obesity pharmacotherapies. These alkaloids are structurally related to nicotine, which can help reduce body weight, but without the same addictive potential. The purpose of the current study was to examine the effects of three MTAs (nornicotine, anatabine, and anabasine) and nicotine on weight gain, body composition, chow intake, and physical activity. We hypothesized that the MTAs and nicotine would reduce weight gain through reductions in chow intake and increases in physical activity. To test this, male Sprague Dawley rats were housed in metabolic phenotyping chambers. Following acclimation to these chambers and to (subcutaneous (sc)) injections of saline, animals received daily injections (sc) of nornicotine, anabasine, anatabine, or nicotine for one week. Compared to saline-injected animals that gained body weight and body fat during the treatment phase, injections of nornicotine and anatabine prevented additional weight gain, alongside reductions in body fat. Rats receiving anabasine and nicotine gained body weight at a slower rate relative to rats receiving saline injections, and body fat remained unchanged. All compounds reduced the intake of chow pellets. Nornicotine and nicotine produced consistent increases in physical activity 6 h post-injection, whereas anabasine’s and anatabine’s effects on physical activity were more transient. These results show that short-term, daily administration of nornicotine, anabasine, and anatabine has positive effects on weight loss, through reductions in body fat and food intake and increases in physical activity. Together, these findings suggest that MTAs are worthy of further investigations as anti-obesity pharmacotherapies.
... In a derivation cohort of 617 patients, BMI < 30 kg/m 2 was associated with an increased risk of microscopic colitis, OR 2.15 (95%CI: 1.19-3.88). Weight loss has been shown to be associated with MC in publications by the same authors [21,22], and it is not clear whether weight loss might have led to misclassification of BMI category. Liu et al [12] used the two Nurses' Health Study cohorts to identify 244 cases of self-reported microscopic colitis with 4.2 million person-years of observation. ...
Article
Background: Microscopic colitis is a leading cause of diarrhea in the older adults. There is limited information about risk factors. We hypothesized that obesity would be associated with microscopic colitis. Aim: To examine the association between obesity and microscopic colitis in men and women undergoing colonoscopy. Methods: We conducted a case-control study at the University of North Carolina Hospitals. We identified and enrolled men and women referred for elective, outpatient colonoscopy for chronic diarrhea. We excluded patients with a past diagnosis of Crohn's disease or ulcerative colitis. A research pathologist reviewed biopsies on every patient and classified them as microscopic colitis cases or non-microscopic colitis controls. Patients provided information on body weight, height and exposure to medications via structured interviews or Internet based forms. The analysis included 110 patients with microscopic colitis (cases) and 252 non-microscopic colitis controls. Multivariable analyses were performed using logistic regression to estimate odds ratios and 95% confidence intervals. Results: Cases were older and more likely than controls to be white race. Study subjects were well educated, but cases were better educated than controls. Cases with microscopic colitis had lower body mass index than controls and reported more weight loss after the onset of diarrhea. Compared to patients who were normal or under-weight, obese (BMI > 30 kg/m2) patients were substantially less likely to have microscopic colitis after adjusting for age and education, adjusted OR (aOR) 0.35, 95% confidence interval (CI) 0.18-0.66). When stratified by sex, the association was limited to obese women, aOR 0.21, 95%CI: 0.10-0.45. Patients with microscopic colitis were more likely to report weight loss after the onset of diarrhea. After stratifying by weight loss, there remained a strong inverse association between obesity and microscopic colitis, aOR 0.33, 95%CI: 0.10 - 1.11 among the patients who did not lose weight. Ever use of birth control pills was associated with lower risk of microscopic colitis after adjusting for age, education and BMI, aOR 0.38, 95%CI: 0.17-0.84. Conclusion: Compared to controls also seen for diarrhea, microscopic colitis cases were less likely to be obese. Mechanisms are unknown but could involve hormonal effects of obesity or the gut microbiome.
... In this work, the smoking women displayed signi cantly higher consumptions of calories, micronutrients, and macronutrients. One reason is that once the women stopped smoking during the rst trimester of pregnancy, the cessation of smoking itself could increase food consumption [59,60] in two ways: rst, nicotine inhibits food desire, and second, cigarette reward is substituted with food-reward ( with smokers, which could explain the lower global metDNA levels as we have proposed ( Figure 3). This could be explained by lower absorption rate [67], altered vitamin metabolism [68-70], or increased elimination rate [68,71] in the smoking women group. ...
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Background: Smoking is practiced worldwide for both men and women, and it is associated with different diseases and deleterious effects on gestational products, chiefly during pregnancy. Epigenetic alterations induced by cigarette smoke must be related to perinatal abnormalities. Methods: 219 pregnant women, aged 16 to 34 years, with or without a history of cigarette consumption (1–5/day) during the first trimester of pregnancy and their offspring were studied in this work. A validated dietary questionnaire was used to estimate daily consumptions of macronutrients and micronutrients, including total energy, during pregnancy. As a marker of DNA damage, 8-hydroxy-2’-deoxyguanosine (8-OHdG) levels were determined in plasma of women, before delivery, in umbilical cord blood after delivery, in the new-borns. The proportion of methylated DNA in the placentas (metDNA) was determined by ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry (UPLC-HRMS). Results: Non-significant differences were observed between smoking and non-smoking women groups, or between the new-borns groups (p > 0.05). Smoking women showed up higher intakes of vitamins, lipids, proteins, and carbohydrates in comparison with non-smoking women (p < 0.01). 8-OHdG levels correlated among the mothers and new-borns (p = 5.386e-15) and were lower in the smoking binomials in comparison with non-smoking binomials (β = −1.20 to −64). Negative correlations were found between micronutrients and macronutrients but Vitamin C, and 8-OHdG levels of the women (p < 0.01). However, the new-borns 8-OHdG correlated with proteins, vitamin A, and vitamin B12 (p < 0.05). Cigarettes consumed per day correlated to the 8-8HdG levels (Rho = −0.247, p = 0.012), alcohol consumption (Rho = 0.219, p = 0.001), to macronutrients (Rho = 212 to 332, p < 0.01), micronutrients (Rho = 186 to 289, p < 0.01), and to energy (Rho = 0.286, p = 0.001). Finally, metDNA deceased in the smoking women than in the non-smoking women (β = −0.12, p < 0.05), and correlated with the number of cigarettes consumed per day (Rho = −0.229, p = 0.009). Conclusion: Cigarette smoking alters metDNA levels of the placenta, however, their clinical effects come out over years or transgenerationally.
... This past research highlights the notion that actual BMI predicts multiple aspects of anti-fat attitudes and weight stigmatization. Given that many individuals believe that smoking is an effective weight control strategy (Audrain-McGovern & Benowitz, 2011;Tian et al., 2015), it is possible that beliefs and emotions about the social character of individuals classified as having higher weight and the perceptions of their physical/romantic unattractiveness are unrelated to smoking behaviors. Rather, beliefs about smoking appear to play a large role in weight control behaviors, which may partially explain why the interaction between weight control/blame and BMI significantly predicted smoking frequency. ...
... This was, however, evidently associated with elevated symptoms of psychological disorders, impaired sleeping, overweight, and reduced quality of life caused by prolonged lockdown (17,18). The overweight population is more likely to smoke than normal-weight people, and then, again, cessation of smoking may increase body weight (19,20). Therefore, prolonged lockdown can intensely affect the dynamics of body weight and smoking behavior. ...
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Objectives: This current study aims to assess the prevalence and factors associated with body mass index (BMI), dietary patterns, and the extent of physical activities among university students following the prolonged coronavirus disease 2019 (COVID-19) lockdown in Bangladesh. Methods: A cross-sectional web-based survey was conducted between July 10 to August 10, 2021, through a pre-designed Google Form to collect the data from Bangladeshi university students (age: ≥ 18 years). Informed consent was electronically obtained from each participant, and a simple snowball technique was employed during the sampling. Frequency and percentage distribution, paired t-test, chi-square [χ2] test, and multinomial and binary logistic regression analyses were consecutively applied to analyze the collected data. Results: Among the total participants (n = 1,602), 45.1% were female and 55.6% were 22 to 25 years' age group students. The BMI (mean ± standard deviation, SD) during the COVID-19 lockdown was 23.52 ± 7.68 kg/m2 which was 22.77 ± 4.11 kg/m2 during the pre-lockdown period (mean difference = 0.753; p < 0.001). The multinomial logistic regression analysis found a significant impact of gender (male vs. female: adjusted relative risk ratio [RRR] = 1.448; 95% confidence interval [CI] = 1.022, 2.053; p = 0.037), age (years) (< 22 vs. > 25: RRR = 0.389, 95% CI = 0.213, 0.710; p = 0.002, and 22-25 vs. > 25: RRR = 0.473, 95% CI = 0.290, 0.772; p = 0.003), monthly family income (BDT) (< 25,000 vs. > 50,000: RRR = 0.525, 95% CI = 0.334, 0.826; p = 0.005), university type (public vs. private: RRR = 0.540, 95% CI = 0.369, 0.791; p = 0.002), eating larger meals/snacks (increased vs. unchanged: RRR = 2.401, 95% CI = 1.597, 3.610; p < 0.001 and decreased vs. unchanged: RRR = 1.893, 95% CI = 1.218, 2.942; p = 0.005), and verbally or physically abuse (yes vs. no: RRR = 1.438, 95% CI = 0.977, 2.116; p = 0.066) on obesity during COVID-19 pandemic. Besides, the female students and who kept their eating habits constant were more likely to be underweight. Additionally, the binary logistic regression analysis found that the students from private universities (others vs private: adjusted odds ratio [AOR] = 0.461, 95% CI = 0.313, 0.680; p < 0.001), urban areas (urban vs. rural: AOR = 1.451, 95% CI = 1.165, 1.806; p = 0.001), wealthier families (<25000 BDT vs. >50000 BDT: AOR = 0.727, 95% CI = 0.540, 0.979; p = 0.036), and who were taking larger meals/snacks (increased vs. unchanged: AOR = 2.806, 95% CI = 2.190, 3.596; p < 0.001) and had conflicts/arguments with others (no vs. yes: AOR = 0.524, 95% CI = 0.418, 0.657; p < 0.001), were significantly more physically inactive. Finally, level of education and smoking habits significantly influenced the eating habits of university students during the extended strict lockdown in Bangladesh. Conclusion: The current findings would be helpful tools and evidence for local and international public health experts and policymakers to reverse these worsening effects on students mediated by the prolonged lockdown. Several effective plans, programs, and combined attempts must be earnestly implemented to promote a smooth academic and daily life.
... Moreover, a previous study demonstrated that the body fat of smokers is likely to be distributed mainly across the abdomen in a somewhat central or an apple-shaped pattern, which brings about adverse consequences for health [53]. It is worth noting that most of the effects of tobacco on body weight are regulated by nicotine, which induces the consumption of calories that could interfere with the weight gain processes of smokers [54]. ...
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Anthropometric variables (AV) are shown to be essential in assessing health status and to serve as markers for evaluating health-related risks in different populations. Studying the impact of physical activity (PA) on AV and its relationship with smoking is a non-trivial task from a public health perspective. In this study, a total of 107 healthy male smokers (37 ± 9.42 years) were recruited from different states in Malaysia. Standard procedures of measurement of several anthropometric indexes were carried out, and the International Physical Activity Questionnaire (IPPQ) was used to ascertain the PA levels of the participants. A principal component analysis was employed to examine the AV associated with physical activity, k-means clustering was used to group the participants with respect to the PA levels, and discriminant analysis models were utilized to determine the differential variables between the groups. A logistic regression (LR) model was further employed to ascertain the efficacy of the discriminant models in classifying the two smoking groups. Six AV out of twelve were associated with smoking behaviour. Two groups were obtained from the k-means analysis, based on the IPPQ and termed partially physically active smokers (PPAS) or physically nonactive smokers (PNAS). The PNAS were found to be at high risk of contracting cardiovascular problems, as compared with the PPAS. The PPAS cluster was characterized by a desirable AV, as well as a lower level of nicotine compared with the PNAS cluster. The LR model revealed that certain AV are vital for maintaining good health, and a partially active lifestyle could be effective in mitigating the effect of tobacco on health in healthy male smokers.
... Numerous epidemiological studies have shown the role of obesity as an independent risk factor for CVD [35]. It is also a risk factor for other diseases which are themselves CVRF, namely: DM, dyslipidemia and HBP [36]. ...
... Leptin memiliki fungsi mengatur kadar lemak dalam tubuh dan sekresi leptin berfungsi untuk menurunkan nafsu makan. 22 Teori lainnya mengatakan merokok dapat menurunkan produksi hormon leptin. Produksi leptin yang lebih rendah pada perokok, dapat mengakibatkan nafsu makan pada perokok meningkat, sehingga salah satu faktor produksi leptin dapat menjadi pemicu munculnya obesitas sentral. ...
Article
Latar belakang: Berdasarkan Data Riskesdas 2018, Provinsi DKI Jakarta menempati posisi ke-2 obesitas sentral tertinggi di Indonesia, dengan total 42% penduduk usia ≥15 tahun. Tujuan penelitian adalah untuk menganalisis faktor-faktor yang berhubungan dengan kejadian obesitas sentral pada remaja usia 15-18 tahun di Provinsi DKI Jakarta berdasarkan data sekunder Riskesdas 2018.Metode: Jenis penelitian yang digunakan deskriptif kuantitatif dengan pendekatan cross sectional. Sampel adalah seluruh populasi, yaitu 988 remaja usia 15-18 tahun. Penelitian menggunakan data sekunder Riskesdas 2018. Instrumen meliputi kuesioner terstruktur dengan buku pedoman pengisian kuesioner, serta alat ukur yang terbuat dari bahan fiberglass untuk melakukan pengukuran lingkar perut dengan tingkat ketelitian 0,1cm. Uji statistik yang digunakan adalah uji hubungan Chi Square.Hasil: Prevalensi obesitas sentral pada remaja usia 15-18 tahun di DKI Jakarta adalah 14,1%. Terdapat hubungan faktor jenis kelamin (p=0.001) dan status merokok (p=0,033) dengan obesitas sentral. Tidak ada hubungan antara tingkat pendidikan (p=0,104), kondisi mental emosional (p=0,100), konsumsi alkohol (p=0,553), usia (p=0,238), aktivitas fisik (p=0,323), konsumsi makanan berlemak (p=0,276), konsumsi makanan dan minuman manis (p=0,330), dan konsumsi sayur dan buah (p=0,398) dengan obesitas sentral.Simpulan: Kejadian obesitas sentral pada remaja usia 15-18 tahun di Provinsi DKI Jakarta berdasarkan data sekunder Riskesdas 2018 berhubungan dengan faktor status merokok dan jenis kelamin.Kata kunci: Obesitas Sentral; Remaja; Riskesdas 2018ABSTRACTTitle: Related Factor to The Incidence of Central Obesity among Adolescents Aged 15-18 Years in DKI Jakarta Province (Analysis of Riskesdas 2018)Background : According to Riskesdas 2018, DKI Jakarta province ranked the 2nd highest position of central obesity in Indonesia with a total of 42% of the population aged ≥15 years. The purpose of this study was to analyze the factors associated with the incidence of central obesity among adolescents aged 15 to 18 years in DKI Jakarta P rovince based on secondary data from Riskesdas 2018.Method:The type of research used is quantitative descriptive with a cross sectional approach. The study population was 988 adolescents aged 15 to 18 years. The research instruments used in Riskesdas 2018 consisted structured questionnaire with a guidebook for filling out the questionnaire, as well as measuring instruments made of fiberglass to measure the circumference of the abdomen with an accuracy of 0.1cm. The statistical test used is the frequency distribution and the Chi Square correlation test.Result: The prevalence of central obesity among adolescents aged 15 to 18 years in DKI Jakarta is 14.1%. There is a relationship between gender (p=0.000) and smoking status (p=0.033) with central obesity. There was no relationship between education level (p=0,104), mental emotional condition (p=0,100), alcohol consumption (p=0,553), age (p=0,238), physical activity (p=0,323), consumption of fatty foods (p= 0.276), consumption of sweet foods and drinks (p=0.330), consumption of vegetables and fruit (p=0.398) with central obesity. Central obesity among adolescents aged 15-18 years in DKI Jakarta province is influenced by smoking status and gender. Conclusion: The incidence of central obesity among adolescents aged 15-18 years in the DKI Jakarta Province based on 2018 Riskesdas secondary data is associated to smoking status and gender.Keywords: Central Obesity; Adolescent; Riskesdas 2018
... In the present study, smoking was associated with lower BMI in women. In the literature, smoking is often associated with lower BMI (40,41) , however heavy smoking has been suggested to be associated with higher BMI. The direction of causality is still unclear, it is possible that individuals with high BMI smoke to reduce weight (42) . ...
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Excess weight is caused by multiple factors and has increased sharply in Switzerland since the 1990s. Its consequences represent a major challenge for Switzerland, both in terms of health and the economy. Until now, there has been no cross-dataset overview study on excess weight in adults in Switzerland. Therefore, our aim was to conduct the first synthesis on excess weight in Switzerland. We included all existing nationwide Swiss studies (eight total), which included information on body mass index (BMI). Mixed multinomial logistic regression analyses were performed to assess the associations between different socio-demographic, lifestyle cofactors and the World Health Organization (WHO) categories for BMI. Along with lifestyle factors, socio-demographic factors were among the strongest determinants of BMI. In addition, self-rated health status was significantly lower for underweight, pre-obese and obese men and women than for normal weight persons. The present study is the first to synthesise all nationwide evidence on the importance of several socio-demographic and lifestyle factors as risk factors for excess weight. In particular, the highlighted importance of lifestyle factors for excess weight opens up the opportunity for further public health interventions.
... Similar to previous studies in Iran [24,30], the results of the present study showed that women were more obese than men. In previous studies, a number of factors such as unemployment, depression, unhealthy eating patterns, sleep disorders and illiteracy, low SES, number of pregnancies and physical inactivity have been identified as risk factors of obesity in women [31]. Generally, Iranian women have less physical activity than men due to limited social conditions and the type of outdoor clothing or the limited number of suitable gyms and sport clubs. ...
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Introduction The aim of the present study was to explore and determine the association between BMI and socio-economic factors in Iran. Methods Adults aged 35 to 70 ( n = 20,460) were included from Ardabil Non-Communicable Disease (ArNCD) cohort study. BMI was calculated as kg/m ² . Principal Component Analysis (PCA) was used to determine the socio-economic quintiles. Multivariate linear regression was performed to analyze the association of BMI as dependent variable with explanatory variables, Additionally, decomposition analyzing conducted to identify factors that explained wealth-related inequality in obesity. Results The prevalence of overweight and obese people was 83.7% (41.4% overweight and 42.5% obese) wherein the highest frequency of obese people belonged to the age group of 45 to 49 years old (19.9%) and to the illiterate people (33.1%). The results of multivariate linear regression model showed that age, being female, marriage, lower education level, having chronic disease, alcohol use, and higher socioeconomic level positively associated with obesity. The results of the decomposition model showed that the most important variables affecting socioeconomic inequality in higher BMI level were socioeconomic status (75.8%), being women (5.6%), education level (− 4.1%), and having chronic disease (2.4%). Conclusion BMI showed significant association with socio-economic status, where richest people had significantly higher BMI than poorest group. Considering the direct role of high BMI in non-communicable diseases, new policies are needed to be developed and implemented by means of diet intervention and increased physical activity to control the BMI in the population of Iran.
... Our finding of a significant positive association between former smoking and HER2-type YOBC risk was unexpected but may be explicable through BMI's known association with smoking [52,53]. Smoking is associated with lower BMI and studies have shown that HER2-type YOBC may be more common among women with normal vs. obese BMI [54]. ...
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Purpose To evaluate the association between lifetime personal cigarette smoking and young-onset breast cancer (YOBC; diagnosed <50 years of age) risk overall and by breast cancer (BC) subtype, and whether risk varies by race or socioeconomic position (SEP). Methods Data are from the Young Women’s Health History Study (YWHHS), a population-based case–control study of non-Hispanic Black (NHB) and White (NHW) women, ages 20–49 years (n = 1812 cases, n = 1381 controls) in the Los Angeles County and Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) registry areas, 2010–2015. Lifetime personal cigarette smoking characteristics and YOBC risk by subtype were examined using sample-weighted, multivariable-adjusted polytomous logistic regression. Results YOBC risk associated with ever versus never smoking differed by subtype (Pheterogeneity = 0.01) with risk significantly increased for Luminal A (adjusted odds ratio [aOR] 1.34; 95% confidence interval [CI] 1.06–1.68) and HER2-type (aOR 1.97; 95% CI 1.23–3.16), and no association with Luminal B or Triple Negative subtypes. Additionally, ≥30 years since smoking initiation (versus never) was statistically significantly associated with an increased risk of Luminal A (aOR 1.55; 95% CI 1.07–2.26) and HER2-type YOBC (aOR 2.77; 95% CI 1.32–5.79), but not other subtypes. In addition, among parous women, smoking initiated before first full-term pregnancy (versus never) was significantly associated with an increased risk of Luminal A YOBC (aOR 1.45; 95% CI 1.11–1.89). We observed little evidence for interactions by race and SEP. Conclusion Findings confirm prior reports of a positive association between cigarette smoking and Luminal A YOBC and identify a novel association between smoking and HER2-type YOBC.
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Background: The association between body mass index (BMI) and oesophageal cancer (OC) has been consistently negative among Asians, whereas different associations based on histological OC subtypes have been observed in Europeans and North Americans. We examined the association between BMI and OC mortality in the Asia Cohort Consortium. Methods: We performed a pooled analysis to evaluate the association between BMI and OC mortality among 842 630 Asians from 18 cohort studies. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs. Results: A wide J-shaped association between BMI and overall OC mortality was observed. The OC mortality risk was increased for underweight (BMI <18.5 kg/m2: HR = 2.20, 95% CI 1.80-2.70) and extreme obesity (BMI ≥35 kg/m2: HR = 4.38, 95% CI 2.25-8.52) relative to the reference BMI (23-25 kg/m2). This association pattern was confirmed by several alternative analyses based on OC incidence and meta-analysis. A similar wide J-shaped association was observed in oesophageal squamous cell carcinoma (OSCC). Smoking and alcohol synergistically increased the OC mortality risk in underweight participants (HR = 6.96, 95% CI 4.54-10.67) relative to that in reference BMI participants not exposed to smoking and alcohol. Conclusion: Extreme obesity and being underweight were associated with an OC mortality risk among Asians. OC mortality and BMI formed a wide J-shaped association mirrored by OSCC mortality. Although the effect of BMI on OSCC and oesophageal adenocarcinoma mortality can be different in Asians, further research based on a large case-control study is recommended.
Article
Background: Because much worldwide cancer incidence and mortality is related to modifiable risk factors, many global health organizations provide evidence-based recommendations on healthy weight, diet, and physical activity levels for cancer prevention. Even though adherence to such guidelines is reported to reduce cancer incidence and mortality, this adherence is often suboptimal. Identifying factors related to adherence to the guidelines can suggest interventions to improve health promoting lifestyle behaviors for cancer prevention. Objectives: Examine a comprehensive set of potentially predictive factors in meeting American Cancer Society's guidelines for healthy weight, fruits and vegetables intake, and physical activity. Methods: Data used in the analysis were from adults aged 18 years and older without a history of a cancer diagnosis who participated in the Health Information National Trends Survey in 2019 (n = 3407). Multivariate logistic regression analyses were used to determine the significant predictors for meeting each of the healthy weight, fruits and vegetables intake, and physical activity guidelines. Results: Overall adherence to each guideline was low: 39.0% met the physical activity guideline, 30.4% met the healthy weight guideline, and 17.6% met the fruits and vegetables intake guideline. Meeting the healthy body weight guideline was greater in current smokers, females, those who had at least some college education, those who did not have a chronic health condition, and those who had very good self-rated health. Meeting the fruits and vegetables intake guideline was greater in females, those who had very good self-rated health, and those who talked to friends or family members regarding their health. Meeting the physical activity guideline was greater in males, those who had household incomes of at least $50,000, those who did not have a chronic health condition, and those who had very good self-rated health. Conclusions: The current analyses identified a unique set of predictors for meeting each guideline among US adults who reported never having been diagnosed with cancer. Based on these findings, interventions related to each guideline should be especially targeted to individuals having characteristics that were less likely to meet them. Clinical relevance: Findings from the current study can assist health care providers who counsel about cancer prevention in the clinical setting.
Article
This study investigated weight control behaviors associated with early menopause among Korean women, utilizing cross-sectional Korean National Health and Nutrition Examination Survey (KNHANES) data obtained from 2014 to 2018 to analyze 3,591 women aged 20–64 years with complete responses to questions dealing with natural menopause status and age. The data were analyzed using multivariate ordinal logistic regression. After adjusting for confounding variables affecting weight control behaviors and the timing of menopause, not having lost weight (odds ratio [OR] = 0.69, 95% confidence interval [CI] = 0.50–0.97, p = .033) and less use of reducing and controlling food for weight control (OR = 0.67, 95% CI = 0.55–0.81, p < .001) were shown to be associated with earlier menopause. In a further analysis, higher fat intake and lower monounsaturated fatty acid intake were associated with earlier menopause (OR = 1.06, 95% CI = 1.02–1.11, p = .007; OR = 0.94, 95% CI = 0.89–0.99, p = .014, respectively). This study findings are applicable in policies or interventions aiming to prevent cardiovascular risks among those with different timing of menopause and possibly delay early menopause.
Article
Tobacco product use (TPU; e.g., smoking, e‐cigarettes, other emerging products) is elevated in eating disorders (EDs), yet the phenomenology of tobacco use within EDs has not received much attention. Due to the appetite suppressant effects of tobacco products as well as the array of availability of tobacco products in hedonic flavors (e.g., gummy bear, fruit), TPU may be used for weight control, such as to suppress appetite, satisfy cravings, or for meal replacement. The purpose of this article was to outline theoretical research on TPU for weight control as a mechanism in EDs as well as key areas for future research. We discuss the conceptualization and nature of TPU for weight control and how it may be related to EDs and associated behaviors, TPU patterns and smoking for weight control in EDs, and the effectiveness of current interventions and development of novel intervention protocols for individuals with EDs who use tobacco. Overall, this article outlines novel research questions on TPU in EDs and as a weight control behavior and provides recommendations to clarify the conceptualization and role of TPU within EDs.
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The mesolimbic dopamine (DA) system reinforces behaviors that are critical for survival. However, drug dependence can occur when drugs of abuse, such as nicotine, highjack this reinforcement system. Pharmacologically targeting the DA system to selectively block drug reinforcement requires a detailed understanding of the neural circuits and molecular pathways that lead to the reward-based activation of mesolimbic circuits. Varenicline is an approved smoking cessation drug that has been shown to block nicotine-evoked DA increases in the nucleus accumbens (NAc) through action on nicotinic acetylcholine receptors. Because these receptors have been implicated in the reinforcement of other addictive substances, we explored the possibility that varenicline could broadly affect reward processing. We used in vivo fiber photometry to monitor midbrain DA neuron activity and striatal DA levels following either natural or drug rewards in mice treated with varenicline. We demonstrate that varenicline pretreatment enhances the suppression of nicotine-evoked DA release by attenuating DA neuron activity in the VTA. Varenicline’s ability to attenuate DA release is highly specific to nicotine, and varenicline slightly elevates DA release when co-administered with morphine or ethanol. Furthermore, varenicline has no effect on DA release in response to naturally rewarding behavior such as food intake or exercise. These results demonstrate the exquisite specificity with which varenicline blocks nicotine reward and highlight the complexity with which different rewards activate the mesolimbic DA system.
Article
Background China is a country with a large alcohol user population, but it also faces other public health challenges like the growth of older adult population and shift in dietary behaviors in the past few decades. We examined the associations of alcohol consumption and dietary behaviors with severe cognitive impairment among Chinese older men and women. Methods We used panel data from three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to examine this topic of interest. Older adults who answered three survey waves were analyzed (age ≥ 65), with a total of 7,950 observations (n = 7,950). Results In the panel logistic regression models, only former alcohol use was positively associated with severe cognitive impairment among older men (p < .05), but not in older women. Neither current light nor heavy alcohol consumption was associated with cognitive impairment. Older men and women who did not consume or rarely consume fruits and vegetables were more likely to develop severe cognitive impairment (all p < .01). Conclusion Public health practitioners can use the empirical results from this research to identify what patterns of alcohol use and dietary behaviors can help prevent cognitive impairment among older adults.
Article
Metabolic syndrome is a growing epidemic that increases the risk for cardiovascular disease, diabetes, stroke, and mortality. It is diagnosed by the presence of three or more of the following risk factors: 1) obesity, with an emphasis on central adiposity, 2) high blood pressure, 3) hyperglycemia, 4) dyslipidemia, with regard to reduced high-density lipoprotein concentrations, and 5) dyslipidemia, with regard to elevated triglycerides. Smoking is one lifestyle factor that can increase the risk for metabolic syndrome as it has been shown to exert negative effects on abdominal obesity, blood pressure, blood glucose concentrations, and blood lipid profiles. Smoking may also negatively affect other factors that influence glucose and lipid metabolism including lipoprotein lipase, adiponectin, peroxisome proliferator-activated receptors, and tumor necrosis factor-alpha. Some of these smoking-related outcomes may be reversed with smoking cessation, thus reducing the risk for metabolic disease; however, metabolic syndrome risk may initially increase post cessation, possibly due to weight gain. Therefore, these findings warrant the need for more research on the development and efficacy of smoking prevention and cessation programs.
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Overweight is increasingly prevalent in people living with HIV (PLWH), and is a high risk factor for metabolic disorders in this population. PLWH co-infected with hepatitis C virus (HCV) have a higher risk of metabolic disorders than their mono-infected counterparts. The putative relationship between cannabis use and body weight found in the general population has never been documented in HIV-HCV co-infected people. We tested whether cannabis use is associated with body mass index (BMI), overweight, and underweight in HCV co-infected PLWH (N = 992). Mixed-effects linear and logistic regression models were used to study the association between cannabis use and the three outcomes over time. After multivariable adjustment, cannabis use was inversely associated with BMI. Cannabis use was associated with a lower and higher risk of overweight and underweight, respectively. Cannabis use should be assessed and taken into account in the clinical management of the HIV-HCV co-infected population.
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About the Book: This book compiled with quality research papers of the Two Day International E-Conference on “Trends Issues and Development of Physical Education and Sports” under the theme of “All round development of human personality” jointly organised by Department of Physical Education and Sports Science, Fit India Campaign Committee and Fit India Club, Manipur University, Canchipur in collaboration with National Association of Physical Education and Sports Science (NAPESS). This book has been undertaken by the organisers to share the knowledge of the professionals through their research papers and to exchange their experience and research finding area in the field of physical educational and sports science. This is the book of the reviews on the concrete solutions to the permanent problems in the physical education and sports science. It is a humble energy to bind the drowning talents of physical education and sports. We express our gratitude, to those humble physical education teachers, research scholars, students, sports lovers, coaches, and sports administrators, who made this chance. Editor Dr. L.Santosh Singh
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Objective: Menopause is the period when significant changes occur in women and influence their life quality. The aim of this study was to investigate lifestyle behaviours and dietary habits in an Italian sample of pre-menopausal and postmenopausal women. Materials and Methods: A cross-sectional online survey was conducted May to July 2021 by online platforms. A total of 250 women (130 pre-menopausal and 120 post-menopausal) completed a self-reported questionnaire, comprising questions on demographic characteristics, anthropometrics data, lifestyle behaviours and dietary habits. Results: Overweight/obesity prevalence was 22.4% with higher values of post-menopausal than pre-menopausal women (25.9% vs 19.2%). Pre-menopausal women were slightly more physically active (67.7% vs 65.8), but with significantly lower percentages when exercised for 60+ minutes (36.2% vs 54.7%; p=0.0130). As to sedentary activities, higher and significant percentage of pre-menopausal women was found compared to post-menopausal women (89.2% vs 67.5%; p <0.0001). Regarding the dietary habit of having breakfast regularly, a significantly higher percentage of post-menopausal than pre-menopausal women (90.0% vs 80.0%) emerged. Multiple logistic regression model showed that smoking, physical activity and sleep duration affected significantly the ponderal status, whereas age, marital status, alcohol consumption, breakfast habit, and sweet consumption were not significant. Conclusions: Not many differences in lifestyle and eating habits exist between pre-menopausal and post-menopausal women. The only significant differences relate to physical activity duration, sedentary behaviours and breakfast habit in favor of post-menopausal women. However, the prevalence of overweight/obesity was particularly linked to lifestyle behaviors such as smoking, sleep and physical activity in all participating women. Key words: Premenopausal women, postmenopausal women, lifestyle behaviours, dietary habits, overweight/obese.
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Background: Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection. Methods: Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models. Results: Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37-0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19-0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38-0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI. Conclusions: We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure. Trial registration: ClinicalTrials.gov identifier: NCT01953458 .
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Objective: The authors hypothesize that an untargeted metabolomics study will identify novel mechanisms underlying smoking-associated weight loss. Methods: This study performed cross-sectional analyses among 1,252 participants in the Bogalusa Heart Study and assessed 1,202 plasma metabolites for mediation effects on smoking-BMI associations. Significant metabolites were tested for associations with smoking genetic risk scores among a subset of participants (n = 654) with available genomic data, followed by direction dependence analysis to investigate causal relationships between the metabolites and smoking and BMI. All analyses controlled for age, sex, race, education, alcohol drinking, and physical activity. Results: Compared with never smokers, current and former smokers had a 3.31-kg/m2 and 1.77-kg/m2 lower BMI after adjusting for all covariables, respectively. A total of 22 xenobiotics and 94 endogenous metabolites were significantly associated with current smoking. Eight xenobiotics were also associated with former smoking. Forty metabolites mediated the smoking-BMI associations, and five showed causal relationships with both smoking and BMI. These metabolites, including 1-oleoyl-GPE (18:1), 1-linoleoyl-GPE (18:2), 1-stearoyl-2-arachidonoyl-GPE (18:0/20:4), α-ketobutyrate, and 1-palmitoyl-GPE (16:0), mediated 26.0% of the association between current smoking and BMI. Conclusions: This study cataloged plasma metabolites altered by cigarette smoking and identified five metabolites that partially mediated the association between current smoking and BMI.
Article
Objective: To explore oral health by increasing degree of obesity and the influence of modifying factors. Materials and methods: A cross-sectional design was used. Swedish females (n = 118; 18-35 years) with morbid obesity were recruited from the BAriatric SUbstitution and Nutrition study (BASUN). Body mass index (BMI) was used as continuous and categorized into 35-39.9 kg/m2/40-44.9 kg/m2/≥45 kg/m2. Oral examinations assessed dental caries using the ICDAS system, periodontal status and saliva characteristics. Information on sociodemographics, oral health behaviour and symptoms was collected via a questionnaire. Results: Mean BMI was 42.2 kg/m3 (SD 4.0; range 35.0-63.7). Significantly higher frequencies of dentine caries (p = .001) and total caries (p = .046) were found with higher BMI with an increase in total caries by 0.59 tooth surface (p = .025) for each increasing BMI degree. There were consistent associations between obesity and dentine caries for the group with the highest BMI (≥45), adjusted RR 2.08 (95% CI 1.20-3.61), and all stages of caries, adjusted RR 1.41 (95% CI 1.02-1.96). High scores were found for dental plaque (50.2%) and gingivitis (34.5%). Conclusion: Young obese women exhibited poor oral health with higher caries levels by higher BMI. Dental care should adapt the prevention efforts for obese individuals. Trial Registration: The trial was prospectively registered on March 03; 2015; NCT03152617.
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The purpose of this study was to elucidate the association between weight cycling and clinical outcomes such as type 2 diabetes and hypertension with differential effects of baseline age and obesity. Nationwide data from 6,132,569 healthy adults who underwent five or more health screenings between 2002 and 2011 were analyzed and followed until December 2019 for type 2 diabetes and hypertension. Weight cycling was defined as a change in body weight followed by another change in the opposite direction. Through the Cox proportional hazards model, the number and degree of weight cycles were positively associated with increased risk of type 2 diabetes and hypertension. The hazard ratios (HRs) of weight cycling for type 2 diabetes and hypertension were as high as 1.263 (1.213–1.315) and 1.175 (1.144–1.207) at two or more weight cycles of 10% of body weight (BW), respectively. The association was stronger for females, individuals with normal body weight/BMI, and older individuals. Weight cycling was significantly associated with an increased risk of adverse health outcomes and was stronger in individuals with normal BMI and females, indicating that these people should be informed about the potential risk of weight cycling.
Thesis
Contexte : Chez la femme, le cancer du poumon représente la deuxième cause de mortalité par cancer après le cancer du sein. Le tabac est le principal facteur de risque du cancer du poumon, aussi bien chez l’homme que chez la femme. Cependant, des différences cliniques, histologiques et de survie entre les hommes et les femmes laissent supposer que d’autres facteurs de risque, insuffisamment étudiés, pourraient intervenir spécifiquement dans la cancérogenèse pulmonaire chez la femme. Objectif : Nous avons étudié le rôle des diverses caractéristiques de la consommation de tabac et des facteurs hormonaux endogènes et exogènes dans la survenue du cancer du poumon chez la femme. Matériel et méthodes : L’étude WELCA (Women Epidemiology Lung Cancer) une étude cas-témoins sur 747 femmes atteintes d’un cancer primitif du poumon et 762 femmes témoins recrutées en population générale. Des informations détaillées sur les habitudes de consommation tabagique et les comportements de dépendance à la nicotine, les facteurs menstruels et reproductifs et les traitements hormonaux contraceptifs et de la ménopause (THM) ont été recueillies à l’aide d’un questionnaire standardisé. Des modèles de régression logistique multivariés ont été utilisés pour calculer des odds ratios et leurs intervalles de confiance à 95%. Résultats : L'intensité, la durée, le délai depuis l'arrêt du tabac ainsi que le CSI (Comprehensive Smoking Index), un score combinant les effets des 3 premiers indicateurs, étaient associés au risque de cancer du poumon dans des proportions différentes selon le type histologique. Les habitudes tabagiques délétères et les comportements de forte dépendance à la nicotine étaient associés de manière indépendante au risque de cancer du poumon. Concernant les facteurs menstruels, une longue durée de vie reproductive et un âge tardif à la ménopause étaient associés inversement au risque de cancer du poumon, chez les femmes n’ayant jamais fumé et chez les femmes ex-fumeuses après ajustement sur le CSI. Une gestité et une parité élevées étaient inversement associées avec le risque de cancer du poumon, mais ces associations étaient fortement atténuées par l’ajustement sur le CSI, et n’étaient pas confirmées chez les non-fumeuses. Des associations inverses ont été observées avec l’allaitement chez les fumeuses actuelles et chez les femmes non-ménopausées. Concernant les THM, leur utilisation à une période quelconque de la vie, ou la consommation actuelle chez les femmes fumeuses étaient associées positivement au risque de cancer du poumon. Conclusion : Nos résultats confirment le rôle du tabac, des habitudes tabagiques et de la dépendance à la nicotine dans la survenue du cancer du poumon chez la femme. Les résultats sur les facteurs hormonaux endogènes et exogènes doivent être confirmés par des études complémentaires.
Article
Introduction: Some adolescents report using e-cigarettes (EC) for weight-related reasons, but longitudinal studies are lacking. This study examined associations between tobacco weight control beliefs and body mass index (BMI) with EC use patterns over one year. Methods: Data from Waves 1 and 2 (September 2013 to October 2015) of the Population Assessment of Tobacco and Health (PATH) study were used. Questions about tobacco weight control beliefs, EC use patterns (never, ever, never to current, ever to current, current to current), cigarette and other tobacco product use, demographics, and BMI were examined among adolescent respondents across Wave 1 and Wave 2. Results: Most adolescents were never EC users (85.8%). Prevalence of EC use patterns was low across categories of use (0.6%-5.3%). Higher BMI was associated with transition from ever but not current use at Wave 1 to current use at Wave 2. Greater baseline tobacco weight control beliefs and increases in tobacco weight control beliefs were associated with most EC use patterns compared to never use. Conclusions: Greater tobacco weight control beliefs were risk factors for e-cigarette initiation and maintenance among a nationally representative sample of adolescents. BMI was minimally associated with e-cigarette use patterns. Additional studies are needed to replicate and further examine these preliminary prospective associations between weight control beliefs and EC use.
Article
Introduction: Hypertension and smoking are two independent risk factors for oxidative stress and dyslipidaemia, thereby development of cardio and cerebrovascular diseases are common. The effect of smoking on oxidants, antioxidants and lipid profile in hypertensive individuals is the matter of concern. Aim: To compare fasting serum lipid profile, Glutathione (GSH) and Thiobarbituric Acid Reactive Substances (TBARS) of hypertensive smokers and hypertensive non smokers. Materials and Methods: This case-control study was conducted in the Department of Biochemistry, Kanachur Institute of Medical Sciences, Mangalore, Karnataka, India, between September 2021 to December 2021. The study population consisted of 58 hypertensive smokers and 58 hypertensive non smokers visiting the Department of Internal Medicine, tertiary care hospital. Height, weight, smoking intensity, family history of hypertension was recorded, fasting serum lipid profile, GSH and TBARS were estimated. Smoking intensity was expressed as pack-years. Body Mass Index (BMI) was calculated using the measured height and weight. The data were analysed using Chi-square test, independent sample t-test and Pearson’s correlation. Results: The mean age of cases were 40.38±14.96 years whereas among controls, it was 45.98±14.96 years. Among cases, 50 were males and eight were females, whereas among the controls, 47 were males and 11 were females. Out of total 58 subjects in each group, 43 in cases and 45 in controls had a family history of hypertension. A significant increase in the levels of serum TC, TAG, LDL-C, TBARS and a significant decrease in GSH, BMI in cases compared to the control (p
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Purpose The purpose of this paper was to study responses to traditional food of a country, focusing on emotion-motivational responses by locals and foreigners. Design/methodology/approach Through an experimental design study, Portuguese and Foreign participants were exposed to both traditional and nontraditional food pictures of a country and asked to evaluate their emotional and motivational responses while physiological responses of electrodermal activity were being continuously recorded. Predisposition factors of body dissatisfaction, food neophobia and food involvement were also evaluated given their potential role in predicting the responses to the visualization of the food pictures. Findings This study found that local traditional food received a higher positive evaluation than nontraditional food with locals evaluating it even higher than foreigners. Higher feelings of arousal and desire as well as willingness to try in response to traditional food were also found as well as higher feelings of pleasure by locals. However, interestingly, and contrary to expectations derived from previous literature, emotion-motivational responses were not significantly different between locals and foreigners. Originality/value To the best of the authors’ knowledge, this research addressed an identified research gap in the literature, being the first one evaluating the autonomic responses of consumers to traditional food by exploring how local and foreign consumers respond to traditional food versus nontraditional food using psychophysiological measures of emotion.
Article
Smoking-related weight control expectancies are a motivational factor for maintaining cigarette use, particularly among women. Yet, less research has investigated the physiological and behavioral daily life weight-related experiences of women with smoking-related weight control expectancies. Increased research could contribute to understanding of maintenance factors for this group of smokers as well as unique intervention targets. Female smokers completed a baseline survey of smoking-related weight control expectancies and 35-days of ecological momentary assessment of physiological (i.e., smoking-related reduction in hunger, end-of-day perceived weight gain and bloating) and behavioral (i.e., daily exercise and sitting) weight-related experiences. Higher smoking-related weight control expectancies were associated with perceived smoking-related reductions in hunger and end-of-day perceived weight gain. Smoking-related weight control expectancies did not significantly associate with end-of-day bloating, daily exercise, or sitting. Given these findings, smoking-related weight control expectancies may maintain smoking in order to reduce hunger and to cope with perceived fluctuations in weight in daily life. It is critical for smoking cessation programs to assess smoking-related weight control expectancies and implement targeted treatments for these women.
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Long term e-cigarette vaping induces inflammation, which is largely nicotine independent. High-fat diet (HFD) consumption is anoter cause of systemic low-grade inflammation. The likelihood of using e-cigarettes as a weight control strategy is concomitant with the increase in obesity. In Australia, only nicotine-free e-fluid is legal for sale. Therefore, this study aimed to investigate how nicotine-free e-cigarette vapour exposure affects inflammatory responses in mice with long term HFD consumption. Mice were fed a HFD for 16 weeks, while in the last 6 weeks, half of the chow and HFD groups were exposed to nicotine-free e-vapour, while the other half to ambient air. Serum, lung, liver and epididymal fat were collected to measure inflammatory markers. While both e-vapour exposure and HFD consumption independently increased serum IFN-γ, CX3CL1, IL-10, CCL20, CCL12, and CCL5 levels, the levels of IFN-γ, CX3CL1, and IL-10 were higher in mice exposed to e-vapour than HFD. The mRNA expression pattern in the epididymal fat mirrors that in the serum, suggesting the circulating inflammatory response to e-vapour is from the fat tissue. Of the upregulated cytokines in serum, none were found to change in the lungs. The anti-inflammatory cytokine IL-10 was increased by combining e-vapour and HFD in the liver. We conclude that short-term nicotine-free e-vapour is more potent than long term HFD consumption in causing systemic inflammation. Future studies will be needed to examine the long-term health impact of nicotine-free e-cigarettes.
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A major obstacle to successful smoking cessation is the prospect of weight gain. Despite a clear relationship between cigarette smoking and body weight, surprisingly little is known about the physiological and molecular mechanism by which nicotine affects energy homeostasis and food motivated behaviors. Here we use loss-of-function mouse models to demonstrate that two nicotinic acetylcholine receptor (nAChR) subunits encoded by the CHRNA5-CHRNA3-CHRNB4 gene cluster, α5 and β4, exhibit divergent roles in food reward. We also reveal that β4-containing nAChRs are essential for the weight-lowering effects of nicotine in diet-induced obese mice. Finally, our data support the notion of cross-talk between incretin biology and nAChR signaling, as we demonstrate that the glycemic benefits of glucagon-like peptide-1 receptor (GLP-1R) activation partially relies on β4-containing nAChRs. Together, these data encourage further research into the role of cholinergic neurotransmission in regulating food reward and the translational pursuit of site-directed targeting of β4-containing nAChRs for treatment of metabolic disease.
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Background The prevalence of hypertension may be affected by environmental pollution and personal behavior. Objectives We aimed to evaluate the interaction effects of secondhand smoke exposure and overweight on hypertension. Methods In this cross-sectional study, a total of 627 workers from a coking plant in China and 1011 individuals from the NHANES database in the United States from 2013 to 2016 were selected as the research participants. The concentrations of 11 urinary polycyclic aromatic hydrocarbons (PAHs) metabolites and 3 tobacco metabolites were measured. An interaction effect was tested in the modified Poisson regression models. Results For smokers among Chinese coke oven workers, the only statistically significant positive association was with hypertension in the highest tertile of nicotine metabolized ratio (NMR) (PR: 1.539, 95% CI: 1.013–2.337). Nonsmoking Chinese workers with 3rd tertile urinary nicotine levels were associated with a 114.8% significantly increased prevalence of hypertension (PR: 2.148, 95% CI: 1.025–4.500) compared to nonsmokers 1st tertile with nicotine levels. Association between tobacco exposure and hypertension is possibly modified by PAHs exposure (PR: 2.335, 95% CI: 0.933–5.841). Nonsmokers in the NHANES database with high urinary nicotine levels were associated with a 17.3% significantly increased prevalence of hypertension (PR: 1.173, 95% CI: 1.028–1.338) compared to those with low nicotine levels. We observed that overweight people with high nicotine levels had a significantly higher likelihood of hypertension than no overweight people with low nicotine levels among nonsmoking Chinese coke oven workers and NHANES participants (PR = 4.686, 95% CI: 1.488–14.754; PR = 1.251, 95% CI: 1.039–1.506). Conclusions Tobacco exposure and overweight are important risk factors for hypertension, and secondhand smoke exposure and overweight have an interactive effect on the incidence of hypertension in nonsmoking Chinese coke oven workers and NHANES participants.
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Background Chlorinated polyfluorinated ether sulfonic acids (Cl-PFESA 6:2 and 8:2), used as perfluorooctane sulfonate (PFOS) alternatives, affect lipid metabolism in vivo and in vitro studies. The association between Cl-PFESAs exposure and the prevalence of overweight /obesity in human is unknown. Objectives We investigated associations of serum 6:2 Cl-PFESA and 8:2 Cl-PFESA with overweight/obesity status in adults. Methods We quantified four perfluoroalkyl substances (PFAS), including 6:2 Cl-PFESA, 8:2 Cl-PFESA, PFOS, and perfluorooctanoic acid (PFOA) in 1275 Chinese adults from the Isomers of C8 Health Project in China study. Participants were categorized into normal weight group [body mass index (BMI) < 25 kg/m²] and overweight/obesity group (BMI ≥ 25 kg/m²). Results Adjusted for potential confounders, BMI in the second quartile of each ln-ng/mL greater concentration of 6:2 Cl-PFESA and 8:2 Cl-PFESA were 0.45 [95% confidence interval (CI): 0.08, 0.82], and 0.39 (95% CI:0.03, 0.76) significantly higher than the lowest quartile, respectively. Cl-PFESAs displayed inverted U-shaped associations with the risk of overweight/obesity, and the inflection point of 6:2 Cl-PFESA and 8:2 Cl-PFESA were 1.80 ng/mL, 0.01 ng/mL, respectively. PFOS was associated with waist circumference (WC) but not BMI in each quartile. For PFOA, the associations with outcomes were linearly positive (P for trend < 0.05). Conclusions This study reports the first observations on non-monotonic associations between serum 6:2 Cl-PFESA and 8:2 Cl-PFESA concentrations and the prevalence of overweight/obesity in adults. More epidemiological investigations are required to confirm the observed associations.
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To examine the effect of body mass index (BMI) on weight change over 8 years in a cohort of continuing smokers and a cohort that quit and remained abstinent. 8 year prospective cohort study. Participants smoking >15 cigarettes daily enrolled in a clinical trial of nicotine patch or placebo in Oxfordshire general practices and were reviewed 8 years later. 832 male and female participants. Abstainers were 85 participants who …
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Drugs and food exert their reinforcing effects in part by increasing dopamine (DA) in limbic regions, which has generated interest in understanding how drug abuse/addiction relates to obesity. Here, we integrate findings from positron emission tomography imaging studies on DA's role in drug abuse/addiction and in obesity and propose a common model for these two conditions. Both in abuse/addiction and in obesity, there is an enhanced value of one type of reinforcer (drugs and food, respectively) at the expense of other reinforcers, which is a consequence of conditioned learning and resetting of reward thresholds secondary to repeated stimulation by drugs (abuse/addiction) and by large quantities of palatable food (obesity) in vulnerable individuals (i.e. genetic factors). In this model, during exposure to the reinforcer or to conditioned cues, the expected reward (processed by memory circuits) overactivates the reward and motivation circuits while inhibiting the cognitive control circuit, resulting in an inability to inhibit the drive to consume the drug or food despite attempts to do so. These neuronal circuits, which are modulated by DA, interact with one another so that disruption in one circuit can be buffered by another, which highlights the need of multiprong approaches in the treatment of addiction and obesity.
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Past therapies for the treatment of obesity have typically involved pharmacological agents usually in combination with a calorie-controlled diet. This paper reviews the efficacy and safety of pharmacotherapies for obesity focusing on drugs approved for long-term therapy (orlistat), drugs approved for short-term use (amfepramone [diethylpropion], phentermine), recently withdrawn therapies (rimonabant, sibutamine) and drugs evaluated in Phase III studies (taranabant, pramlintide, lorcaserin and tesofensine and combination therapies of topiramate plus phentermine, bupropion plus naltrexone, and bupropion plus zonisamide). No current pharmacotherapy possesses the efficacy needed to produce substantial weight loss in morbidly obese patients. Meta-analyses support a significant though modest loss in bodyweight with a mean weight difference of 4.7 kg (95% CI 4.1 to 5.3 kg) for rimonabant, 4.2 kg (95% CI 3.6 to 4.8 kg) for sibutramine and 2.9 kg (95% CI 2.5 to 3.2 kg) for orlistat compared to placebo at ≥12 months. Of the Phase III pharmacotherapies, lorcaserin, taranabant, topiramate and bupropion with naltrexone have demonstrated significant weight loss compared to placebo at ≥12 months. Some pharmacotherapies have also demonstrated clinical benefits. Further studies are required in some populations such as younger and older people whilst the long term safety continues to be a major consideration and has led to the withdrawal of several drugs.
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Background We previously documented that cognitive behavioral therapy for smoking-related weight concerns (CONCERNS) improves cessation rates. However, the efficacy of combining CONCERNS with cessation medication is unknown. We sought to determine if the combination of CONCERNS and bupropion therapy would enhance abstinence for weight-concerned women smokers. Methods In a randomized, double-blind, placebo-controlled trial, weight-concerned women (n = 349; 86% white) received smoking cessation counseling and were randomized to 1 of 2 adjunctive counseling components: CONCERNS or STANDARD (standard cessation treatment with added discussion of smoking topics but no specific weight focus), and 1 of 2 medication conditions: bupropion hydrochloride sustained release (B) or placebo (P) for 6 months. Rates and duration of biochemically verified prolonged abstinence were the primary outcomes. Point-prevalent abstinence, postcessation weight gain, and changes in nicotine withdrawal, depressive symptoms, and weight concerns were evaluated. Results Women in the CONCERNS + B group had higher rates of abstinence (34.0%) and longer time to relapse than did those in the STANDARD + B (21%; P = .05) or CONCERNS + P (11.5%; P = .005) groups at 6 months, although rates of prolonged abstinence in the CONCERNS + B and STANDARD + B groups did not differ significantly at 12 months. Abstinence rates and duration did not differ in the STANDARD + B group (21% and 19%) compared with the STANDARD + P group (10% and 7%) at 6 and 12 months, respectively. There were no differences among abstinent women in postcessation weight gain or weight concerns, although STANDARD + B produced greater decreases in nicotine withdrawal and depressive symptoms than did STANDARD + P. Conclusions Weight-concerned women smokers receiving the combination of CONCERNS + B were most likely to sustain abstinence. This effect was not related to differences in postcessation weight gain or changes in weight concerns. Trial Registration clinicaltrials.gov Identifier: NCT00006170
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Obesity is associated with coronary heart disease, stroke, certain cancers, hypertension, and type 2 diabetes. Concern about obesity among older adults is growing, and research to examine behaviors associated with risk for increased weight in this population is needed. We examined differences by sex in behaviors associated with overweight and obesity among older adults (aged > or =50 years). We analyzed data from the 2005 National Health Interview Survey using logistic regression to predict the likelihood of overweight (body mass index [BMI], 25.0-29.9 kg/m2) and obesity (BMI > or =30.0 kg/m2) relative to healthy weight (BMI, 18.5-24.9 kg/m2) among older adults. We used self-reported weights and heights. Correlates were risk behaviors for chronic disease (smoking status, alcohol intake, consumption of fruits and vegetables, leisure-time physical activity, walking for leisure, walking for transportation, and strength training). Among older men, the prevalence of overweight was 46.3%, and the prevalence of obesity was 25.1%. Among older women, the prevalence of overweight was 33.4%, and the prevalence of obesity was 28.8%. In adjusted logistic regression models, sex differences were observed in the significance of most risk factors for overweight and obesity. Men who were occasional, light, or moderate drinkers were 28% more likely to be obese than men who were nondrinkers; women who were heavy drinkers were 55% less likely to be obese than women who were nondrinkers. Compared with men and women who were regularly active during leisure time, inactive men were 39% more likely to be obese, and inactive women were 28% more likely to be obese. Several risk behaviors for chronic disease appear to be associated with overweight and obesity among older adults. Modification of these behaviors has the potential to reduce weight.
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Thirteen sedentary adult females successfully quit smoking cigarettes for 48 days. Mean daily caloric consumption increased 227 kcal and mean weight gain was 2.2 kg. There were no measurable acute effects of smoke inhalation and no chronic net effects of smoking cessation on resting metabolic rate, as determined by oxygen consumption and respiratory exchange ratio. After 1 yr, subjects who continued to abstain gained an average of 8.2 kg. HDL-cholesterol increased 7 mg/dl in 48 days; however, this effect was lost in those who returned to smoking. Increased caloric consumption accounted for 69% of weight gained immediately following smoking cessation. Factors other than changes in caloric consumption and metabolic rate may be responsible for a significant proportion (31%) of the weight gained in individuals who quit smoking.
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Data from two surveys of the National Academy of Sciences-National Research Council Twin Registry, conducted 16 years apart, were used to determine characteristics of individuals that were predictive of excessive weight gain after smoking cessation. Over the follow-up, 2179 men quit smoking and averaged a weight gain of 3.5 kg. Quitters were grouped into four categories of weight change: lost weight, no change, gained weight, and excessive weight gain ("super-gainers"). In comparison with quitters reporting no change in weight, super-gainers were younger, were of lower socioeconomic status, and differed on a number of health habits before quitting (all Ps < .05). At follow-up, super-gainers reported changes in health habits that were significantly different from those seen in quitters reporting stable weight (all Ps < .05). Pairwise concordance for weight change in 146 monozygotic and 111 dizygotic twin pairs in which both twins quit smoking was significantly greater in monozygotic than dizygotic pairs (P < .01). These results indicate that super-gainers differ in important ways from those who do not gain weight after smoking cessation and that these weight changes may be influenced by underlying genetic factors.
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The relationship between thermogenic and potentially atherogenic effects of cigarette smoking (CS) and its cessation was investigated. Heavy smokers (n = 7, serum cotinine > 200 ng/ml, > 20 cigarettes/d) were maintained on isoenergetic, constant diets for 2 wk, 1 wk with and 1 wk without CS. Stable isotope infusions with indirect calorimetry were performed on day 7 of each phase, after an overnight fast. CS after overnight abstention increased resting energy expenditure by 5% (not significant vs. non-CS phase; P = 0.18). CS increased the flux of FFA by 77%, flux of glycerol by 82%, and serum FFA concentrations by 73% (P < 0.02 for each), but did not significantly affect fat oxidation. Hepatic reesterification of FFA increased more than threefold (P < 0.03) and adipocyte recycling increased nonsignificantly (P = 0.10). CS-induced lipid substrate cycles represented only 15% (estimated 11 kcal/d) of observed changes in energy expenditure. De novo hepatic lipogenesis was low (< 1-2 g/d) and unaffected by either acute CS or its chronic cessation. Hepatic glucose production was not affected by CS, despite increased serum glycerol and FFA fluxes. Cessation of CS caused no rebound effects on basal metabolic fluxes. In conclusion, a metabolic mechanism for the atherogenic effects of CS on serum lipids (increased hepatic reesterification of FFA) has been documented. Increased entry of FFA accounts for CS-induced increases in serum FFA concentrations. The thermogenic effect of CS is small or absent in heavy smokers while the potentially atherogenic effect is maintained, and cessation of CS does not induce a rebound lipogenic milieu that specifically favors accrual of body fat in the absence of increased food intake.
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The authors examine weight gains associated with smoking cessation in the Lung Health Study (1986–1994) over a 5-year follow-up period. A cohort of 5,887 male and female smokers in the United States and Canada, aged 35–60 years, were randomized to either smoking intervention or usual care. Among participants who achieved sustained quitting for 5 years, women gained a mean of 5.2 (standard error, 5.0) kg in year 1 and a mean of 3.4 (standard error, 5.5) kg in years 1–5. Men gained a mean of 4.9 (standard error, 4.9) kg in year 1 and a mean of 2.6 (standard error, 5.8) kg in years 1–5. In regression analyses, smoking-change variables were the most potent predictors of weight change. Participants going from smoking to quit-smoking in a given year had mean weight gains of 2.95 kg/year (3.61%) in men and 3.09 kg/year (4.69%) in women. Over 5 years, 33% of sustained quitters gained ≥10 kg compared with 6% of continuing smokers. Also among sustained quitters, 7.6% of men and 19.1% of women gained ≥20% of baseline weight; 60% of the gain occurred in year 1, although significant weight gains continued through year 5. The average gains and the high proportions of sustained and intermittent quitters who gained excessive weight suggest the need for more effective early interventions that address both smoking cessation and weight control. Am J Epidemiol 1998; 148:821–30.
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Our aim was to critically evaluate the relations among smoking, body weight, body fat distribution, and insulin resistance as reported in the literature. In the short term, nicotine increases energy expenditure and could reduce appetite, which may explain why smokers tend to have lower body weight than do nonsmokers and why smoking cessation is frequently followed by weight gain. In contrast, heavy smokers tend to have greater body weight than do light smokers or nonsmokers, which likely reflects a clustering of risky behaviors (eg, low degree of physical activity, poor diet, and smoking) that is conducive to weight gain. Other factors, such as weight cycling, could also be involved. In addition, smoking increases insulin resistance and is associated with central fat accumulation. As a result, smoking increases the risk of metabolic syndrome and diabetes, and these factors increase risk of cardiovascular disease. In the context of the worldwide obesity epidemic and a high prevalence of smoking, the greater risk of (central) obesity and insulin resistance among smokers is a matter of major concern.
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Estimates of postcessation weight gain vary widely. This study determined the magnitude of weight gain in a cohort using both point prevalence and continuous abstinence criteria for cessation. Participants were 196 volunteers who participated in a smoking cessation program and who either continuously smoked (n = 118), were continuously abstinent (n = 51), or who were point prevalent abstinent (n = 27) (i.e., quit at the 1-year follow-up visit but not at others). Continuously abstinent participants gained over 13 lbs. (5.90 kg) at 1 year, significantly more than continuously smoking (M = 2.4 lb.) and point prevalent abstinent participants (M = 6.7 lbs., or 3.04 kg). Individual growth curve analysis confirmed that weight gain and the rate of weight gain (pounds per month) were greater among continuously smoking participants and that these effects were independent of gender, baseline weight, smoking and dieting history, age, and education. Results suggest that studies using point prevalence abstinence to estimate postcessation weight gain may be underestimating postcessation weight gain.
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Background: Cigarette smoking is an established predictor of incident type 2 diabetes mellitus, but the effects of smoking cessation on diabetes risk are unknown. Objective: To test the hypothesis that smoking cessation increases diabetes risk in the short term, possibly owing to cessation-related weight gain. Design: Prospective cohort study. Setting: The ARIC (Atherosclerosis Risk in Communities) Study. Patients: 10,892 middle-aged adults who initially did not have diabetes in 1987 to 1989. Measurements: Smoking was assessed by interview at baseline and at subsequent follow-up. Incident diabetes was ascertained by fasting glucose assays through 1998 and self-report of physician diagnosis or use of diabetes medications through 2004. Results: During 9 years of follow-up, 1254 adults developed type 2 diabetes. Compared with adults who never smoked, the adjusted hazard ratio of incident diabetes in the highest tertile of pack-years was 1.42 (95% CI, 1.20 to 1.67). In the first 3 years of follow-up, 380 adults quit smoking. After adjustment for age, race, sex, education, adiposity, physical activity, lipid levels, blood pressure, and ARIC Study center, compared with adults who never smoked, the hazard ratios of diabetes among former smokers, new quitters, and continuing smokers were 1.22 (CI, 0.99 to 1.50), 1.73 (CI, 1.19 to 2.53), and 1.31 (CI, 1.04 to 1.65), respectively. Further adjustment for weight change and leukocyte count attenuated these risks substantially. In an analysis of long-term risk after quitting, the highest risk occurred in the first 3 years (hazard ratio, 1.91 [CI, 1.19 to 3.05]), then gradually decreased to 0 at 12 years. Limitation: Residual confounding is possible even with meticulous adjustment for established diabetes risk factors. Conclusion: Cigarette smoking predicts incident type 2 diabetes, but smoking cessation leads to higher short-term risk. For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.
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This study investigated the effect of binge eating on smoking cessation outcomes. Participants (n = 186) reported binge eating status at baseline and at a 6-week postquit evaluation during a larger clinical trial for smoking cessation. Binge eating was defined with a single self-report questionnaire item from the Dieting and Bingeing Severity Scale. Participant groups defined by binge eating status were compared on abstinence rates. Among participants, 22% reported binge eating at baseline, 17% denied binge eating at baseline but endorsed binge eating by 6 weeks, and 61% denied binge eating at both timepoints. Participants who reported binge eating prior to or during treatment had lower quit rates at 6-week postquit and at the 24-week follow-up point than those without binge eating; the groups did not differ at the 12-week follow-up point. The group that experienced an emergence of binge eating reported significantly more weight gain than the other groups. These results suggest that treatments addressing problematic eating behaviors during smoking cessation are warranted.
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Nicotine is central to maintaining tobacco use. Understanding how nicotine sustains smoking provides a necessary basis for optimal smoking cessation therapy. This article updates several earlier reviews on the pharmacology of nicotine addiction.5, 7 and 8
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Cigarette smoking is an established predictor of incident type 2 diabetes mellitus, but the effects of smoking cessation on diabetes risk are unknown. To test the hypothesis that smoking cessation increases diabetes risk in the short term, possibly owing to cessation-related weight gain. Prospective cohort study. The ARIC (Atherosclerosis Risk in Communities) Study. 10,892 middle-aged adults who initially did not have diabetes in 1987 to 1989. Smoking was assessed by interview at baseline and at subsequent follow-up. Incident diabetes was ascertained by fasting glucose assays through 1998 and self-report of physician diagnosis or use of diabetes medications through 2004. During 9 years of follow-up, 1254 adults developed type 2 diabetes. Compared with adults who never smoked, the adjusted hazard ratio of incident diabetes in the highest tertile of pack-years was 1.42 (95% CI, 1.20 to 1.67). In the first 3 years of follow-up, 380 adults quit smoking. After adjustment for age, race, sex, education, adiposity, physical activity, lipid levels, blood pressure, and ARIC Study center, compared with adults who never smoked, the hazard ratios of diabetes among former smokers, new quitters, and continuing smokers were 1.22 (CI, 0.99 to 1.50), 1.73 (CI, 1.19 to 2.53), and 1.31 (CI, 1.04 to 1.65), respectively. Further adjustment for weight change and leukocyte count attenuated these risks substantially. In an analysis of long-term risk after quitting, the highest risk occurred in the first 3 years (hazard ratio, 1.91 [CI, 1.19 to 3.05]), then gradually decreased to 0 at 12 years. Residual confounding is possible even with meticulous adjustment for established diabetes risk factors. Cigarette smoking predicts incident type 2 diabetes, but smoking cessation leads to higher short-term risk. For smokers at risk for diabetes, smoking cessation should be coupled with strategies for diabetes prevention and early detection.
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The prospect of weight gain discourages many cigarette smokers from quitting. Practice guidelines offer varied advice about managing weight gain after quitting smoking, but no systematic review and meta-analysis have been available. We reviewed evidence to determine whether behavioral weight control intervention compromises smoking cessation attempts, and if it offers an effective way to reduce post-cessation weight gain. We identified randomized controlled trials (RCTs) that compared combined smoking treatment and behavioral weight control to smoking treatment alone for adult smokers. English-language studies were identified through searches of PubMed, Ovid MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials. Of 779 articles identified and 35 potentially relevant RCTs screened, 10 met the criteria and were included in the meta-analysis. Patients who received both smoking treatment and weight treatment showed increased abstinence [odds ratio (OR) = 1.29, 95% confidence interval (CI) = 1.01, 1.64] and reduced weight gain (g = -0.30, 95% CI = -0.57, -0.02) in the short term (<3 months) compared with patients who received smoking treatment alone. Differences in abstinence (OR = 1.23, 95% CI = 0.85, 1.79) and weight control (g = -0.17, 95% CI = -0.42, 0.07) were no longer significant in the long term (>6 months). Findings provide no evidence that combining smoking treatment and behavioral weight control produces any harm and significant evidence of short-term benefit for both abstinence and weight control. However, the absence of long-term enhancement of either smoking cessation or weight control by the time-limited interventions studied to date provides insufficient basis to recommend societal expenditures on weight gain prevention treatment for patients who are quitting smoking.
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Background: Most people who stop smoking gain weight, on average about 7 kg in the long term. There are some interventions that have been specifically designed to tackle smoking cessation whilst also limiting weight gain. Many smoking cessation pharmacotherapies and other interventions may also limit weight gain. Objectives: This review is divided into two parts. (1) Interventions designed specifically to aid smoking cessation and limit post-cessation weight gain (2) Interventions designed to aid smoking cessation that may also plausibly have an effect on weight Search strategy: Part 1: We searched the Cochrane Tobacco Addiction Group's Specialized Register which includes trials indexed in MEDLINE, EMBASE, SciSearch and PsycINFO, and other reviews and conference abstracts. Part 2: We searched the included studies of Cochrane smoking cessation reviews of nicotine replacement therapy, antidepressants, nicotine receptor partial agonists, cannabinoid type 1 receptor antagonists (rimonabant), and exercise interventions, published in Issue 4, 2008 of The Cochrane Library. Selection criteria: Part 1: We included trials of interventions designed specifically to address both smoking cessation and post-cessation weight gain that had measured weight at any follow-up point and/or smoking six months or more after quitting.Part 2: We included trials from the selected Cochrane reviews that could plausibly modify post-cessation weight gain if they had reported weight gain by trial arm at end of treatment or later. Data collection and analysis: We extracted data in duplicate on smoking and weight for part 1 trials, and on weight only for part 2. Abstinence from smoking is expressed as a risk ratio (RR), using the most rigorous definition of abstinence available in each trial, and biochemically validated rates if available. The outcome is expressed as the difference in weight change between trial arms from baseline. Where appropriate, we performed meta-analysis using the Mantel-Haenszel method for smoking and inverse variance for weight using a fixed-effect model. Main results: We found evidence that pharmacological interventions aimed at reducing post-cessation weight gain resulted in a significant reduction in weight gain at the end of treatment (dexfenfluramine (-2.50kg [-2.98kg to -2.02kg], fluoxetine (-0.80kg [-1.27kg to -0.33kg], phenylpropanolamine (PPA) (-0.50kg [-0.80kg to -0.20kg], naltrexone (-0.76kg [-1.51kg to -0.01kg])). No evidence of maintenance of the treatment effect was found at six or 12 months.Among the behavioural interventions, only weight control advice was associated with no reduction in weight gain and with a possible reduction in abstinence. Individualized programmes were associated with reduced weight gain at end of treatment and at 12 months (-2.58kg [-5.11kg to -0.05kg]), and with no effect on abstinence (RR 0.74 [0.39 to 1.43]). Very low calorie diets (-1.30kg (-3.49kg to 0.89kg] at 12 months) and cognitive behavioural therapy (CBT) (-5.20kg (-9.28kg to -1.12kg] at 12 months) were both associated with improved abstinence and reduced weight gain at end of treatment and at long-term follow up.Both bupropion (300mg/day) and fluoxetine (30mg and 60mg/day combined) were found to limit post-cessation weight gain at the end of treatment (-0.76kg [-1.17kg to -0.35kg] I(2)=48%) and -1.30kg [-1.91kg to -0.69kg]) respectively. There was no evidence that the weight reducing effect of bupropion was dose-dependent. The effect of bupropion at one year was smaller and confidence intervals included no effect (-0.38kg [-2.001kg to 1.24kg]).We found no evidence that exercise interventions significantly reduced post-cessation weight gain at end of treatment but evidence for an effect at 12 months (-2.07kg [-3.78kg, -0.36kg]).Treatment with NRT resulted in attenuation of post-cessation weight gain (-0.45kg [-0.70kg, -0.20kg]) at the end of treatment, with no evidence that the effect differed for different forms of NRT. The estimated weight gain reduction was similar at 12 months (-0.42kg [-0.92kg, 0.08kg]) but the confidence intervals included no effect.There were no relevant data on the effect of rimonabant on weight gain.We found no evidence that varenicline significantly reduced post-cessation weight gain at end of treatment and no follow-up data are currently available. One study randomizing successful quitters to 12 more weeks of active treatment showed weight to be reduced by 0.71kg (-1.04kg to -0.38kg). In three studies, participants taking bupropion gained significantly less weight at the end of treatment than those on varenicline (-0.51kg [-0.93kg to -0.09kg]). Authors' conclusions: Behavioural interventions of general advice only are not effective and may reduce abstinence. Individualized interventions, very low calorie diets, and CBT may be effective and not reduce abstinence. Exercise interventions are not associated with reduced weight gain at end of treatment, but may be associated with worthwhile reductions in weight gain in the long term, Bupropion, fluoxetine, nicotine replacement therapy, and probably varenicline all reduced weight gain while being used. Although this effect was not maintained one year after quitting for bupropion, fluoxetine, and nicotine replacement, the evidence is insufficient to exclude a modest long-term effect. The data are not sufficient to make strong clinical recommendations for effective programmes.
Article
The inverse relationship between cigarette smoking and body weight, a potent obstacle to stopping smoking, may be due in part to effects of smoking on increasing whole body metabolism. Studies examining chronic and acute metabolic effects of smoking, as well as its constituent nicotine, are reviewed. Evidence suggests the absence of a chronic effect; most studies indicate that smokers and nonsmokers have similar resting metabolic rates (RMR) and that RMR declines very little after smoking cessation. Although an acute effect due to smoking is apparent, its magnitude is inconsistent across studies, possibly because of variability in smoke exposure or nicotine intake. In smokers at rest, the acute effect of smoking (and nicotine intake) appears to be significant but small (less than 10% of RMR) and transient (less than or equal to 30 min). However, the specific situations in which smokers tend to smoke may mediate the magnitude of this effect, inasmuch as smoking during casual physical activity may enhance it while smoking after eating may reduce it. Sympathoadrenal activation by nicotine appears to be primarily responsible for the metabolic effect of smoking, but possible contributions from nonnicotine constituents of tobacco smoke and behavioral effects of inhaling may also be important. Improved understanding of these metabolic effects may lead to better prediction and control of weight gain after smoking cessation, thus increasing the likelihood of maintaining abstinence.
Article
Many believe that the prospect of weight gain discourages smokers from quitting. Accurate estimates of the weight gain related to the cessation of smoking in the general population are not available, however. We related changes in body weight to changes in smoking status in adults 25 to 74 years of age who were weighed in the First National Health and Nutrition Examination Survey (NHANES I, 1971 to 1975) and then weighed a second time in the NHANES I Epidemiologic Follow-up Study (1982 to 1984). The cohort included continuing smokers (748 men and 1137 women) and those who had quit smoking for a year or more (409 men and 359 women). The mean weight gain attributable to the cessation of smoking, as adjusted for age, race, level of education, alcohol use, illnesses related to change in weight, base-line weight, and physical activity, was 2.8 kg in men and 3.8 kg in women. Major weight gain (greater than 13 kg) occurred in 9.8 percent of the men and 13.4 percent of the women who quit smoking. The relative risk of major weight gain in those who quit smoking (as compared with those who continued to smoke) was 8.1 (95 percent confidence interval, 4.4 to 14.9) in men and 5.8 (95 percent confidence interval, 3.7 to 9.1) in women, and it remained high regardless of the duration of cessation. For both sexes, blacks, people under the age of 55, and people who smoked 15 cigarettes or more per day were at higher risk of major weight gain after quitting smoking. Although at base line the smokers weighed less than those who had never smoked, they weighed nearly the same at follow-up. Major weight gain is strongly related to smoking cessation, but it occurs in only a minority of those who stop smoking. Weight gain is not likely to negate the health benefits of smoking cessation, but its cosmetic effects may interfere with attempts to quit. Effective methods of weight control are therefore needed for smokers trying to quit.