Body Composition, Gender, and Illicit Drug Use in an Urban Cohort
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.The American Journal of Drug and Alcohol Abuse (Impact Factor: 1.78). 02/2007; 33(3):467-74. DOI: 10.1080/00952990701301616
This cross-sectional study of adult (137 male, 128 female), urban, community dwelling users and nonusers of illicit drugs evaluated associations of demographic, medical, and drug factors with body composition. The population was 49% HIV-positive and 94% African-American. In multivariate analysis, there were no body composition differences among males based on drug use. Among females, the highest tertile of drug use had less fat (12.3 vs.19.9 kg, p = .01) and lower body mass index (21.9 vs. 25.1, p = .01) versus less frequent or nonusers. These data suggest a sex difference in body composition associated with drug use.
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ABSTRACT: Alcohol, illicit drugs, and nicotine can affect appetite and body weight, but few epidemiologic studies have examined relationships between body mass index (BMI) and substance use disorders. This study used logistic regression to examine effects of BMI and gender on risk for DSM-IV substance use disorders in a sample of 40 364 adults. Overweight and obesity were associated with increased risk for lifetime alcohol abuse and dependence in men but not women. Overweight and obesity were associated with decreased risk for past-year alcohol abuse in women. BMI was not associated with illicit drug use disorders. Overweight and obese men were at decreased risk for both lifetime and past-year nicotine dependence. Overweight women were at increased risk for lifetime nicotine dependence, and obese women were at decreased risk for past-year nicotine dependence. Further research is needed to identify reasons for observed gender differences in relationships between BMI and substance use disorders.
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ABSTRACT: The clinical implications of lower body weight in drug using populations are uncertain given that lower mean weights may still fall within the healthy range. To determine the effect of type, mode and frequency of drug use on underlying body composition after accounting for differences in body shape and size. We conducted a cross-sectional analysis of 511 participants from the Tufts Nutrition Collaborative (TNC) Study. Data included measures of body composition, a 24-hour dietary recall, and a detailed health history and lifestyle questionnaire. Multivariate regression analysis was used to determine the independent effect of drug use on percent body fat (BF) after adjusting for BMI and waist circumference. Heavy injection drug users (IDUs) had a 2.6% lower percent BF than non-users after adjusting for BMI, waist circumference, and other confounders. (p = 0.0006). Differences in percent BF were predominantly due to higher lean mass, rather than lower fat mass. Cocaine and heroin had similar effects on body composition. In the U.S., where the general population is prone to over-nutrition, the average percent BF for heavy injectors does not fall into a range low enough to suggest harmful effects. However, in populations with substantial levels of under-nutrition, small differences in percent BF among drug users will have a greater impact on health status. Differences in BMI, weight and body composition are not always straightforward. Accounting for underlying nutritional status and relative differences in fat and FFM is critical when interpreting results. diagnosed patients and prevent them from returning to prison.
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