Department of Internal Medicine, University of Turin, Turin, Italy.
Int J Obes (Lond). 2011 Nov;35(11):1442-9. doi: 10.1038/ijo.2011.5. Epub 2011 Feb 1.
Relatively unexplored contributors to the obesity and diabetes epidemics may include sleep restriction, increased house temperature (HT), television watching (TW), consumption of restaurant meals (RMs), use of air conditioning (AC) and use of antidepressant/antipsychotic drugs (ADs).
In a population-based cohort (n=1597), we investigated the possible association among these conditions, and obesity or hyperglycemia incidence at 6-year follow-up. Subjects with obesity (n=315) or hyperglycemia (n=618) at baseline were excluded, respectively, 1282 and 979 individuals were therefore analyzed.
At follow-up, 103/1282 became obese; these subjects showed significantly higher body mass index, waist circumference, saturated fat intake, RM frequency, TW hours, HT, AC and AD use, and lower fiber intake, metabolic equivalent of activity in h per week (METS) and sleep hours at baseline. In a multiple logistic regression model, METS (odds ratio=0.94; 95% confidence interval (CI) 0.91-0.98), RMs (odds ratio=1.47 per meal per week; 1.21-1.79), being in the third tertile of HT (odds ratio=2.06; 1.02-4.16) and hours of sleep (odds ratio=0.70 per h; 0.57-0.86) were associated with incident obesity. Subjects who developed hyperglycemia (n=174/979; 17.8%) had higher saturated fat intake, RM frequency, TW hours, HT, AC and AD use at baseline and lower METS and fiber intake. In a multiple logistic regression model, fiber intake (odds ratio=0.97 for each g per day; 0.95-0.99), RM (1.49 per meal per week; 1.26-1.75) and being in the third tertile of HT (odds ratio=1.95; 1.17-3.26) were independently associated with incident hyperglycemia.
Lifestyle contributors to the obesity and hyperglycemia epidemics may be regular consumption of RM, sleep restriction and higher HT, suggesting potential adjunctive non-pharmacological preventive strategies for the obesity and hyperglycemia epidemics.
肥胖和糖尿病流行的一些尚未被充分研究的因素可能包括睡眠限制、室内温度升高、看电视、外出就餐、使用空调和服用抗抑郁药/抗精神病药物。
在一项基于人群的队列研究（n=1597）中，我们调查了这些情况与 6 年后肥胖或高血糖发生之间的可能关联。分别排除了基线时有肥胖（n=315）或高血糖（n=618）的人群，因此对 1282 名和 979 名个体进行了分析。
随访时，103/1282 人发生肥胖；这些患者的体重指数、腰围、饱和脂肪摄入量、外出就餐频率、看电视时间、室内温度、使用空调和抗抑郁药/抗精神病药物的比例更高，而每周代谢当量（METs）、睡眠时间和纤维摄入量则更低。在多因素逻辑回归模型中，METs（比值比=0.94；95%置信区间 0.91-0.98）、外出就餐（每周每增加一顿餐，比值比=1.47；1.21-1.79）、处于室内温度第三 tertile（比值比=2.06；1.02-4.16）和睡眠时间（每减少 1 小时，比值比=0.70；0.57-0.86）与肥胖发生相关。发生高血糖的患者（n=174/979；17.8%）基线时的饱和脂肪摄入量、外出就餐频率、看电视时间、室内温度、使用空调和抗抑郁药/抗精神病药物的比例更高，METs 和纤维摄入量更低。在多因素逻辑回归模型中，纤维摄入量（每天增加 1 克，比值比=0.97；0.95-0.99）、外出就餐（每周每增加一顿餐，比值比=1.49；1.26-1.75）和处于室内温度第三 tertile（比值比=1.95；1.17-3.26）与高血糖发生独立相关。
肥胖和高血糖流行的生活方式因素可能是经常外出就餐、睡眠限制和较高的室内温度，这提示可能存在针对肥胖和高血糖流行的辅助非药物预防策略。
