Background/ PurposeDespite emerging evidence suggesting harmful influences of accurate weight perception on psychological health among individuals with obesity, little is known about the association in Asian populations. The aim of this study was investigate the association between body weight perception and depressive symptoms among Korean adults, and potential differential associations across gender.MethodsWe used data from the sixth Korea National Health and Nutrition Examination Survey in 2014, comprising 3,318 female (n = 1,876) and male (n = 1,442) participants, aged 19–65 years, with no history of depression and a body-mass index (BMI)> = 18.5kg/m2. Depressive symptoms were measured by the Patient Health Questionnaire-9 Korean version. Weight perception patterns were categorized by comparing self-perceived and objectively measured weight status. Gender-stratified four-level multilevel linear models adjusted for age, BMI, menopause, education, income, marital status, urbanicity, chronic conditions, exercise, smoking, and alcohol use. Subgroup analyses were performed across BMI category.ResultsAmong women with obesity, those who underperceived their weight status reported fewer depressive symptoms compared to those who accurately perceived their weight status (β = -1.25, p<0.05). Among women with normal weight, those who overperceived their weight status reported more depressive symptoms compared to those who accurately perceived their weight status (β = 1.00, p<0.05). The same associations were not found in men.ConclusionAwareness-oriented strategies for obesity prevention and weight management focused on providing information on weight status may need to consider unintended consequences of accurate weight perception on mental health among individuals with obesity, particularly among women.
Background
Little is known about occupational class differences in pancreatic cancer survival.
Methods
Using a population‐based cancer registry in Japan, 3 578 patients with incident pancreatic cancer (1970‐2011) were followed up for 5 years (median follow‐up time 0.42 years). We classified patients into four occupational classes based on their longest‐held jobs: white‐collar (professional and managers), service, blue‐collar, and those not actively employed. Using white‐collar class as the reference group, hazard ratios (HRs) and 95% confidence intervals (CIs) for overall death were estimated by Cox proportional hazard model. Covariates included age, sex, and year of diagnosis. Prognostic variables (pathology, stage, and treatment) and smoking behaviors were additionally adjusted as possible mediating factors.
Results
Overall survival was poor in this population (median, 0.50 and 0.33 years in white‐collar and service classes, respectively). Compared with white‐collar patients, survival was significantly poorer across all occupational classes, most pronounced in the service worker group: mortality HRs ranged from 1.11 (95% CI 1.00‐1.24) in blue‐collar workers to 1.24 (95% CI 1.12‐1.37) in service workers. Even after controlling for potential mediating factors, service workers showed worse survival.
Conclusion
We documented occupational class disparities in pancreatic cancer survival in Japan. Even in the setting of lethal prognostic cancer with universal health coverage, high‐occupational class groups may enjoy a health advantage.
The findings suggest that DWCB are prevalent among Korean adolescents across age, sex, and socioeconomic status. Social contextual factors including school and familial environmental factors, as well as individual characteristics, should be considered when developing effective prevention strategies.
Ovarian cancer is the deadliest gynecologic cancer. Chronic stress accelerates tumor growth in animal models of ovarian cancer. We therefore postulated that posttraumatic stress disorder (PTSD) may be associated with increased risk of ovarian cancer. We used data from the Nurses' Health Study II, a longitudinal cohort study with 26 years of follow-up, conducted from 1989 to 2015 with 54,710 subjects. Lifetime PTSD symptoms were measured in 2008. Self-reported ovarian cancer was validated with medical records. Risk of ovarian cancer was estimated with Cox proportional hazards models and further adjusted for known ovarian cancer risk factors (e.g., hormonal factors) and health risk factors (e.g., smoking). Fully prospective secondary analyses examined incident ovarian cancer occurring after PTSD assessment in 2008. In addition, we examined associations by menopausal status. During follow-up, 110 ovarian cancers were identified. Women with high PTSD symptoms had 2-fold greater risk of ovarian cancer versus women with no trauma exposure [age-adjusted HR ¼ 2.10; 95% confidence interval (CI), 1.12-3.95]. Adjustment for health and ovarian cancer risk factors moderately attenuated this association (HR ¼ 1.86; 95% CI, 0.98-3.51). Associations were similar or moderately stronger in fully prospective analyses (age-adjusted HR ¼ 2.38; 95% CI, 0.98-5.76, N cases ¼ 50) and in premenopausal women (HR ¼ 3.42; 95% CI, 1.08-10.85). In conclusion, we show that PTSD symptoms are associated with increased risk of ovarian cancer. Better understanding of the underlying molecular mechanisms could lead to interventions that reduce ovarian cancer risk in women with PTSD and other stress-related mental disorders.Significance: PTSD is associated with ovarian cancer risk, particularly in premenopausal women. Understanding the underlying molecular mechanisms will aid in formulating ways to reduce ovarian cancer risk associated with chronic stress.
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