Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.

We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive...

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Autores principales:	Jameson D Voss, David B Allison, Bryant J Webber, Jean L Otto, Leslie L Clark
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1be6e6e1bde24a44b9d11242bbe57056
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spelling	oai:doaj.org-article:1be6e6e1bde24a44b9d11242bbe570562021-11-18T08:22:56ZLower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.1932-620310.1371/journal.pone.0093493https://doaj.org/article/1be6e6e1bde24a44b9d11242bbe570562014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24740173/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive long-term metabolic effects in rats. Whether or not high altitude residence confers benefit in humans, however, remains unknown. Using a quasi-experimental, retrospective study design, we observed all outpatient medical encounters for overweight active component enlisted service members in the U.S. Army or Air Force from January 2006 to December 2012 who were stationed in the United States. We compared high altitude (>1.96 kilometers above sea level) duty assignment with low altitude (<0.98 kilometers). The outcome of interest was obesity related ICD-9 codes (278.00-01, V85.3x-V85.54) by Cox regression. We found service members had a lower hazard ratio (HR) of incident obesity diagnosis if stationed at high altitude as compared to low altitude (HR 0.59, 95% confidence interval [CI] 0.54-0.65; p<0.001). Using geographic distribution of obesity prevalence among civilians throughout the U.S. as a covariate (as measured by the Centers for Disease Control and Prevention and the REGARDS study) also predicted obesity onset among service members. In conclusion, high altitude residence predicts lower rates of new obesity diagnoses among overweight service members in the U.S. Army and Air Force. Future studies should assign exposure using randomization, clarify the mechanism(s) of this relationship, and assess the net balance of harms and benefits of high altitude on obesity prevention.Jameson D VossDavid B AllisonBryant J WebberJean L OttoLeslie L ClarkPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e93493 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jameson D Voss David B Allison Bryant J Webber Jean L Otto Leslie L Clark Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
description	We sought to evaluate whether residence at high altitude is associated with the development of obesity among those at increased risk of becoming obese. Obesity, a leading global health priority, is often refractory to care. A potentially novel intervention is hypoxia, which has demonstrated positive long-term metabolic effects in rats. Whether or not high altitude residence confers benefit in humans, however, remains unknown. Using a quasi-experimental, retrospective study design, we observed all outpatient medical encounters for overweight active component enlisted service members in the U.S. Army or Air Force from January 2006 to December 2012 who were stationed in the United States. We compared high altitude (>1.96 kilometers above sea level) duty assignment with low altitude (<0.98 kilometers). The outcome of interest was obesity related ICD-9 codes (278.00-01, V85.3x-V85.54) by Cox regression. We found service members had a lower hazard ratio (HR) of incident obesity diagnosis if stationed at high altitude as compared to low altitude (HR 0.59, 95% confidence interval [CI] 0.54-0.65; p<0.001). Using geographic distribution of obesity prevalence among civilians throughout the U.S. as a covariate (as measured by the Centers for Disease Control and Prevention and the REGARDS study) also predicted obesity onset among service members. In conclusion, high altitude residence predicts lower rates of new obesity diagnoses among overweight service members in the U.S. Army and Air Force. Future studies should assign exposure using randomization, clarify the mechanism(s) of this relationship, and assess the net balance of harms and benefits of high altitude on obesity prevention.
format	article
author	Jameson D Voss David B Allison Bryant J Webber Jean L Otto Leslie L Clark
author_facet	Jameson D Voss David B Allison Bryant J Webber Jean L Otto Leslie L Clark
author_sort	Jameson D Voss
title	Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
title_short	Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
title_full	Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
title_fullStr	Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
title_full_unstemmed	Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
title_sort	lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/1be6e6e1bde24a44b9d11242bbe57056
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Lower obesity rate during residence at high altitude among a military population with frequent migration: a quasi experimental model for investigating spatial causation.

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