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Rodopaios NE, Poulios E, Papadopoulou SK, Alexatou O, Koulouri AA, Kafatos AG, Papaliagkas V, Psara E, Giannakoula A, Tsourouflis G, Antasouras G, Giaginis C. Association of Christian Orthodox Fasting with Sociodemographic, Anthropometric and Lifestyle Factors and Serum Biochemical Indices: A Cross-Sectional Study on Patients with Metabolic Diseases. Metabolites 2024; 14:67. [PMID: 38276302 PMCID: PMC10821505 DOI: 10.3390/metabo14010067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Christian Orthodox fasting, a type of time-restricted diet, which presents some similarities to the Mediterranean Diet, also including certain similarities with periodic vegetarianism or other time-restricted diets (e.g., intermittent diet and Ramadan fasting), may cumulatively be related to the same or even better beneficial healthy effects as these well-recognized dietary patterns. The present study aimed to explore the potential beneficial impact of Christian Orthodox fasting in patients with metabolic disorders, such as diabetes mellitus type 2, excessive obesity, hypothyroidism and osteoporosis. This was a cross-sectional study, including 135 patients with metabolic disorders (67 fasters and 68 non-fasters). The enrolled fasters had adapted Christian Orthodox fasting recommendations for at least twelve consecutive years or even from childhood. Relevant questionnaires were used to record sociodemographic, anthropometric and lifestyle data of the study population through face-to-face interviews between the enrolled individuals and qualified personnel during a non-fasting period. Christian Orthodox fasting patients showed a significantly and independently lower prevalence of overweight/obesity and abdominal obesity, which is highly associated with cardiometabolic disease risks, as well as a significantly and independently lower incidence of hypertension, including separately lower systolic and diastolic pressure, than non-fasting patients. Fasters also had a significantly and independently increased prevalence of an advanced educational level and no smoking history, as well as a lower incidence of sedentary behavior, and a trend of a correlation with reduced c-reactive protein (CRP), an indicator of inflammation, compared to non-fasters. Fasters also exhibited higher serum albumin and high-density lipoprotein (HDL) levels, as well as lower glucose levels, than non-fasters. This is one of the few cross-sectional studies demonstrating that Christian Orthodox fasting may promote metabolic health by improving several aspects of metabolic disorders, being associated with specific sociodemographic, anthropometric and lifestyle factors. Further studies conducted on larger sample sizes from different countries and different ethnicities that include Christian Orthodox fasters are recommended to evaluate the impact of long-term religious fasting effects on human health, either as a preventative factor reducing the risk of chronic diseases and especially cardiometabolic disorders or as a nutritional intervention to ameliorate symptom severity.
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Affiliation(s)
- Nikolaos E. Rodopaios
- Department of Social Medicine, Preventive Medicine and Nutrition, Medical School, University of Crete, 70013 Heraklion, Crete, Greece; (N.E.R.); (A.-A.K.); (A.G.K.)
| | - Efthymios Poulios
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (E.P.); (G.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (E.P.); (G.A.)
| | - Alexandra-Aikaterini Koulouri
- Department of Social Medicine, Preventive Medicine and Nutrition, Medical School, University of Crete, 70013 Heraklion, Crete, Greece; (N.E.R.); (A.-A.K.); (A.G.K.)
| | - Anthony G. Kafatos
- Department of Social Medicine, Preventive Medicine and Nutrition, Medical School, University of Crete, 70013 Heraklion, Crete, Greece; (N.E.R.); (A.-A.K.); (A.G.K.)
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (E.P.); (G.A.)
| | - Anastasia Giannakoula
- Department of Agriculture, International Hellenic University, Sindos, 54700 Thessaloniki, Greece;
| | - Gerasimos Tsourouflis
- Second Department of Propaedeutic Surgery, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (E.P.); (G.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Lemnos, Greece; (E.P.); (O.A.); (E.P.); (G.A.)
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Pavlidou E, Papadopoulou SK, Alexatou O, Voulgaridou G, Mentzelou M, Biskanaki F, Psara E, Tsourouflis G, Lefantzis N, Dimoliani S, Apostolou T, Sampani A, Chatziprodromidou IP, Angelakou EP, Giaginis C. Childhood Mediterranean Diet Adherence Is Associated with Lower Prevalence of Childhood Obesity, Specific Sociodemographic, and Lifestyle Factors: A Cross-Sectional Study in Pre-School Children. EPIDEMIOLOGIA 2023; 5:11-28. [PMID: 38247997 PMCID: PMC10801514 DOI: 10.3390/epidemiologia5010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The Mediterranean diet (MD) has been related with a decreased probability of overweight/obesity as well as central obesity at all stages of the human life, decreasing the risk of diverse disease states and improving quality of life. Over the last few years, the prevalence of childhood overweight/obesity and especially abdominal obesity has highly increased worldwide, being associated with a higher likelihood of overweight/obesity as well as central obesity at the next stages of the life during adulthood. The purpose of the present study was to explore the relationship of MD compliance with sociodemographic, anthropometry and lifestyle features in pre-school children aged 2-5 years old. METHODS This is a cross-sectional study, which includes 5188 pre-school children from diverse regions of Greece. Relevant questionnaires were applied to evaluate the sociodemographic features of the enrolled children. Anthropometric parameters were measured by relevant techniques. Qualified questionnaires were utilized for assessing several lifestyle factors such as physical activity, quality of life, breastfeeding practices, MD adherence, as well as the prevalence of childhood asthma and diabetes mellitus type I. RESULTS Of the enrolled children, 41.7% showed low MD compliance and 36.4% of them indicated moderated compliance, while only 21.9% of them showed a high MD adherence. Overweight/obesity was noted in 24.2% of the assigned children, while abdominal obesity was noticed in 18.2% of them. Higher MD compliance was related with an elevated prevalence of sex (boys, p = 0.0005), Greek nationality (p = 0.0088), rural type of residence (p = 0.0099), childhood overweight/obesity (p < 0.0001) and abdominal obesity (p < 0.0001), lower childbirth weight (p < 0.0001), increased physical activity (p = 0.0041), improved quality of life (p = 0.0008), exclusive breastfeeding (p < 0.0001), childhood asthma (p = 0.0001) and diabetes mellitus type 1 (p = 0.0002). CONCLUSIONS A higher MD adherence is associated with specific sociodemographic, better anthropometric, and beneficial lifestyle factors in pre-school children. However, MD compliance remains low or moderate in the vast majority of children aged 2-5 years old. Thus, future public strategies and policies should be performed to inform parents of the potential beneficial effects of MD against obesity and related chronic diseases at the next stage of their children's lives.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece; (S.K.P.); (G.V.)
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | | | - Evmorfia Psara
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Gerasimos Tsourouflis
- Second Department of Propedeutic Surgery, Medical School, University of Athens, 11527 Athens, Greece;
| | - Nikos Lefantzis
- Department of Oral and Maxillofacial Surgery, Medical School, Attikon Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Anastasia Sampani
- First Department of Pathology, Medical School, University of Athens, 11527 Athens, Greece;
| | | | - Exakousti-Petroula Angelakou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Myrina, Greece; (E.P.); (O.A.); (M.M.); (E.P.); (S.D.); (E.-P.A.)
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Pavlidou E, Papadopoulou SK, Mentzelou M, Dakanalis A, Vorvolakos T, Antasouras G, Spanoudaki M, Pandi AL, Serdari A, Chrysafi M, Dimoliani S, Giaginis C. Association of Mediterranean Diet Adherence with Sociodemographic, Anthropometric, and Lifestyle Factors during the COVID-19 Pandemic: A Cross-Sectional Study in Greece. Nutrients 2023; 15:4123. [PMID: 37836406 PMCID: PMC10574046 DOI: 10.3390/nu15194123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively affected several aspects of people's lifestyle worldwide. Healthy dietary patterns and their bioactive components may improve or even co-treat the negative impacts of the COVID-19 pandemic in several aspects of people's lifestyle and mental health in daily life. The aim of this survey is to evaluate the potential effect of Mediterranean diet (MD) adherence against COVID-19-induced complications. METHODS This is a cross-sectional survey performed on 3721 adults aged between 18 and 65 years old, which aims to evaluate the potential association of MD adherence with multiple sociodemographic, anthropometric, and lifestyle factors during the COVID-19 pandemic period. RESULTS This study has supported evidence that elevated MD compliance was independently related to female gender, better economic status, no smoking, increased risk of abdominal obesity, higher physical activity levels, greater prevalence of adequate sleep quality, better quality of life, and reduced probability of anxiety and depression during the COVID-19 pandemic by adjusting for multiple confounders. CONCLUSIONS MD compliance may improve or even co-treat the negative impacts of the COVID-19 pandemic in several aspect of people's lifestyle in daily life. Further research is strongly recommended exploring the possible beneficial effects of the MD against COVID-19 lifestyle complications in daily life.
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Affiliation(s)
- Eleni Pavlidou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Antonios Dakanalis
- Department of Mental Health, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, School of Health Sciences, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Aimilia-Lynn Pandi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Aspasia Serdari
- Department of Psychiatry and Child Psychiatry, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Sofia Dimoliani
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of the Environment, University of the Aegean, 81400 Lemnos, Greece
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Abidin NZ. Obesity and Musculoskeletal Health of Young and Older Malaysian Women: A Cross-Sectional Study. Malays J Med Sci 2023; 30:137-151. [PMID: 36875189 PMCID: PMC9984110 DOI: 10.21315/mjms2023.30.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/01/2022] [Indexed: 03/05/2023] Open
Abstract
Background Asian women are more susceptible to musculoskeletal disorders compared to their Caucasian counterparts, and employed women are substantially more prone to musculoskeletal disorders compared to men. Data on musculoskeletal health in Malaysian women are lacking. The study's goal was to evaluate the body composition and functional performance of older and younger Malaysian women for obesity and musculoskeletal health problems. Methods The study included 141 post-menopausal Malaysian women and 118 young Malaysian women between 18 years old and 32 years old of age. Body composition, bone density, handgrip strength and physical performance were assessed using bio-electrical impedance analyser, calcaneal quantitative ultrasound, hand dynamometer and modified short physical performance battery test, respectively. Results There was a higher prevalence of 'low muscle mass' among the younger age group compared to their older counterparts (48 young women [40.0%] versus 44 post-menopausal women [31.2%]). Conversely, there was a higher prevalence of 'obesity' and 'low bone density' among the older age group compared to their younger counterparts. Mean broadband ultrasound attenuation (BUA) for both age groups was ≥ 70.0 dB/MHz. The majority of post-menopausal women had a 'minor functional decline' (40.6%), followed by moderate (28.1%), major (22.7%), severe (6.3%) and the lowest percentage for 'no decline' (2.3%). Conclusion There was a high prevalence of obesity with poor musculoskeletal health in older Malaysian women, which may lead to frailty and higher incidences of falls and fractures at an advanced age. The screening of musculoskeletal conditions among Malaysian women may aid in early detection of abnormalities and timely intervention.
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Affiliation(s)
- Nurdiana Zainol Abidin
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia.,School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Selangor, Malaysia
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Capuno J, Kraft A, Calicdan KG, O’Donnell O. Associations between health-related quality of life and measures of adiposity among Filipino adults. PLoS One 2022; 17:e0275798. [PMID: 36288388 PMCID: PMC9605333 DOI: 10.1371/journal.pone.0275798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/23/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Estimate associations between the health-related quality of life (HRQoL) and adiposity in a low-income population. METHODS In a cluster random sample of 3796 Filipinos aged 40-70 years in Nueva Ecija province, we measured body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and six dimensions of HRQoL using the 20-item Short Form Health Survey. We stratified by sex and used nonparametric regression to graph mean HRQoL in each dimension by BMI, WC, and WHR. We used ordinary least squares regression to estimate differences in each HRQoL dimension by categories of BMI, WC, and WHR adjusted for sociodemographic characteristics and smoking. RESULTS Mean HRQoL was lowest for health perception (Males: 67.5 (SD = 15.9); Females: 66.7 (15.8)) and highest for role functioning (Males: 97.5 (12.9); Females: 97.4 (13.3)). Mean (SD) values of BMI, WC, and WHR were 22.1 (3.6), 84.8 cm (9.5), and 0.9 (0.1), respectively for males, and 23.7 (4.2), 86.5 cm (10.2), and 0.9 (0.1), respectively, for females. There was no evidence that higher BMI was associated with lower HRQoL. Adjusted mean social functioning was 4.92 (p = 0.076) higher for males with high BMI risk (8.6% prevalence) compared with acceptable BMI risk (50.3%). Mean social functioning was 3.61 (p = 0.012) and 5.48 (p = 0.017) lower for females with high WC (44.7%) and WHR (83.1%), respectively, compared with those with low WC (23.8%) and WHR (3.6%). Mean physical functioning was lower by 2.70 (p = 0.204) and 1.07 (p = 0.198) for males and females, respectively, with high compared with low WC. Mean physical functioning was 3.93 (p = 0.037) lower for males with high (7.6%) compared with low (38.8%) WHR. Mean role functioning was 1.09 (p = 0.124) and 2.46 (p = 0.158) lower for males with borderline and high WHR, respectively. CONCLUSIONS There is discordance between future adiposity-related health risk and current experience of HRQoL.
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Affiliation(s)
- Joseph Capuno
- School of Economics, University of the Philippines, Diliman, Quezon City, Philippines
| | - Aleli Kraft
- School of Economics, University of the Philippines, Diliman, Quezon City, Philippines
| | - Kayleen Gene Calicdan
- School of Economics, University of the Philippines, Diliman, Quezon City, Philippines
| | - Owen O’Donnell
- Department of Applied Economics, Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, Netherlands
- Tinbergen Institute, Amsterdam, Netherlands
- University of Lausanne, Lausanne, Switzerland
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Gradidge PJ, Norris SA, Crowther NJ. The Effect of Obesity on the Waist Circumference Cut-Point Used for the Diagnosis of the Metabolic Syndrome in African Women: Results from the SWEET Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610250. [PMID: 36011884 PMCID: PMC9407919 DOI: 10.3390/ijerph191610250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 05/27/2023]
Abstract
Waist circumference (WC) is one of the diagnostic criteria for metabolic syndrome (MetS). However, studies have shown that the waist cut-point may be influenced by BMI. The aim of this study was to, therefore, determine whether the presence of obesity influences the WC cut-point used to diagnose MetS in sub-Saharan African women. The second aim was to determine whether calculated cut-points of other waist-related and dual-energy X-ray absorptiometry (DXA)-determined anthropometric measures used for the diagnosis of MetS were also influenced by BMI. Biochemical, simple anthropometric and dual-energy X-ray absorptiometry-derived anthropometric data were collected in 702 black South African women from the Study of Women Entering and in Endocrine Transition (SWEET). A receiver operating characteristic curve analysis was used to determine waist, waist-to-hip (WHR) and waist-to-height ratios, body shape index (ABSI), total body fat, trunk fat, and peripheral (arm + leg) fat cut-points for MetS (without waist) in subjects with BMI above or below the median value. The estimated WC cut-points (107 cm, 93.5 cm) for women with high BMI and low BMI, respectively, and the cut-points for the other anthropometric variables for the diagnosis of MetS were greater in high BMI women compared to low BMI women. The exceptions were WHR and ABSI, for which the cut-points were very similar in both BMI groups, and peripheral fat, where the cut-point was lower in the high BMI group. Logistic regression analysis demonstrated that WC was associated with a higher risk (odds ratio [95% CIs]: 1.07 [1.04, 1.10]; p < 0.0001), whilst hip was associated with a lower risk (0.97 [0.94, 0.99]; p = 0.02) for MetS. These data suggest that with increasing BMI, the higher levels of protective gluteofemoral fat lead to the requirement for higher WC cut-points for MetS diagnosis. The opposing associations of waist and hip with MetS risk make WHR a more appropriate variable for diagnosing MetS among African women as the WHR cut-point is less influenced by increasing BMI than is WC, which was also observed for ABSI.
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Affiliation(s)
- Philippe J. Gradidge
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - Nigel J. Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa
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Zhu XW, Liu KQ, Yuan CD, Xia JW, Qian Y, Xu L, Gao JH, Rong XL, Chen GB, Karasik D, Xie SY, Zheng HF. General and abdominal obesity operate differently as influencing factors of fracture risk in old adults. iScience 2022; 25:104466. [PMID: 35677640 PMCID: PMC9167983 DOI: 10.1016/j.isci.2022.104466] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/24/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
To infer the causality between obesity and fracture and the difference between general and abdominal obesity, a prospective study was performed in 456,921 participants, and 10,142 participants developed an incident fracture with follow-up period of 7.96 years. A U-shape relationship was observed between BMI and fracture, with the lowest risk of fracture in overweight participants. The obesity individuals had higher fracture risk when BMD was adjusted, and the protective effect of moderate-high BMI on fracture was mostly mediated by bone mineral density (BMD). However, for abdominal obesity, the higher WCadjBMI (linear) and HCadjBMI (J-shape) were found to be related to higher fracture risk, and less than 30% of the effect was mediated by BMD. By leveraging genetic instrumental variables, it provided additional evidences to support the aforementioned findings. In conclusion, keeping moderate-high BMI might be of benefit to old people in terms of fracture risk, whereas abdominal adiposity might increase risk of fracture.
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Affiliation(s)
- Xiao-Wei Zhu
- Fudan University, Shanghai 200433, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China
| | - Ke-Qi Liu
- WBBC Jiangxi Center, Jiangxi Medical College, Shangrao, Jiangxi 334000, China
| | - Cheng-Da Yuan
- Department of Dermatology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310007, China
| | - Jiang-Wei Xia
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China
| | - Yu Qian
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China
| | - Lin Xu
- WBBC Shandong Center, Binzhou Medical University, Yantai, Shandong 264003, China
| | - Jian-Hua Gao
- WBBC Jiangxi Center, Jiangxi Medical College, Shangrao, Jiangxi 334000, China
| | - Xiao-Li Rong
- Institute for Cell Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Guo-Bo Chen
- Clinical Research Institute, Zhejiang Provincial People’s Hospital, Hangzhou Medical College, Hangzhou 310014, China
| | - David Karasik
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 5290002, Israel
| | - Shu-Yang Xie
- WBBC Shandong Center, Binzhou Medical University, Yantai, Shandong 264003, China
| | - Hou-Feng Zheng
- Fudan University, Shanghai 200433, China
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang 310024, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang 310024, China
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Charupinijkul A, Arunyanak S, Rattanasiri S, Vathesatogkit P, Thienpramuk L, Lertpimonchai A. The effect of obesity on periodontitis progression: the 10-year retrospective cohort study. Clin Oral Investig 2021; 26:535-542. [PMID: 34180000 DOI: 10.1007/s00784-021-04031-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/09/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Due to inconsistent findings in limited previous cohort studies, the aim of this study was to estimate the obesity effect on periodontitis progression in Thai adults. MATERIALS AND METHODS This 10-year retrospective cohort study comprised 2216 employees of the Electric Generation Authority of Thailand (EGAT). Their demographic, medical, and periodontal status was collected. Subjects with periodontitis progression were defined as having ≥ 2 teeth with progression. Additional proximal clinical attachment loss ≥ 3 mm or tooth loss with severe periodontitis at baseline were used to identify disease progression at the tooth level. Central obesity was classified using the waist-hip ratio. Multi-level Poisson regression was used to determine the effect of obesity on periodontitis progression by adjusting for age, sex, education, income, smoking, alcohol drinking, exercise, diabetes mellitus, and hypertension. RESULTS The cumulative incidence of periodontitis progression during the 10-year period was 59.6 cases per 100 persons (95% CI: 57.5, 61.6). The univariate analysis indicated that obese subjects had 15% higher risk of progression than that of healthy subjects. However, when confounders were analyzed simultaneously, the effect of obesity was not significant with a risk ratio of 0.98 (95% CI: 0.88, 1.08). CONCLUSIONS Despite the higher incidence of disease progression in the obese, obesity is not an independent risk factor for periodontitis progression. CLINICAL RELEVANCE Obesity and periodontitis progression share many common risk factors. Using the obesity as a preliminary screening for periodontitis progression may be an alternative prevention protocol.
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Affiliation(s)
- Apinun Charupinijkul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sirikarn Arunyanak
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Lalitsara Thienpramuk
- Medical and Health Division, Electric Generation Authority of Thailand, Nonthaburi, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. .,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand.
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9
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Zhu Q, Huang B, Li Q, Huang L, Shu W, Xu L, Deng Q, Ye Z, Li C, Liu P. Body mass index and waist-to-hip ratio misclassification of overweight and obesity in Chinese military personnel. J Physiol Anthropol 2020; 39:24. [PMID: 32831152 PMCID: PMC7444050 DOI: 10.1186/s40101-020-00236-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 08/12/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The rising prevalence of obesity in military personnel has raised great concerns. Previous studies suggest that body mass index (BMI)- and waist-to-hip ratio (WHR)-based obesity classifications in US military personnel and firefighters have high false negative and subsequently cause obesity misclassification. OBJECTIVE To determine whether BMI and WHR could reflect the fat mass of Chinese military personnel. METHODS Three hundred fifty-three male Chinese military personnel and 380 age-matched male adults were recruited. Obesity classification was defined by BMI, WHR, and body fat percentage (BFP). RESULTS Chinese military personnel had extremely low obesity rate determined by either BFP (0.3%) or BMI (0.6%). By combining overweight and obese individuals, BMI- and WHR-determined prevalence of overweight/obesity was 22.4% and 17.0% compared to BFP-based standard (4.0%) (P < 0.05). In reference to BFP, BMI and WHR have high false-positive rate compared to the control group. Further analysis showed that Chinese military personnel consisted of high percentage of BFPlowBMIhigh and/or BFPlowWHRhigh subpopulations. Eighty-one percent of BMIhigh and 78.3% of WHRhigh of them were BFP low. CONCLUSIONS Chinese military personnel has extremely low obesity rate. BMI and WHR have high false-positive rates in reference to BFP, which cannot accurately reflect the mass of adipose tissue and leads to obesity misclassification.
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Affiliation(s)
- Qingqing Zhu
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Binbin Huang
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Qiaoli Li
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Liqian Huang
- Department of Anatomy, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Wenbo Shu
- Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lin Xu
- Department of Anatomy, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Qiongying Deng
- Department of Anatomy, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Ziliang Ye
- The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Chunyan Li
- The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Peng Liu
- Department of Anatomy, Guangxi Medical University, Nanning, 530021, Guangxi, China.
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10
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Sommer I, Teufer B, Szelag M, Nussbaumer-Streit B, Titscher V, Klerings I, Gartlehner G. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Sci Rep 2020; 10:12699. [PMID: 32728050 PMCID: PMC7391719 DOI: 10.1038/s41598-020-69498-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of this systematic review was to assess the performance of anthropometric tools to determine obesity in the general population (CRD42018086888). Our review included 32 studies. To detect obesity with body mass index (BMI), the meta-analyses rendered a sensitivity of 51.4% (95% CI 38.5-64.2%) and a specificity of 95.4% (95% CI 90.7-97.8%) in women, and 49.6% (95% CI 34.8-64.5%) and 97.3% (95% CI 92.1-99.1%), respectively, in men. For waist circumference (WC), the summary estimates for the sensitivity were 62.4% (95% CI 49.2-73.9%) and 88.1% for the specificity (95% CI 77.0-94.2%) in men, and 57.0% (95% CI 32.2-79.0%) and 94.8% (95% CI 85.8-98.2%), respectively, in women. The data were insufficient to pool the results for waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) but were similar to BMI and WC. In conclusion, BMI and WC have serious limitations for use as obesity screening tools in clinical practice despite their widespread use. No evidence supports that WHR and WHtR are more suitable than BMI or WC to assess body fat. However, due to the lack of more accurate and feasible alternatives, BMI and WC might still have a role as initial tools for assessing individuals for excess adiposity until new evidence emerges.
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Affiliation(s)
- Isolde Sommer
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria.
| | - Birgit Teufer
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Monika Szelag
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Barbara Nussbaumer-Streit
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Viktoria Titscher
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Irma Klerings
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
| | - Gerald Gartlehner
- Department for Evidence-Based Medicine and Evaluation, Danube University Krems, Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria
- RTI-UNC Evidence-Based Practice Center, Research Triangle Institute International, East Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC, 27709-2194, USA
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11
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Samuels JD, Lui B, White RS. Clearing Up the Obesity Paradox in Cardiac Surgery. J Cardiothorac Vasc Anesth 2020; 35:959-960. [PMID: 32660926 PMCID: PMC7309770 DOI: 10.1053/j.jvca.2020.06.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Jon D Samuels
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY
| | - Briana Lui
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY
| | - Robert S White
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY
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12
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Tutunchi H, Ebrahimi-Mameghani M, Ostadrahimi A, Asghari-Jafarabadi M. What are the optimal cut-off points of anthropometric indices for prediction of overweight and obesity? Predictive validity of waist circumference, waist-to-hip and waist-to-height ratios. Health Promot Perspect 2020; 10:142-147. [PMID: 32296627 PMCID: PMC7146042 DOI: 10.34172/hpp.2020.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Planning for obesity prevention is an important global health priority. Our aim in this study was to find the optimal cut-off points of waist circumference (WC), waist- to- hipratio (WHR) and waist- to- height ratio (WHtR), as three anthropometric indices, for prediction of overweight and obesity. We also aimed to compare the predictive ability of these indices to introduce the best choice. Methods: In this cross-sectional study, a total of 500 subjects were investigated. Anthropometric indicators were measured using a standard protocol. We considered body mass index (BMI) as the simple and most commonly used index for measuring general obesity as the comparison indicator in the present study to assess the diagnostic value for other reported obesity indices.We also performed receiver operating characteristic (ROC) curve analysis to define the optimal cut-off points of the anthropometric indicators and the best indices for overweight and obesity. Results: The proposed optimal cut-offs for WC, WHtR, and WHR were 84 cm, 0.48 and 0.78 for women and 98 cm, 0.56 and 0.87 for men, respectively. The area under the ROC curve ofWHtR (women: AUC=0.97, 95% CI: 0.96-0.99 vs. men: AUC=0.97, 95%CI: 0.96-0.99) and WC(women: AUC=0.97, 95% CI, 0.95-0.99 vs. men: AUC=0.98, 95% CI: 0.97-0.99) were greater than WHR (women: AUC=0.79, 95% CI =0.74-0.85 vs. men: AUC=0.84, 95% CI=0.79-0.88). Conclusion: This study demonstrated that the WC and WHtR indicators are stronger indicators compared to the others. However, further studies using desirable and also local cutoffs against more accurate techniques for body fat measurement such as computerized tumor (CT) scans and dual-energy x-ray absorptiometry (DEXA) are required.
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Affiliation(s)
- Helda Tutunchi
- Student Research Committee, Nutrition Research Center, School of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
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Liu L, Liu Y, Sun X, Yin Z, Li H, Deng K, Chen X, Cheng C, Luo X, Zhang M, Li L, Zhang L, Wang B, Ren Y, Zhao Y, Liu D, Zhou J, Han C, Liu X, Zhang D, Liu F, Wang C, Hu D. Identification of an obesity index for predicting metabolic syndrome by gender: the rural Chinese cohort study. BMC Endocr Disord 2018; 18:54. [PMID: 30081888 PMCID: PMC6090693 DOI: 10.1186/s12902-018-0281-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To compare the accuracy of different obesity indexes, including waist circumference (WC), weight-to-height ratio (WHtR), body mass index (BMI), and lipid accumulation product (LAP), in predicting metabolic syndrome (MetS) and to estimate the optimal cutoffs of these indexes in a rural Chinese adult population. METHODS This prospective cohort involved 8468 participants who were followed up for 6 years. MetS was defined by the International Diabetes Federation, American Heart Association, and National Heart, Lung, and Blood Institute criteria. The power of the 4 indexes for predicting MetS was estimated by receiver operating characteristic (ROC) curve analysis and optimal cutoffs were determined by the maximum of Youden's index. RESULTS As compared with WHtR, BMI, and LAP, WC had the largest area under the ROC curve (AUC) for predicting MetS after adjusting for age, smoking, drinking, physical activity, and education level. The AUCs (95% CIs) for WC, WHtR, BMI, and LAP for men and women were 0.862 (0.851-0.873) and 0.806 (0.794-0.817), 0.832 (0.820-0.843) and 0.789 (0.777-0.801), 0.824 (0.812-0.835) and 0.790 (0.778-0.802), and 0.798 (0.785-0.810) and 0.771 (0.759-0.784), respectively. The optimal cutoffs of WC for men and women were 83.30 and 76.80 cm. Those of WHtR, BMI, and LAP were approximately 0.51 and 0.50, 23.90 and 23.00 kg/m2, and 19.23 and 20.48 cm.mmol/L, respectively. CONCLUSIONS WC as a preferred index over WHtR, BMI, and LAP for predicting MetS in rural Chinese adults of both genders; the optimal cutoffs for men and women were 83.30 and 76.80 cm.
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Affiliation(s)
- Leilei Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Zhaoxia Yin
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Honghui Li
- The Affiliated Luohu Hospital of Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Kunpeng Deng
- Yantian Entry-exit Inspection and Quarantine Bureau, Shenzhen, Guangdong People’s Republic of China
| | - Xu Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Xinping Luo
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Ming Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Linlin Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Lu Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Bingyuan Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Yongcheng Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Dechen Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Junmei Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Chengyi Han
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Xuejiao Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Dongdong Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Feiyan Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen, Guangdong People’s Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan People’s Republic of China
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14
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Relationship between various anthropometric measures and apnea-hypopnea index in Korean men. Auris Nasus Larynx 2018; 45:295-300. [DOI: 10.1016/j.anl.2017.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/24/2017] [Accepted: 05/01/2017] [Indexed: 01/28/2023]
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15
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Optimal Anthropometric Cutoff Points to Predict Overweight and Obesity: A Cross-Sectional Survey in Iranian Females. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.41497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Pan J, Wang M, Ye Z, Yu M, Shen Y, He Q, Cao N, Ning G, Bi Y, Gong W, Hu R. Optimal cut-off levels of obesity indices by different definitions of metabolic syndrome in a southeast rural Chinese population. J Diabetes Investig 2016; 7:594-600. [PMID: 27181602 PMCID: PMC4931211 DOI: 10.1111/jdi.12440] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 10/09/2015] [Accepted: 10/15/2015] [Indexed: 12/26/2022] Open
Abstract
AIMS/INTRODUCTION The aim of the present study was to compare the cut-off values and prediction effect of different obesity indices by different definitions of metabolic syndrome (MetS) in Zhejiang Province of China. MATERIALS AND METHODS We carried out a cross-sectional survey of 10,100 individuals (age 40 years and older) in Jiashan, Zhejiang Province. Receiver operating characteristic analysis was used to examine discrimination and find optimal cut off values of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) to predict two or more non-adipose components of MetS by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) definition modified by the Asia-Pacific region criteria, International Diabetes Federation definition for the Chinese population and Chinese Diabetes Society definitions of MetS. RESULTS The age-standardized prevalence of MetS was 23.78% vs 28.76% vs 19.37% by The National Cholesterol Education Program Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III), International Diabetes Federation and Chinese Diabetes Society definitions, respectively. Cut-off values of BMI were approximately 24 kg/m(2) both in men and women by three definitions; the average cut-off values of WC, WHR and WHtR were 83 cm in men vs 81 cm in women, 0.89 in men vs 0.86 in women and 0.50 in men vs 0.51 in women, respectively. The area under receiver operating characteristic curve of BMI was larger than WC both in men and women (P < 0.05); in women, the area under receiver operating characteristic curve of WHtR was larger than WC, and WHR was smaller. CONCLUSIONS MetS is prevalent in Zhejiang Province of China, especially in the female population. BMI and WHtR might be more useful than WC and WHR for predicting two or more non-adipose components of MetS.
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Affiliation(s)
- Jin Pan
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Meng Wang
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Yuhua Shen
- Jiashan Center for Disease Control and PreventionJiashanChina
| | - Qinfang He
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Naxin Cao
- Jiashan Center for Disease Control and PreventionJiashanChina
| | - Guang Ning
- Department of Endocrinology and MetabolismRui‐Jin HospitalShanghai Jiao‐Tong University School of MedicineShanghaiChina
| | - Yufang Bi
- Department of Endocrinology and MetabolismRui‐Jin HospitalShanghai Jiao‐Tong University School of MedicineShanghaiChina
| | - Weiwei Gong
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and PreventionHangzhouChina
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Ahmad N, Adam SIM, Nawi AM, Hassan MR, Ghazi HF. Abdominal Obesity Indicators: Waist Circumference or Waist-to-hip Ratio in Malaysian Adults Population. Int J Prev Med 2016; 7:82. [PMID: 27330688 PMCID: PMC4910307 DOI: 10.4103/2008-7802.183654] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 05/05/2016] [Indexed: 11/18/2022] Open
Abstract
Background: Waist circumference (WC) is an accurate and simple measure of abdominal obesity as compared to waist–hip ratio (WHR). The aim of this study was to determine the correlation between body mass index (BMI) with WC and WHR and suggest cutoff points for WC among Rural Malaysian adults. Methods: A cross-sectional study was conducted among 669 respondents from three villages in Tanjung Karang, located in the district of Kuala Selangor. Data collection was carried out by guided questionnaires and anthropometric measures. Results: The prevalence of abdominal obesity for BMI was almost similar for both gender across Caucasian and Asian BMI cutoff points. Based on Caucasian cutoff points, the prevalence of abdominal obesity for WC was 23.8% (male) and 66.4% (female) while for WHR was 6.2% (male) and 54.2% (female). Asian cutoff points gave higher prevalence of abdominal obesity compared to that of WC among male respondents and WHR for both genders. WC showed strong and positive correlation with BMI compared to WHR (in male WC r = 0.78, WHR r = 0.24 and in female WC r = 0.72, WHR r = 0.19; P < 0.001). Receiver operating characteristic curve analysis suggested WC cutoff points of 92.5 cm in men and 85.5 cm in women is the optimal number for detection of abdominal obesity. Conclusions: WC is the best indicator as compared with WHR for abdominal obesity for Malaysian adults.
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Affiliation(s)
- Norfazilah Ahmad
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Samia Ibrahim Mohamed Adam
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hasanain Faisal Ghazi
- Department of Community Medicine, International Medical School, Management and Science University, Selangor, Malaysia
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Anggraini R, Februhartanty J, Bardosono S, Khusun H, Worsley A. Food Store Choice Among Urban Slum Women Is Associated With Consumption of Energy-Dense Food. Asia Pac J Public Health 2016; 28:458-68. [PMID: 27208014 DOI: 10.1177/1010539516646849] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers' diet.
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Affiliation(s)
- Roselynne Anggraini
- SEAMEO RECFON (Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition), Central Jakarta, Indonesia
| | - Judhiastuty Februhartanty
- SEAMEO RECFON (Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition), Central Jakarta, Indonesia
| | | | - Helda Khusun
- SEAMEO RECFON (Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition), Central Jakarta, Indonesia
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Salama HM, Galal A, Motawie AA, Kamel AF, Ibrahim DM, Aly AA, Hassan EA. Adipokines Vaspin and Visfatin in Obese Children. Open Access Maced J Med Sci 2015; 3:563-6. [PMID: 27275288 PMCID: PMC4877888 DOI: 10.3889/oamjms.2015.123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 02/19/2014] [Accepted: 02/20/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adipokines provides new insights about the physiology, pathology and treatment of obesity. AIM We investigated the association between serum vaspin and serum visfatin concentrations with obesity in Egyptian children. MATERIAL AND METHODS Twenty two obese children with body mass index (BMI) above 95th percentile; 11 males and 11 females were included in this study. Their mean age was 9.18 ± 2.8 years. After general clinical examination, fasting blood glucose, triglycerides, total cholesterol and high density lipoprotein cholesterol were measured in cases and controls (n=11). Fasting insulin, vaspin and visfatin were detected using ELIZA. Insulin resistance was estimated by Homeostasis model assessment method (HOMA-IR). RESULTS Blood pressure, in both systolic and diastolic measurements was elevated significantly in obese children. Significant elevation of serum insulin and insulin resistance (HOMA/IR) were observed in obese children too. Vaspin and visfatin showed significant elevation in obese children than controls. Significant positive correlations were detected between visfatin and BMI, waist circumference, hip circumference and HOMA/IR. We found that Vaspin and visfatin are higher in obese children. CONCLUSION Visfatin but not vaspin correlates positively with waist circumference and HOMA/IR in obese children.
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Affiliation(s)
| | - Ashraf Galal
- National Research Centre, Pediatrics, Cairo, Egypt
| | | | | | | | - Azza A Aly
- National Research Centre, Department of Chemical and Clinical Pathology, Cairo, Egypt
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20
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Association of Adiposity Indices with Platelet Distribution Width and Mean Platelet Volume in Chinese Adults. PLoS One 2015; 10:e0129677. [PMID: 26058081 PMCID: PMC4461260 DOI: 10.1371/journal.pone.0129677] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/12/2015] [Indexed: 11/30/2022] Open
Abstract
Hypoxia is a prominent characteristic of inflammatory tissue lesions. It can affect platelet function. While mean platelet volume (MPV) and platelet distribution width (PDW) are sample platelet indices, they may reflect subcinical platelet activation. To investigated associations between adiposity indices and platelet indices, 17327 eligible individuals (7677 males and 9650 females) from the Dongfeng-Tongji Cohort Study (DFTJ-Cohort Study, n=27009) were included in this study, except for 9682 individuals with missing data on demographical, lifestyle, physical indicators and diseases relative to PDW and MPV. Associations between adiposity indices including waist circumstance (WC), waist-to-height ratio (WHtR), body mass index (BMI), and MPV or PDW in the participants were analyzed using multiple logistic regressions. There were significantly negative associations between abnormal PDW and WC or WHtR for both sexes (ptrend<0.001 for all), as well as abnormal MPV and WC or WHtR among female participants (ptrend<0.05 for all). In the highest BMI groups, only females with low MPV or PDW were at greater risk for having low MPV (OR=1.33, 95% CI=1.10, 1.62 ptrend<0.001) or PDW (OR=1.34, 95% CI=1.14, 1.58, ptrend<0.001) than those who had low MPV or PDW in the corresponding lowest BMI group. The change of PDW seems more sensitive than MPV to oxidative stress and hypoxia. Associations between reduced PDW and MPV values and WC, WHtR and BMI values in Chinese female adults may help us to further investigate early changes in human body.
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Lee CW, Kim SG, An BW. The effects of horseback riding on body mass index and gait in obese women. J Phys Ther Sci 2015; 27:1169-71. [PMID: 25995581 PMCID: PMC4434002 DOI: 10.1589/jpts.27.1169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/11/2014] [Indexed: 11/26/2022] Open
Abstract
[Purpose] The aim of this study was to examine the effect of horseback riding on body
mass index (BMI) and gait in obese women. [Subjects and Methods] Twenty-four obese women
residing in Seoul and Gyeonggi-do were randomly divided into a horseback riding group and
a walking group and conducted their respective exercises 3 times a week for 8 weeks.
[Results] Step length increased significantly and BMI and width of the base of support
significantly decreased in both groups. A comparison of BMI and width of the base of
support after the intervention between the two groups revealed that the horseback riding
group showed larger decreases than the walking group. [Conclusion] The result of this
study indicated that the horseback riding may improve gait ability and obesity.
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Affiliation(s)
- Chae-Woo Lee
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Seong-Gil Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
| | - Byung-Wook An
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Republic of Korea
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The performance of obesity screening tools among young Thai adults. J Community Health 2014; 39:1216-21. [PMID: 24832544 DOI: 10.1007/s10900-014-9881-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Obesity is a worldwide medical condition that leads to physical and psychological impairment. Specific ethnicity, gender and age group are related to different performances of anthropometric indices to predict obesity. The objectives of this study were to estimate the performance of the anthropometric indices for detecting obesity based on percentage of body fat (PBF), to study the correlation among those indices, and to determine the optimal cut-off point of the indices among young Thai adults. This is a cross-sectional study of healthy urban subjects in Khon Kaen, Thailand who were aged 20-39 years. Baseline characteristics and anthropometric measures were collected. PBF was determined using bioelectrical impedance analysis. Demographic data and anthropometric variables were analyzed using descriptive statistics. Receiver-operating characteristic (ROC) curves were used to compare the performance of anthropometric measures as predictors of obesity. One-hundred men and 100 women were recruited for this study. Body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio (WSR) were significantly correlated to PBF. BMI demonstrated the best performance according to the area under the ROC curves in both sexes at cut-off points of 22.5 in women or 25 kg/m(2) in men. WC and WSR showed better performance than WHR to detect obesity. In conclusion, anthropometric indices in young Thai adults were correlated well with PBF to predict obesity as shown in prior reports. Different cut-off points of these indices to define obesity in young Thai adults are recommended. The global cut-off points of WSR in women regardless of ethnicity are supported.
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Body fat throughout childhood in 2647 healthy Danish children: agreement of BMI, waist circumference, skinfolds with dual X-ray absorptiometry. Eur J Clin Nutr 2014; 68:664-70. [PMID: 24473457 DOI: 10.1038/ejcn.2013.282] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND/OBJECTIVES Total body fat percentage (%BF) evaluated by dual energy X-ray absorptiometry (DXA) scans (DXA %BF) is widely recognized as a precise measure of fatness. We aimed to establish national reference curves for DXA %BF, %BF calculated from skinfolds (SF %BF) and waist circumference (WC) in healthy children, and to compare agreement between the different methods. SUBJECTS/METHODS Based on 11 481 physical examinations (anthropometry) and 1200 DXA scans from a longitudinal cohort of Danish children (n=2647), we established reference curves (LMS-method) for SF %BF, WC (birth to 14 years) and DXA %BF (8-14 years). Age- and sex-specific Z-scores for body mass index (BMI), WC and SF %BF were compared. Sensitivity and specificity were calculated for agreement of WC, SF %BF and BMI with DXA %BF to identify obese children (>+1 s.d.). RESULTS %BF differed with age, sex, pubertal stage and social class. SF %BF correlated strongly with DXA %BF (r=0.86). BMI and WC also correlated positively with DXA %BF (Z-scores; r= 0.78 and 0.69). Sensitivity and specificity were 79.5 and 93.8 for SF %BF, 75.9 and 90.3 for BMI and 59.2 and 95.4 for WC. CONCLUSIONS SF %BF showed the highest correlation and best agreement with DXA %BF in identifying children with excess fat (+1 s.d.).
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Differences in obesity measures and selected comorbidities in former National Football League professional athletes. J Occup Environ Med 2012; 54:816-9. [PMID: 22796925 DOI: 10.1097/jom.0b013e3182572e53] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the accuracy of body mass index (BMI) as a measure of obesity compared with percent body fat (%BF) directly measured by dual energy x-ray absorptiometry among retired football players. METHODS The level of agreement between BMI and %BF as measures of obesity was assessed by sensitivity, specificity, and the kappa statistic among 129 retired football players. Logistic regression was used to investigate the association between obesity and selected comorbidities. RESULTS Using BMI 30 kg/m or higher to identify obesity had poor specificity (0.36): 87 of 129 subjects were classified as obese, yet only 13 were truly obese based on %BF. Although BMI did not reliably indicate true %BF-obesity, BMI-obesity was significantly correlated with lineman position (P < 0.0001), years played (P = 0.03), and obstructive sleep apnea (P = 0.0005). CONCLUSIONS Percent body fat measured by dual energy x-ray absorptiometry provides a more accurate measure of obesity than does BMI among retired football players.
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Abstract
In Korea, a person with a body mass index (BMI) ≥25 kg/m(2) is considered obese, and a person with a BMI ≥30 kg/m(2) is classified as severely obese. Central obesity is defined as a waist circumference ≥90 cm for Korean men and ≥85 cm for Korean women. Recent epidemiologic data show that the prevalence of severe obesity and metabolic syndrome is steadily increasing. These epidemics increased morbidity and mortality of type 2 diabetes, cardiovascular diseases, and obesity-related cancers such as breast, colorectal, and other cancers in Korea. Decreased physical activity, increased fat and alcohol consumption, heavy smoking, and stress/depressed mood are the primary modifiable life-style risk factors for Koreans. Recently, public health interventions to encourage life-style changes have shown promising results in reducing the prevalence of severe obesity and metabolic syndrome.
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Affiliation(s)
- Sang Woo Oh
- Center for Obesity, Nutrition, and Metabolism, Department of Family Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
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26
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Ballian N, Lubner MG, Munoz A, Harms BA, Heise CP, Foley EF, Kennedy GD. Visceral obesity is associated with outcomes of total mesorectal excision for rectal adenocarcinoma. J Surg Oncol 2011; 105:365-70. [PMID: 21751219 DOI: 10.1002/jso.22031] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 06/22/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES General obesity, measured by the body mass index (BMI), increases the technical difficulty of total mesorectal excision (TME) but does not affect oncologic outcomes. The purpose of this study is to compare visceral and general obesity as predictors of outcomes of TME for rectal adenocarcinoma. METHODS Adult patients undergoing TME for rectal adenocarcinoma were retrospectively identified. Preoperative computed tomography scans were used to measure abdominal circumference (AC), visceral (VFA), and subcutaneous fat area (SFA). BMI, AC, VFA, SFA, total fat area (TFA, sum of VFA and SFA), and VFA/SFA ratio were examined for association with operative, postoperative, oncologic, and survival outcomes in a univariate analysis model. RESULTS Between 1999 and 2009, 113 patients met inclusion criteria. Increasing VFA and VFA/SFA ratio were associated with reduced lymph node retrieval (P = 0.03 and P = 0.009, respectively). The association between increasing VFA/SFA ratio with delayed resumption of oral intake (P = 0.05) and prolonged overall survival (P = 0.003) were also significant. Increasing BMI was associated with improved overall (P = 0.02) but not disease-free survival (P = 0.14). CONCLUSION Visceral obesity, measured by VFA/SFA ratio, is a better predictor of postoperative, oncologic, and survival outcomes after TME for rectal adenocarcinoma than general obesity measured by the BMI.
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Affiliation(s)
- Nikiforos Ballian
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Li X, Tan L, Liu X, Lei S, Yang T, Chen X, Zhang F, Fang Y, Guo Y, Zhang L, Yan H, Pan F, Zhang Z, Peng Y, Zhou Q, He L, Zhu X, Cheng J, Zhang L, Liu Y, Tian Q, Deng H. A genome wide association study between copy number variation (CNV) and human height in Chinese population. J Genet Genomics 2010; 37:779-85. [DOI: 10.1016/s1673-8527(09)60095-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 10/27/2010] [Accepted: 10/29/2010] [Indexed: 12/24/2022]
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Optimal cut-off values and population means of waist circumference in different populations. Nutr Res Rev 2010; 23:191-9. [PMID: 20642876 DOI: 10.1017/s0954422410000120] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abdominal obesity is a risk factor for cardiometabolic disease, and has become a major public health problem in the world. Waist circumference is generally used as a simple surrogate marker to define abdominal obesity for population screening. An increasing number of publications solely rely on the method that maximises sensitivity and specificity to define ‘optimal’ cut-off values. It is well documented that the optimal cut-off values of waist circumference vary across different ethnicities. However, it is not clear if the variation in cut-off values is a true biological phenomenon or an artifact of the method for identifying optimal cut-off points. The objective of the present review was to assess the relationship between optimal cut-offs and population waist circumference levels. Among sixty-one research papers, optimal cut-off values ranged from 65·5 to 101·2 cm for women and 72·5 to 103·0 cm for men. Reported optimal cut-off values were highly correlated with population means (correlation coefficient: 0·91 for men and 0·93 for women). Such a strong association was independent of waist circumference measurement techniques or the health outcomes (dyslipidaemia, hypertension or hyperglycaemia), and existed in some homogeneous populations such as the Chinese and Japanese. Our findings raised some concerns about applying the sensitivity and specificity approach to determine cut-off values. Further research is needed to understand whether the differences among populations in waist circumference were genetically or environmentally determined, and to understand whether using region-specific cut-off points can identify individuals with the same absolute risk levels of metabolic and cardiovascular outcomes among different populations.
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Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes (Lond) 2010; 34:791-9. [PMID: 20125098 DOI: 10.1038/ijo.2010.5] [Citation(s) in RCA: 706] [Impact Index Per Article: 50.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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30
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Wang F, Wu S, Song Y, Tang X, Marshall R, Liang M, Wu Y, Qin X, Chen D, Hu Y. Waist circumference, body mass index and waist to hip ratio for prediction of the metabolic syndrome in Chinese. Nutr Metab Cardiovasc Dis 2009; 19:542-547. [PMID: 19188050 DOI: 10.1016/j.numecd.2008.11.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 10/21/2008] [Accepted: 11/10/2008] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS To explore the ability of waist circumference (WC), body mass index (BMI) and waist to hip ratio (WHR) to predict two or more non-adipose components of the metabolic syndrome (MetS) among individuals aged 18-85 in North China. METHODS AND RESULTS This study is a cluster sample survey of 101,510 individuals, complete data are 75,788 subjects, 59,874 males and 15,914 females. Their ages were 51.9+/-12.7 years (males) and 48.7+/-11.5 years (females). Receiver operating characteristic (ROC) analysis was used to examine discrimination and find optimal cut off values of WC, BMI and WHR to predict two or more non-adipose components of MetS. The area under the ROC curve (AURC) for WC (0.694) and BMI (0.692) in females showed no difference. In males BMI (0.657) had a better discrimination than WC (0.634). WHR was weaker in both sexes. The optimal cut off value of WC in males (86.5 cm) was higher than in females (82.1cm); and that of BMI was about 24 kg/m(2) in both genders. The optimal cut off values of WC, BMI, and WHR, increased with age in both sexes. CONCLUSIONS BMI and WC are more useful than WHR for predicting two or more non-adipose components of MetS. Cut off values for WC in males, and those of BMI and WHR in both sexes are lower than that in present MetS criteria; WC in females is slightly higher. Cut off values of WC, BMI and WHR were increased with age in the Chinese.
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Affiliation(s)
- F Wang
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Key Laboratory of Epidemiology of Peking University, Ministry of Education, China
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Heterogeneity of body mass index, waist circumference, and waist-to-hip ratio in predicting obesity-related metabolic disorders for Taiwanese aged 35-64 y. Clin Nutr 2009; 28:543-8. [PMID: 19473734 DOI: 10.1016/j.clnu.2009.04.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 03/11/2009] [Accepted: 04/13/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Obesity-related metabolic disorders such as hypertension, diabetes mellitus, hypercholesterolemia, hypertriglyceridemia, and hyperuricemia are major risk factors for cardiovascular disease. The aim was to compare body mass index, waist circumference, and waist-to-hip ratio as predictors of these metabolic disorders. METHODS We evaluated 1625 men and 1779 women, aged 35-64 y who participated in the 2001 National Health Interview Survey and 2002 Taiwan Three High Prevalence Survey. Their anthropometric measurements were analyzed as predictors of metabolic disorders using empirical receiver-operating characteristic curves and logistic regression models. RESULTS Overall, waist circumference performed well as a predictor of metabolic disorders. Body mass index was the best predictor for men who smoked, whereas waist circumference and waist-to-hip ratio were better alternatives for non-smoking men and women. Anthropometric measures had higher predictabilities for those aged 35-44 y but relatively weak associations with diabetes mellitus for men aged 45-64 y and hypercholesterolemia for men and women. CONCLUSIONS The associations between anthropometric measures and the metabolic disorders varied with comorbidity, gender, age groups, and smoking status. Waist-to-hip ratio was the best predictor for diabetes mellitus, especially for participants aged 45-64 y. The anthropometric measures did not predict hypercholesterolemia well.
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Abstract
Despite the rising incidence of type 2 diabetes in Korean immigrants, little is known about glucose control in these individuals. This descriptive study examined factors influencing glucose control in Korean immigrants with type 2 diabetes. Participants were 143 Korean immigrants with type 2 diabetes who completed questionnaires, a finger stick blood test for glycosylated hemoglobin (HbA1c), and anthropometric measures. The mean HbA1c level was 7.6 % (SD = 1.5; range = 5.6 to 12.5). Less than half of the participants (41.3%) met the American Diabetes Association's goal of less than 7%. After adjusting for demographic and health variables, family diet support, waist-to-hip ratio (WHR), the duration of diabetes, the number of diabetic medications, and age significantly influenced glucose control. Findings support the positive role of family involvement in diabetes management. Patients with long-standing diabetes, higher WHR, and more diabetic medications deserve special attention because they tend to have higher HbA1c levels.
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Ay L, Hokken-Koelega ACS, Mook-Kanamori DO, Hofman A, Moll HA, Mackenbach JP, Witteman JCM, Steegers EAP, Jaddoe VWV. Tracking and determinants of subcutaneous fat mass in early childhood: the Generation R Study. Int J Obes (Lond) 2008; 32:1050-9. [PMID: 18560371 DOI: 10.1038/ijo.2008.76] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the development and tracking of subcutaneous fat mass in the first 2 years of life and to examine which parental, fetal and postnatal characteristics are associated with subcutaneous fat mass. DESIGN This study was embedded in the Generation R Study, a prospective cohort study from early fetal life onward. Subcutaneous fat mass was measured by skinfold thickness (biceps, triceps, suprailiacal, subscapular) at the ages of 1.5, 6 and 24 months in 1012 children. Information about parental, fetal and postnatal growth characteristics was collected by physical and fetal ultrasound examinations and questionnaires. RESULTS Normal values of subcutaneous fat mass are presented. Total subcutaneous fat mass was higher in girls than in boys at the age of 24 months (P=0.01). Subjects in the lowest and highest quartiles at the age of 6 months tended to keep their position in the same quartile at the age of 24 months (odds ratios 1.86 (95% confidence interval (CI) 1.3, 2.7)) and 1.84 (95% CI: 1.3, 2.6), respectively). Maternal height and weight, paternal weight, fetal weight at 30 weeks, birth weight and weight at the age of 6 weeks were each inversely associated with subcutaneous fat mass at the age of 24 months after adjustment for current weight at 24 months. CONCLUSION This study shows for the first time that subcutaneous fat mass tends to track in the first 2 years of life. Furthermore, the results suggest that an adverse fetal environment and growth are associated with increased subcutaneous fat mass at the age of 24 months. Further studies are needed to examine whether these associations persist in later life.
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Affiliation(s)
- L Ay
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
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Wang B, Necheles J, Ouyang F, Ma W, Li Z, Liu X, Yang J, Xing H, Xu X, Wang X. Monozygotic co-twin analyses of body composition measurements and serum lipids. Prev Med 2007; 45:358-65. [PMID: 17765960 DOI: 10.1016/j.ypmed.2007.07.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2006] [Revised: 07/09/2007] [Accepted: 07/10/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate BMI and direct measures of body fat (BF) and lean body mass (LBM) in relation to fasting serum lipid profiles in a large Chinese population based twin sample using a monozygotic (MZ) co-twin analysis. METHODS Adiposity measures collected 1998-2000 on 987 MZ female 20-60 year old twin pairs (n=1974) included BMI, waist circumference (WC), waist/hip ratio (WHR), LBM, trunk fat (TF), %TF, total BF, and % total BF (measured by DEXA). Serum lipids included total cholesterol (TC), triglycerides (TG), LDL, and HDL. Co-twin analyses and conventional regression analyses were used to assess the association between individual adiposity and LBM measures, and serum lipids. RESULTS In this lean population with a mean BMI 21.8 (2.8), we observed considerable variability in adiposity measures and serum lipids. A positive linear association between all adiposity measures with LDL, TC, and TG, and a negative linear association with HDL was observed. A 1-unit z-score increase of adiposity measures, reflecting fat distribution, was associated with increases in (mmol/L) TC (0.063 to 0.164), LDL (0.064 to 0.131), TG (0.049 to 0.164), and a decrease in HDL (0.021 to 0.038) while controlling for matched factors within twin pairs (i.e., age and unmeasured confounders). However, similar associations were not observed for LBM. CONCLUSION It is the BF (not LBM) that appears to be associated with serum lipid profiles. This study underscores that in populations where BMI is highly correlated with BF, BMI can be used as a surrogate for BF in evaluating risk of dyslipidemia. Otherwise, direct measures of BF are needed.
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Affiliation(s)
- Binyan Wang
- Mary Ann J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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