Obesity Prevention and Screening

Obesity: Assessment and prevention: Module 23.2 from Topic 23 "Nutrition in obesity"

Obesity is one the major health problems of today showing an increasing prevalence among most countries. It is associated with increased risk of several diseases. The importance of early life strategies in the prevention of obesity is well established, whereas, in general, breastfed infants tend to have a lower body mass index (BMI) than formula-fed infants. There seem to be a series of behavioral and hormonal mechanisms that explain this difference. Lifestyle plays a crucial role in the development of overweight and/or obesity and targeted lifestyle modifications have an important impact on preventing obesity. In particular, sedentary behavior (viewing television, playing video games, doing cognitive work, and listening to music) and reduced overall physical activity along with shorter sleep duration promote the overconsumption of dietary macronutrients leading to obesity; at the same time physical activity or exercise in a sufficient dose seems to better facilitate long-term maintenance of new lower body weight. There is enough discussion about a potential effect of nutrients on obesity. Nevertheless, the most the crucial parameter regarding weight loss and prevention of obesity is to achieve a negative energy balance. In regard to specific diet regimes, again energy balance rather that any specific macronutrients composition and/or favoring of low glycemic index products, seems to be have a stronger effect on maintenance of lower weight after 12 months. It has to be noted, that for specific sup groups, obesity or overweight might be showing some favorable trends in survival. In particular, "obesity paradox" (OP) refers to an overall prognosis that is no worse and may even be better in some groups than non-obese patients. The OP could be explained by the fact that current classifications of obesity based on BMI may place together, in the same category, subjects with very different clinical and biochemical characteristics.

Comparison of the Effect of Different Resistance Training Frequencies on Phase Angle and Handgrip Strength in Obese Women: a Randomized Controlled Trial

Phase angle (PA) is a strong predictor of sarcopenia, fragility, and risk of mortality in obese people, while an optimal muscular function and handgrip strength (HS) are required to perform different daily activities. Although there is a general agreement that resistance training improves health status in obese people, the optimal weekly training frequency for PA and physical performance parameters is not clear. This study aimed to compare the effects of different weekly resistance training frequencies performed over a 24 week exercise program on PA and HS in obese people. Forty-two women (56.2 ± 9.1 years, body mass index (BMI) 37.1 ± 4.9 kg/m²) were randomly allocated to one of two groups: a group with a high weekly training frequency of three times a week (HIGH, n = 21) and a group that performed only one weekly session (LOW, n = 21). The groups trained with an identical exercise intensity and volume per session for 6 months. Before and after the intervention period, the participants were assessed for anthropometric measures, bioimpedance analysis, and HS. There was a significant group × time interaction (p < 0.05) for waist circumference, bioimpedance reactance divided by body height (Xc/H), PA, and HS measures. In addition, only the HIGH group increased Xc/H, PA, and HS after the intervention period (p < 0.05), even after adjusting for weight loss and menopausal status. Physical exercise performed three times a week promotes better adaptations in PA and HS when compared with the same program performed once a week in obese women.

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

Obesity in adolescence is a public health priority because it usually tracks into adulthood, resulting in enormous medical and social costs. This underscores the importance of early identification and intervention. Acanthosis nigricans (AN) was once considered a rare paraneoplastic dermatosis, but is now frequently observed in obese adolescents. Current understanding suggests that it is associated with insulin resistance and has a unique role in secondary prevention. The purpose of this narrative review is to provide a comprehensive overview of AN in obese adolescents, covering its history, current knowledge on the condition, its clinical significance, management challenges, and the direction of future research.