Trends in the prevalence of adult overweight and obesity in Australia, and its association with geographic remoteness

Social marketing targeting healthy eating and physical activity in young adult university students: A scoping review

Adult obesity has remained a key health concern globally. Theory-based social marketing interventions are considered effective for improving dietary and physical activity (PA) behaviours. However, their application in universities is not yet established. This review aimed to identify social marketing strategies targeting healthy eating and/or PA behaviours of young adult university students and outline the intervention effectiveness. Literature search, screening, and data extraction followed the Joanna Briggs Institute (JBI) methodology for scoping reviews. PubMed/Medline and Scopus databases were searched for intervention and exploratory studies published between January 1, 2000, and September 20, 2023. Twelve articles were selected based on the eligibility criteria. Although different in study design, all studies reported improved healthy eating-related outcomes, while three showed improved PA-related outcomes. One study incorporated all six of the social marketing benchmarks, but the majority identified two. Most studies focused on behavioural objective, formative research, and marketing mix in their intervention design. Four studies incorporated behaviour change theories in development of the social marketing campaigns. Social marketing using social media could be a significant approach for improving healthy eating and PA in young adult university students when behavioural change theories and all social marketing benchmarks are adopted. More generalizable longer-term investigation into the effectiveness of this approach in university young adults is needed to tackle adult obesity related health issues.

The association between body mass index and health-related quality of life in the 2017 and 2018 health survey of England data: A cross-sectional observational analysis

AIM

To provide an updated estimate of the association between body mass index (BMI) and health-related quality of life (HRQoL) among the general population in England and to identify population subgroups with the highest potential utility gains from obesity interventions.

MATERIALS AND METHODS

The sample included 12 158 adults with valid HRQoL and BMI data from the 2017 and 2018 Health Survey for England. Robust standard error linear regression, controlling for demographic and socioeconomic characteristics, lifestyle behaviours and obesity-related comorbidities, was used for the baseline analysis. Robustness checks assessed the impact of (a) estimator selection; (b) model specifications; (c) statistical outliers at high BMI; (d) potential BMI measurement error; and (e) data pooling.

RESULTS

The study found a significant association between HRQoL and BMI, which exhibited an inverted U-shaped relationship. The mean HRQoL peaked at 25.7 kg/m2 in men and 22.6 kg/m2 in women and was reduced in the underweight, overweight and obesity BMI ranges. Sensitivity analyses reported similar coefficients, suggesting a robust model specification.

CONCLUSIONS

Reduced HRQoL beyond optimal BMI underlines the importance of maintaining a normal BMI range for overall health. The rising prevalence of class III obesity is a major public health concern given its disproportionate impact on health, health care utilization and costs. Obesity management is key to preventing the reduction in HRQoL associated with obesity-related comorbidities, and this analysis supports the development of targeted policies and population health initiatives for people with class III obesity.

Prevalence of pre-obesity and above and its associated factors in adult women: an analysis of the 2020 Korea National Health and Nutrition Examination Survey

PURPOSE

This study was conducted to determine the prevalence of pre-obesity (overweight) and above in adult women and to identify associated factors.

METHODS

Data were obtained from the eighth Korea National Health and Nutrition Examination Survey (KNHANES VIII-2), conducted in 2020. The sample comprised 2,288 women aged 19-64 years who participated in the KNHANES VIII-2. Data were analyzed using complex sample design analysis with SPSS version 20.1.

RESULTS

The prevalence of pre-obesity and above among adult women was 46.5%, with 18.6% classified as having pre-obesity and 27.9% as having obesity. A higher prevalence of pre-obesity and above was observed in women aged 50-59 years (odds ratio [OR]=1.67, p=.019) or 60-64 years (OR=1.80, p=.029); women whose highest educational attainment was high school (OR=1.28, p=.018) or middle school or less (OR=1.60, p=.017); those in middle-income households (OR=1.55, p=.005); those engaging in muscle-strengthening activities less than 2 days per week (OR=1.37, p=.019); and those sleeping less than 6 hours per night during the week (OR=1.37, p=.025).

CONCLUSION

As nearly half of all adult women have either pre-obesity or obesity, prevention and management strategies must target both groups. Interventions should be prioritized for women in their 50s and older, as well as those with low education or income levels. Additionally, receiving adequate sleep of 7 hours or more and engaging in muscle-strengthening activities at least 2 days per week are important components of obesity management.

Panniculectomy for a Rare End-Stage Complication of Severe Obesity and Increasing Surgical Phenomenon

Panniculus morbidus (PM) is a presentation of severe chronic abdominal lymphoedema associated with obesity resulting in oedema and chronic fibrosis. It is a multifaceted condition with significant clinical and psychosocial implications. A 29-year-old female weighing 260 kg with a body mass index of 95 kg/m2 had recurrent infections and sepsis associated with an abdominal pannus extending to her knees and an area of ulceration. The pannus was indurated with extensive fibrosis that significantly affected her quality of life (QOL) requiring assistance for all activities of daily living (ADLs). A panniculectomy was performed with a negative pressure skin dressing over the skin wound. She was discharged after two days. Two months postoperatively, she reported significant improvement in QOL and can now mobilise and perform ADLs independently with no recurrent admissions. The global prevalence of obesity is reaching pandemic proportions and so will its complications. It can be functionally debilitating and worsen obesity. Surgical resection is indicated to restore mobility and function, prevent recurrent infections, improve QOL, and reduce economic burden. Patients report high satisfaction rates following surgery. Panniculectomy is an effective treatment to alleviate morbidity in severe obesity and should be considered in patients with recurrent infections and a significant impact on QOL.

An exploration of extreme obesity and weight loss management for adults in rural, remote, and regional areas: a systematic review

BACKGROUND

Extreme obesity is a global health issue impacting health and related health outcomes. Although extreme obesity is prevalent across all geographical settings, the condition is more common in geographically isolated locations. The success of mainstream weight loss strategies such as surgery, exercise, and dietary information within these communities remains unknown, and it is unclear if isolation facilitates or hinders treatment for weight management.

AIM

This review aimed to identify common themes around weight loss and health and social impacts for extremely obese adults living in rural, remote, and regional locations.

METHODS

A systematic literature review of peer-reviewed publications from May 2013 to May 2023 was undertaken and appraised using the Mixed Method Appraisal Tool (MMAT). Sequential synthesis was thematically analysed and described within a narrative account. Earlier dates were not included as initial research indicated a global surge in obesity within the early 2010s (Wang, Y., Beydoun, M. A., Min, J., Xue, H., Kaminsky, L. A., & Cheskin, L. J. (2020). Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic. International Journal of Epidemiology, 49(3), 810-823) and a surge in bariatric treatments for the management of extreme obesity was noted around the same time (Mocanu, V., Dang, J. T., Sun, W., Birch, D. W., Karmali, S., & Switzer, N. J. (2020). An evaluation of the modern North American bariatric surgery landscape: current trends and predictors of procedure selection. Obesity Surgery, 30, 3064-3072).

RESULTS

This review identified 13 studies that reported negative trends in extreme obesity for isolated locations linked to gender, culture, and poor mental health. Individualised and community models of weight loss support can be positive for certain demographic groups, specifically females, through the promotion of cost-effective, and locally available traditional food choices.

CONCLUSION

Living with extreme obesity within geographically isolated locations and losing weight is challenging for women, Indigenous peoples, and people with low literacy and those from lower socio-economic backgrounds. Generalised advice about weight loss is often unsuccessful; however, weight loss is achievable with consumer engagement which considers the influence and impact of rurality. Further research focusing on individualised nursing models for managing morbid obesity within isolated locations is required.

Changes in the prevalence of dementia in Australia and its association with geographic remoteness

BACKGROUND

The exact prevalence of dementia in Australia is ambiguous. Australia is a vast continent with a small population, and 80% of the population live in five cities. This study explores recent changes in the prevalence of dementia. It also investigates geographic remoteness as a potential risk factor for developing dementia.

METHODS

Survey of Disability, Ageing and Carers (SDAC), a nationally representative database, was used to conduct this study. A total of 74,862 and 65,487 individuals from 2015 and 2018, respectively, were considered for this study. A multivariable logistic regression model was used to evaluate the association between dementia and geographic remoteness for older adults aged 65 years and over.

RESULTS

The results reveal that from 2015 to 2018, the prevalence of dementia among adults aged 65 years and older was higher in 2018 (5,229 per 100,000) than in 2015 (5,099 per 100,000). Significant geographical differences in the prevalence of dementia are observed among Australian adults, and this trend appears to be increasing. Furthermore, the unadjusted model revealed that, in 2015, older adults living in major cities had 1.29 (AOR: 1.29, 95% CI: 1.17-1.41) times higher odds of having dementia compared with their counterparts from outer regional and remote areas. In 2018, the adjusted model found that older adults living in major cities had 1.12 (AOR: 1.12, 95% CI: 1.01-1.25) times elevated odds of having dementia than their peers living in outer regional and remote areas.

CONCLUSION

There is a rising prevalence of dementia in Australia. Further investigation is required to identify the causes of this increase. Increased public health initiatives should concentrate on behavioural characteristics and contextual environmental factors to ameliorate this trend.

The effect of motivational interviewing and/or cognitive behaviour therapy techniques on gestational weight gain - a systematic review and meta-analysis

BACKGROUND

Women with gestational weight gain (GWG) that is below or above recommendations are at risk of adverse perinatal outcomes. Motivational interviewing and/or cognitive behaviour therapy have demonstrated efficacy in initiating and sustaining behaviour change, including weight control. The objective of this review was to investigate the effect of antenatal interventions that include components of motivational interviewing and/or cognitive behaviour therapy on gestational weight gain.

METHODS

This review was designed and reported in accordance with guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Five electronic databases were systematically searched to March 2022. Randomised controlled trials evaluating interventions with identified components of motivational interviewing and/or cognitive behaviour therapies were included. Pooled proportions of appropriate GWG and GWG above or below guidelines, and standardised mean difference for total gestational weight gain, were calculated. Risk of bias in included studies was evaluated using the Risk of Bias 2 tool, and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence.

RESULTS

Twenty-one studies (8030 participants) were included. Overall, MI and/or CBT interventions had a small effect on the total gestational weight gain (SMD: -0.18, 95% confidence interval: -0.27 to -0.09, p < 0.001) and improved the proportion of women achieving recommended gestational weight gain (29% versus 23% in the comparison, p < 0.001). The GRADE assessment indicated that overall quality of evidence is very uncertain, however sensitivity analyses to account for high risk of bias produced similar results to original meta-analyses. The magnitude of effect was greater in women with overweight or obesity when compared to women with BMI < 25 kg/m².

CONCLUSION

Motivational interviewing and/or cognitive behaviour therapy techniques may be effective for promoting healthy gestational weight gain. Nevertheless, a high proportion of women do not achieve recommended gestational weight gain. Future interventions should consider factors, including clinician and consumer perspectives, in the design and delivery of psychosocial interventions that aim to support healthy gestational weight gain.

TRIAL REGISTRATION

The protocol for this review was registered with the PROSPERO International register of systematic reviews (registration number CRD42020156401).

"An Ounce of Prevention is Worth a Pound of Cure": Proposal for a Social Prescribing Strategy for Obesity Prevention and Improvement in Health and Well-being

BACKGROUND

Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The rampant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional "biomedical approach of care" to a "biopsychosocial model" required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level.

OBJECTIVE

The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases; (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion; and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation.

METHODS

This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated "navigator" will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives.

RESULTS

A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on individuals, community groups, and the health care system will be implemented within the initial pilot phase of the project.

CONCLUSIONS

Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life examples of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The diverse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/41280.

Does global warming increase the risk of liver cancer in Australia? Perspectives based on spatial variability

Australia has experienced an astonishing increase in liver cancer over the past few decades and the epidemiological reasons behind this are puzzling. The existing recognized risk factors for liver cancer, viral hepatitis, and alcohol consumption, are inconsistent with the trend in liver cancer. Behind the effects of migration and metabolic disease lies a potential contribution of climate change to an increase in liver cancer. This study explored the climate-associated distribution of high-risk areas for liver cancer by comparing liver cancer to lung cancer and finds that the incidence of liver cancer is more pronounced in hot and humid areas. This study showed the risk of liver cancer was higher in the equatorial region and tropical regions. These results will extend the study on the health consequences of climate change and provide more ideas and directions for future researchers.

Incidence of iron deficiency Anaemia during pregnancy in Far North Queensland

INTRODUCTION

The WHO estimates the incidence of iron deficiency anaemia in Australia is 25%. However there is considerable variation during pregnancy and in regional areas.

OBJECTIVE

The aim of this investigation is to quantify the incidence of iron deficiency anaemia during pregnancy within Far North Queensland.

DESIGN

This is a single-centre retrospective cohort study. Cairns Hospital is the main referral centre for complex maternity care in Far North Queensland with an estimated population of 280-000, which includes many people from rural and remote communities and a high proportion who identify as Aboriginal or Torres Strait Islander. This study included all births at the Cairns Hospital in 2018, a total of 2190 deliveries.

FINDINGS

The study randomly sampled 551 mothers from the cohort, and the incidence of iron deficiency anaemia was 34.9%. 48.7% of women who identified as Aboriginal or Torres Strait Islander within the region were anaemic. This was significantly higher than an incidence of 28.9% for the rest of the population. Other risk factors include booking appointment after 28-weeks, Asian ethnicity and age less than 25-years. A BMI greater than 35 was protective DISCUSSION: This study will inform antenatal care providers within the region and improve obstetric outcomes by increasing awareness. Identifying risk factors will also facilitate prompt treatment and improve maternity care for vulnerable patient groups. On a broader level, the study provides new data to inform population health estimates both nationally and internationally.

CONCLUSION

The incidence of iron deficiency anaemia during pregnancy in Far North Queensland is significantly higher than previous estimates.

Red cells manufactured from lipaemic whole blood donations: Do they have higher haemolysis?

BACKGROUND AND OBJECTIVES

Lipaemia in blood donations is thought to influence haemolysis in stored red blood cell (RBC) components. Higher lipid concentrations are believed to increase red cell fragility, exacerbating haemolysis during collection and subsequent red cell storage. This study aimed to investigate associations between lipoproteins in plasma and haemolysis of red cells stored in saline-adenine-glucose-mannitol (SAGM).

MATERIALS AND METHODS

Fifty-four plasma and matched RBCs were obtained from lipaemic whole blood donations. Plasma was tested for coagulation factors, triglycerides and cholesterol. Haemolysis, glucose, lactate, extracellular potassium, lactate dehydrogenase and adenosine triphosphate (ATP) were measured in RBC on Days 7, 21 and 42 of storage. Additionally, 20 plasma and matched RBCs from non-lipaemic donations were tested as controls.

RESULTS

Lipaemic plasma had significantly higher triglyceride concentrations compared with non-lipaemic plasma. However, there was no significant difference in plasma cholesterol between the two groups. There were no significant differences in glucose, extracellular potassium or ATP concentrations in RBC from either group. There was no significant difference in haemolysis at expiry in lipaemic-derived and control RBC, with a weak correlation between haemolysis and either triglycerides or cholesterol.

CONCLUSION

There was no significant difference in haemolysis in RBC manufactured from lipaemic and non-lipaemic whole blood donations when stored in SAGM; however, the proportion of RBC from lipaemic donations with higher haemolysis was greater than in the controls. There was a weak correlation between red cell haemolysis and plasma triglycerides. Therefore, RBCs derived from lipaemic donations are suitable for blood bank inventories.

Trends and Factors Associated with Obesity Prevalence in Rural Australian Adults-Comparative Analysis of the Crossroads Studies in Victoria over 15 Years

This study examined the changes in the prevalence of obesity and associated lifestyle factors using data from repeated cross-sectional, self-reported surveys (Crossroads I: 2001-2003 and Crossroads II: 2016-2018, studies) and clinic anthropometric measurements collected from regional and rural towns in the Goulburn Valley, Victoria. Given that past community studies have only focused categorically on dietary intake, or assessed caloric energy intake, we examined the difference in broad dietary practices at two different times. Clinical assessments from randomly selected household participants aged ≥18 years were analyzed. Differences in obesity prevalence were calculated for each individual variable. Logistic regression was used to determine the odds ratios (95% confidence intervals (CI)) with and without adjustment for key lifestyle factors. There were 5258 participants in Crossroads I and 2649 in Crossroads II surveys. Obesity prevalence increased from 28.2% to 30.8% over 15 years, more among those who ate fried food, but decreased significantly among rural dwellers (31.7: 27.0, 36.8% versus 25.1: 22.9, 27.5%) and those who had adequate fruit intake (28.5: 25.0, 32.3% to 23.9: 21.8, 26.2%). Obesity was associated with older age (≥35 years), use of fat-based spreads for bread (adjusted odds ratio, aOR:1.26: 1.07, 1.48) and physical inactivity. The increase in obesity prevalence especially in the rural towns, was associated with unhealthy dietary behaviour which persisted over 15 years. Understanding and addressing the upstream determinants of dietary intake and choices would assist in the development of future health promotion Programs.

Morbid obesity, multiple long-term conditions, and health-related quality of life among Australian adults: Estimates from three waves of a longitudinal household survey

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Health-related quality of life is negatively impacted by morbid obesity and chronic conditions.

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Morbidly obese individuals scored lower on the PCS, MCS, and SF-6D utility indexes.

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Multiple long-term conditions also decreased PCS, MCS, and SF-6D utility scores.

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The interaction between morbid obesity and MLTCs has had an opposite effect on PCS and MCS.

This study aims to investigate the impact of morbid obesity and multiple long-term conditions (MLTCs) on health-related quality of life (HRQoL). Data for this study were sourced from three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The paper analyses 37,887 person-year observations from 19,387 individuals during the period 2009–2017. The longitudinal random-effects Tobit model was fitted to examine the association between morbid obesity, MLTCs and HRQoL. This study found that morbid obesity and MLTCs were both negatively associated with HRQoL as measured through physical component summary (PCS), mental component summary (MCS), and the short-form six-dimension utility index (SF-6D) of the 36-item Short-Form Health Survey (SF-36). Morbidly obese scored lower points on the PCS (β = −5.05, 95% CI: −5.73, −4.37), MCS (β = −1.03, 95% CI: −1.84, −0.23), and in the SF-6D utility index (β = −0.045, 95% CI: −0.054, −0.036) compared to their healthy weight counterparts. Similar findings were observed for individuals with MLTCs, with lower scores for the PCS (β = −4.79, 95% CI: −5.20, −4.38), MCS (β = −4.95, 95% CI: −5.43, −4.48), and SF-6D utility (β = −0.071, 95% CI: −0.076, −0.066). Additionally, multiplicative interaction between morbid obesity and MLTCs was observed to modestly exacerbated the negative effect of morbid obesity on PCS scores (β = −1.69, 95% CI: −2.74, −0.64). The interaction effect, on the other hand, significantly lessen the unfavourable effect of morbid obesity on the MCS score (β = 1.34, 95% CI: 0.10, 2.58). The findings of this study will be useful for future cost-effectiveness analyses and measuring the burden of diseases since it provides information on the disutility associated with morbid obesity and MLTCs.

Geographical disparities in obesity prevalence: small-area analysis of the Chilean National Health Surveys

BACKGROUND

Previous representative health surveys conducted in Chile evidenced a high obesity prevalence rate among adults, especially in female and urban areas. Nevertheless, these have limited utility for targeted interventions and local source allocation for prevention. This study analyzes the increments in obesity prevalence rates in populations ≥15 years of age and the geographic variation at the regional level. We also assessed whether the obesity rates have different patterns on a smaller geographic level than national and regional ones.

METHODS

This ecological study analyzed data from two representative national samples of adolescents and adults ≥15 years old, who participated in the last Chilean health surveys, 2009 (n = 5412) and 2016 (n = 6233). Obesity (body mass index≥30 kg/m²) rates were calculated on the national, regional, and Health service (HS) levels, being HS the smallest unit of analysis available. Obesity rates and relative increase to early identify target populations and geographic areas, with 95% confidence intervals (95% CI), were calculated using the sampling design of the national surveys, at the national and regional level, and by gender, age groups, and socioeconomic status. The Fay-Herriot (FH) models, using auxiliary data, were fitted for obesity rate estimates at the HS level.

RESULTS

The relative increase in obesity rate was 37.1% (95%CI 23.3-52.9) at the national level, with a heterogeneous geographic distribution at the regional one. Southern regions had the highest obesity rates in both surveys (Aysén: 35.2, 95%CI 26.9-43.5 in 2009, 44.3 95%CI 37-51.7 in 2016), but higher increases were predominantly in the northern and central areas of the country (relative increase 91.1 95%CI 39.6-110.1 in Valparaiso and 81.6 95%CI 14.4-196.2 in Tarapacá). Obesity rates were higher in females, older age, and lower socioeconomic groups; nevertheless, relative increases were higher in the opposite ones. The FH estimates showed an obesity rates variation at the HS level, where higher rates tend to converge to specific HS areas of each region.

CONCLUSION

Obesity rates and relative increase are diverse across subnational levels and substantially differ from the national estimates, highlighting a pattern that converges to areas with low-middle income households. Our results emphasize geographical disparities in obesity prevalence among adults and adolescents.

Obesity, Inflammation, and Immune System in Osteoarthritis

Obesity remains the most important risk factor for the incidence and progression of osteoarthritis (OA). The leading cause of OA was believed to be overloading the joints due to excess weight which in turn leads to the destruction of articular cartilage. However, recent studies have proved otherwise, various other factors like adipose deposition, insulin resistance, and especially the improper coordination of innate and adaptive immune responses may lead to the initiation and progression of obesity-associated OA. It is becoming increasingly evident that multiple inflammatory cells are recruited into the synovial joint that serves an important role in pathological changes in the synovial joint. Polarization of macrophages and macrophage-produced mediators are extensively studied and linked to the inflammatory and destructive responses in the OA synovium and cartilage. However, the role of other major innate immune cells such as neutrophils, eosinophils, and dendritic cells in the pathogenesis of OA has not been fully evaluated. Although cells of the adaptive immune system contribute to the pathogenesis of obesity-induced OA is still under exploration, a quantity of literature indicates OA synovium has an enriched population of T cells and B cells compared with healthy control. The interplay between a variety of immune cells and other cells that reside in the articular joints may constitute a vicious cycle, leading to pathological changes of the articular joint in obese individuals. This review addresses obesity and the role of all the immune cells that are involved in OA and summarised animal studies and human trials and knowledge gaps between the studies have been highlighted. The review also touches base on the interventions currently in clinical trials, different stages of the testing, and their shortcomings are also discussed to understand the future direction which could help in understanding the multifactorial aspects of OA where inflammation has a significant function.

mHealth Research for Weight Loss, Physical Activity, and Sedentary Behavior: Bibliometric Analysis

BACKGROUND

Research into mobile health (mHealth) technologies on weight loss, physical activity, and sedentary behavior has increased substantially over the last decade; however, no research has been published showing the research trend in this field.

OBJECTIVE

The purpose of this study was to provide a dynamic and longitudinal bibliometric analysis of recent trends of mHealth research for weight loss, physical activity, and sedentary behavior.

METHODS

A comprehensive search was conducted through Web of Science to retrieve all existing relevant documents published in English between January 1, 2010, and November 1, 2021. We developed appropriate research questions; based on the proven bibliometric approaches, a search strategy was formulated to screen the title for eligibility. Finally, we conducted bibliometric analyses to explore the growth rate of publications; publication patterns; and the most productive authors, institutions, and countries, and visualized the trends in the field using a keyword co-occurrence network.

RESULTS

The initial search identified 8739 articles, of which 1035 were included in the analyses. Our findings show an exponential growth trend in the number of annual publications of mHealth technology research in these fields. JMIR mHealth and uHealth (n=214, 20.67%), Journal of Medical Internet Research (n=71, 6.86%), and BMC Public Health (n=36, 3.47%) were the top 3 journals, publishing higher numbers of articles. The United States remained the leading contributor in these areas (n=405, 39.13%), followed by Australia (n=154, 14.87%) and England (n=125, 12.07%). Among the universities, the University of Sydney (n=36, 3.47%) contributed the most mHealth technology research in these areas; however, Deakin University (n=25, 2.41%) and the National University of Singapore (n=23, 2.22%) were in the second and third positions, respectively.

CONCLUSIONS

Although the number of papers published on mobile technologies for weight loss, physical activity, and sedentary behavior was initially low, there has been an overall increase in these areas in recent years. The findings of the study indicate that mobile apps and technologies have substantial potential to reduce weight, increase physical activity, and change sedentary behavior. Indeed, this study provides a useful overview of the publication trends and valuable guidance on future research directions and perspectives in this rapidly developing field.

Trends in percentages of gestational diabetes mellitus attributable to overweight, obesity, and morbid obesity in regional Victoria: an eight-year population-based panel study

Background

Gestational diabetes mellitus (GDM) is the fastest growing type of diabetes in Australia with rates trebling over the past decades partially explained by rising obesity rates and maternal age among childbearing women. Percentage of GDM attributable to obesity has been documented, mostly focusing on metropolitan populations. In parts of regional (areas outside capital cities) and rural Australia where overweight, obesity and morbid obesity are more prevalent, intertwined with socioeconomic disadvantage and higher migrant communities, trends over time in adjusted percentages of GDM attributed to obesity are unknown.

Methods

In this population-based retrospective panel study, women, without pre-existing diabetes, delivering singletons between 2010 and 2017 in a tertiary regional hospital that serves 26% of Victoria’s 6.5 million Australian population were eligible for inclusion. Secular trends in GDM by body mass index (BMI) and age were evaluated. The percentage of GDM that would have been prevented each year with the elimination of overweight or obesity was estimated using risk-adjusted regression-based population attributable fractions (AFp). Trends in the AFp over time were tested using the augmented Dickey-Fuller test.

Results

Overall 7348 women, contributing to 10,028 births were included. The age of expecting mothers, their BMI, proportion of women born overseas, and GDM incidence significantly rose over time with GDM rising from 3.5% in 2010 to 13.7% in 2017, p <  0.001, increasing in all BMI categories. The incidence was consistently highest among women with obesity (13.8%) and morbid obesity (21.6%). However, the highest relative increase was among women with BMI < 25 kg/m², rising from 1.4% in 2010 to 7.0% in 2017. Adjusting for age, country of birth, socioeconomic status, comorbidities, antenatal and intrapartum factors, an estimated 8.6% (confidence interval (CI) 6.1–11.0%), 15.6% (95% CI 12.2–19.0%), and 19.5% (95% CI 15.3–23.6%) of GDM would have been prevented by eliminating maternal overweight, obesity, and morbid obesity, respectively. However, despite the rise in obesity over time, percentages of GDM attributable to overweight, obesity, and morbid obesity significantly dropped over time. Scenario analyses supported these findings.

Conclusions

Besides increasing prevalence of obesity over time, this study suggests that GDM risk factors, other than obesity, are also increasing over time.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-04420-9.

Age and gender differences in the relationship between obesity and disability with self-perceived employment discrimination: Results from a retrospective study of an Australian national sample

BACKGROUND

Health status is a crucial determinant of an individuals' labour market outcomes. The present study investigates the association between obesity and disability with perceived employment discrimination within Australia.

METHODS

A total of 17,174 person-year observations from the 11,079 respondents were analysed using four waves of data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey. The primary outcome examined was employment discrimination, using obesity and disability as the main exposure variables. The longitudinal random-effects regression technique was applied to investigate the between-person differences in employment discrimination associated with obesity and disability.

RESULTS

The findings suggest that more than one in ten (12.68 %) Australians experienced employment discrimination. The odds of being discriminated against while applying for a job were 1.56 times (aOR: 1.56, 95 % CI: 1.15-2.11) higher for obese than their healthy weight counterparts in youngest women. Adults with a disability had 1.89 times (aOR: 1.89, 95 % CI: 1.65-2.17) higher odds of being discriminated against than peers without disability.

CONCLUSION

The results provide evidence that obesity and disability contribute to employment discrimination in Australia. The findings can assist government and related agencies to consider the adequacy of existing discrimination legislation and help organisations to develop appropriate policies to address discrimination against obese and disabled people in their workplaces.

Obesity and the risk of developing chronic diseases in middle-aged and older adults: Findings from an Australian longitudinal population survey, 2009-2017

Background

Overweight and obesity impose a significant health burden in Australia, predominantly the middle-aged and older adults. Studies of the association between obesity and chronic diseases are primarily based on cross-sectional data, which is insufficient to deduce a temporal relationship. Using nationally representative panel data, this study aims to investigate whether obesity is a significant risk factor for type 2 diabetes, heart diseases, asthma, arthritis, and depression in Australian middle-aged and older adults.

Methods

Longitudinal data comprising three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey were used in this study. This study fitted longitudinal random-effect logistic regression models to estimate the between-person differences in the association between obesity and chronic diseases.

Results

The findings indicated that obesity was associated with a higher prevalence of chronic diseases among Australian middle-aged and older adults. Obese adults (Body Mass Index [BMI] ≥ 30) were at 12.76, 2.05, 1.97, 2.25, and 1.96, times of higher risks of having type 2 diabetes (OR: 12.76, CI 95%: 8.88–18.36), heart disease (OR: 2.05, CI 95%: 1.54–2.74), asthma (OR: 1.97, CI 95%: 1.49–2.62), arthritis (OR: 2.25, 95% CI: 1.90–2.68) and depression (OR: 1.96, CI 95%: 1.56–2.48), respectively, compared with healthy weight counterparts. However, the study did not find any evidence of a statistically significant association between obesity and cancer. Besides, gender stratified regression results showed that obesity is associated with a higher likelihood of asthma (OR: 2.64, 95% CI: 1.84–3.80) among female adults, but not in the case of male adults.

Conclusion

Excessive weight is strongly associated with a higher incidence of chronic disease in Australian middle-aged and older adults. This finding has clear public health implications. Health promotion programs and strategies would be helpful to meet the challenge of excessive weight gain and thus contribute to the prevention of chronic diseases.

Obesity, Disability and Self-Perceived Health Outcomes in Australian Adults: A Longitudinal Analysis Using 14 Annual Waves of the HILDA Cohort

BACKGROUND

Both obesity and disability have been widely recognised as major public health challenges because they play significant roles in determining self-perceived general and mental health. Longitudinal studies of the relationship between obesity and disability with self-reported health outcomes are scarce. Therefore, the objective of the present study is to examine the relationship between obesity and disability with self-perceived general and mental health among Australian adults aged 15 years and above.

METHODS

Data were extracted from the most recent 14 waves (waves 6 through 19) of the annual individual person dataset of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The longitudinal random-effects logistic regression model was adopted to investigate the relationships between obesity and disability with self-reported health outcomes.

RESULTS

The results revealed that obese individuals and adults with some form of disability are more likely to report poor or fair general and mental health. The odds of self-reporting poor or fair general health were 2.40 and 6.07 times higher among obese (aOR: 2.40, 95% CI: 2.22-2.58) and adults with some form of disability (aOR: 6.07, 95% CI: 5.77-6.39), respectively, relative to adults with healthy weight and those without disability . The results also showed that self-rated poor or fair mental health were 1.22 and 2.40 times higher among obese adults (aOR: 1.22, 95% CI: 1.15-1.30) and adults with disability (aOR: 2.40, 95% CI: 2.30-2.51), respectively, compared to their healthy weight peers and peers without disability.

CONCLUSION

As governmental and non-governmental organisations seek to improve the community's physical and mental well-being, these organisations need to pay particular attention to routine health care prevention, specific interventions, and treatment practices, especially for obese and/or people with disabilities.