1
|
Ard JD, Lewis KH, Moore JB. Lifestyle Interventions for Obesity in the Era of GLP-1 Receptor Agonists. JAMA 2024; 332:16-18. [PMID: 38744427 DOI: 10.1001/jama.2024.7062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Affiliation(s)
- Jamy D Ard
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Kristina H Lewis
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Justin B Moore
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
2
|
Basishvili G, Newberry C, Mechanick JI, Barazzoni R, Hennessy S. Key messages on obesity care from the 2023 ASPEN Physician Preconference Course: A narrative review. JPEN J Parenter Enteral Nutr 2024; 48:546-553. [PMID: 38734876 DOI: 10.1002/jpen.2632] [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: 09/15/2023] [Revised: 03/11/2024] [Accepted: 03/29/2024] [Indexed: 05/13/2024]
Abstract
Obesity is a challenging chronic disease process that continues to affect a large percentage of the population at large. With the advent of new therapeutic options and interventions and a deeper scientific understanding of obesity as a complex illness, there is hope in curtailing this evolving pandemic. In this article, we present key medical information to engage and empower nutrition-focused providers to manage obesity and its nutrition complications. The topics summarized here were presented during the 2023 American Society for Parenteral and Enteral Nutrition Preconference Physician Course and include pathophysiology and hormonal regulation of obesity, multidisciplinary care planning and nutrition risk stratification of patients, and common approaches to treatment, including lifestyle modifications, antiobesity medications, and procedures from the perspective of the nutrition specialist.
Collapse
Affiliation(s)
- Givi Basishvili
- Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Carolyn Newberry
- Division of Gastroenterology, Weill Cornell Medical College, New York, New York, USA
| | - Jeffrey I Mechanick
- Divisions of Cardiology and Endocrinology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rocco Barazzoni
- Department of Internal Medicine, Trieste University Hospital, Trieste, Italy
| | - Sara Hennessy
- Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
3
|
Jiang Y, Wang S, Shuai J, Zhang X, Zhang S, Huang H, Zhang Q, Fu L. Dietary dicarbonyl compounds exacerbated immune dysfunction and hepatic oxidative stress under high-fat diets in vivo. Food Funct 2024. [PMID: 38898781 DOI: 10.1039/d3fo05708a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
High-fat diets (HFDs) predispose to obesity and liver dysfunctions, and α-dicarbonyl compounds (α-DCs) present in highly processed foods are also implicated in relevant pathological processes. However, the synergistic harmful effects of α-DCs co-administered with HFDs remain to be elucidated. In this study, 6-week-old C57BL/6 mice were fed with a HFD co-administered with 0.5% methylglyoxal (MGO)/glyoxal (GO) in water for 8 weeks, and multi-omics approaches were employed to investigate the underlying toxicity mechanisms. The results demonstrated that the MGO intervention with a HFD led to an increased body weight and blood glucose level, accompanied by the biological accumulation of α-DCs and carboxymethyl-lysine, as well as elevated serum levels of inflammatory markers including IL-1β, IL-6, and MIP-1α. Notably, hepatic lesions were observed in the MGO group under HFD conditions, concomitant with elevated levels of malondialdehyde. Transcriptomic analysis revealed enrichment of pathways and differentially expressed genes (DEGs) associated with inflammation and oxidative stress in the liver. Furthermore, α-DC intervention exacerbated gut microbial dysbiosis in the context of a HFD, and through Spearman correlation analysis, the dominant genera such as Fusobacterium and Bacteroides in the MGO group and Colidextribacter and Parabacteroides in the GO group were significantly correlated with a set of DEGs involved in inflammatory and oxidative stress pathways in the liver. This study provides novel insights into the healthy implications of dietary ultra-processed food products in the context of obesity-associated disorders.
Collapse
Affiliation(s)
- Yuhao Jiang
- School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou, 310018, Zhejiang Province, China.
| | - Shunyu Wang
- hejiang Li Zi Yuan Food Co., Ltd, Z, Jinhua, 321031, China
| | - Jiangbing Shuai
- Zhejiang Academy of Science & Technology for Inspection & Quarantine, Hangzhou, 310016, China
| | - Xiaofeng Zhang
- Zhejiang Academy of Science & Technology for Inspection & Quarantine, Hangzhou, 310016, China
| | - Shuifeng Zhang
- National Pre-packaged Food Quality Supervision and Inspection Center, Zhejiang Fangyuan Test Group Co., Ltd., Hangzhou, 310018, China
| | - Hua Huang
- Quzhou Institute for Food and Drug Control, Quzhou, 324000, China
| | - Qiaozhi Zhang
- School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou, 310018, Zhejiang Province, China.
| | - Linglin Fu
- School of Food Science and Biotechnology, Zhejiang Gongshang University, 18 Xue Zheng Street, Hangzhou, 310018, Zhejiang Province, China.
| |
Collapse
|
4
|
Allen AM, Younossi ZM, Diehl AM, Charlton MR, Lazarus JV. Envisioning how to advance the MASH field. Nat Rev Gastroenterol Hepatol 2024:10.1038/s41575-024-00938-9. [PMID: 38834817 DOI: 10.1038/s41575-024-00938-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/06/2024]
Abstract
Since 1980, the cumulative effort of scientists and health-care stakeholders has advanced the prerequisites to address metabolic dysfunction-associated steatotic liver disease (MASLD), a prevalent chronic non-communicable liver disease. This effort has led to, among others, the approval of the first drug specific for metabolic dysfunction-associated steatohepatitis (MASH; formerly known as nonalcoholic steatohepatitis). Despite substantial progress, MASLD is still a leading cause of advanced chronic liver disease, including primary liver cancer. This Perspective contextualizes the nomenclature change from nonalcoholic fatty liver disease to MASLD and proposes important considerations to accelerate further progress in the field, optimize patient-centric multidisciplinary care pathways, advance pharmacological, behavioural and diagnostic research, and address health disparities. Key regulatory and other steps necessary to optimize the approval and access to upcoming additional pharmacological therapeutic agents for MASH are also outlined. We conclude by calling for increased education and awareness, enhanced health system preparedness, and concerted action by policy-makers to further the public health and policy agenda to achieve at least parity with other non-communicable diseases and to aid in growing the community of practice to reduce the human and economic burden and end the public health threat of MASLD and MASH by 2030.
Collapse
Affiliation(s)
- Alina M Allen
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Zobair M Younossi
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA
- The Global NASH Council, Washington DC, USA
| | | | - Michael R Charlton
- Center for Liver Diseases, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington DC, USA.
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY, USA.
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
5
|
Foley B, Hopperstad K, Gamble J, Lynn SG, Thomas RS, Deisenroth C. Technical evaluation and standardization of the human thyroid microtissue assay. Toxicol Sci 2024; 199:89-107. [PMID: 38310358 DOI: 10.1093/toxsci/kfae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024] Open
Abstract
The success and sustainability of U.S. EPA efforts to reduce, refine, and replace in vivo animal testing depends on the ability to translate toxicokinetic and toxicodynamic data from in vitro and in silico new approach methods (NAMs) to human-relevant exposures and health outcomes. Organotypic culture models employing primary human cells enable consideration of human health effects and inter-individual variability but present significant challenges for test method standardization, transferability, and validation. Increasing confidence in the information provided by these in vitro NAMs requires setting appropriate performance standards and benchmarks, defined by the context of use, to consider human biology and mechanistic relevance without animal data. The human thyroid microtissue (hTMT) assay utilizes primary human thyrocytes to reproduce structural and functional features of the thyroid gland that enable testing for potential thyroid-disrupting chemicals. As a variable-donor assay platform, conventional principles for assay performance standardization need to be balanced with the ability to predict a range of human responses. The objectives of this study were to (1) define the technical parameters for optimal donor procurement, primary thyrocyte qualification, and performance in the hTMT assay, and (2) set benchmark ranges for reference chemical responses. Thyrocytes derived from a cohort of 32 demographically diverse euthyroid donors were characterized across a battery of endpoints to evaluate morphological and functional variability. Reference chemical responses were profiled to evaluate the range and chemical-specific variability of donor-dependent effects within the cohort. The data-informed minimum acceptance criteria for donor qualification and set benchmark parameters for method transfer proficiency testing and validation of assay performance.
Collapse
Affiliation(s)
- Briana Foley
- Center for Computational Toxicology and Exposure, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - Kristen Hopperstad
- Center for Computational Toxicology and Exposure, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - John Gamble
- Center for Computational Toxicology and Exposure, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee 37831, USA
| | - Scott G Lynn
- Office of Pesticide Programs, U.S. Environmental Protection Agency, Washington, District of Columbia 20460, USA
| | - Russell S Thomas
- Center for Computational Toxicology and Exposure, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| | - Chad Deisenroth
- Center for Computational Toxicology and Exposure, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA
| |
Collapse
|
6
|
Sandri E, Pardo J, Cantín Larumbe E, Cerdá Olmedo G, Falcó A. Analysis of the influence of educational level on the nutritional status and lifestyle habits of the young Spanish population. Front Public Health 2024; 12:1341420. [PMID: 38651128 PMCID: PMC11033505 DOI: 10.3389/fpubh.2024.1341420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Aim This study aims to analyze some nutrition and health habits of young people and the impact of educational attainment on health. Methods An observational, descriptive, and cross-sectional study was carried out using surveys. Using non-probabilistic snowball sampling, a previously validated questionnaire was disseminated through networks, collecting a sample of 9,681 people between 18 and 30 years old. Comparative analyses between groups were obtained by clustering and the corresponding statistical tests. Results The results showed how young people with higher education generally have a lower BMI, a higher healthy nutrition index, less frequent consumption of sugary drinks, and less smoking than their peers with basic education. These healthier habits are reflected in the higher self-perceived health status of the higher-educated group. While for all the educational levels analyzed, the minutes of physical activity practice are above the 150 min recommended by the WHO. Conclusion Our findings suggest that young people's education level is of fundamental importance for health, particularly for nutritional habits. In general, the lifestyle habits of the young Spanish population are healthy, but there is a need for improvement in those aspects related to nutrition and food.
Collapse
Affiliation(s)
- Elena Sandri
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
- Doctoral School, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Juan Pardo
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Eva Cantín Larumbe
- Degree in Data Science, Polytechnical University of Valencia, Valencia, Spain
| | - Germán Cerdá Olmedo
- Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Antonio Falcó
- Department of Mathematics, Physics and Technological Sciences, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| |
Collapse
|
7
|
Taylor KM, Giersch GEW, Caldwell AR, Epstein Y, Charkoudian N. Relation of body surface area-to-mass ratio to risk of exertional heat stroke in healthy men and women. J Appl Physiol (1985) 2024; 136:549-554. [PMID: 38234291 PMCID: PMC11219003 DOI: 10.1152/japplphysiol.00597.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
Risk of exertional heat stroke (EHS) is an ongoing challenge for United States military personnel, for athletes and for individuals with occupational stressors that involve prolonged activity in hot environments. Higher body mass index (BMI) is significantly associated with increased risk for EHS in activity duty U.S. Soldiers. During exercise, heat is generated primarily by contracting skeletal muscle (and other metabolically active body mass) and dissipated based on body surface area (BSA). Thus, in compensable environments, a higher BSA·mass-1 may be a benefit to heat dissipation and decrease the risk of EHS. The purpose of the present analysis was to test the hypothesis that BSA·mass-1 ratio is an important biophysical characteristic contributing to the risk of EHS. We employed a matched case-control approach, where each individual with a diagnosis of EHS was matched to five controls who were never diagnosed with EHS but were in the same unit and had the same job title. We used a multivariate conditional logistic regression model including variables of BSA·mass-1, sex, age, military rank, and race. BSA·mass-1 significantly predicted EHS risk (P = 0.006), such that people with higher BSA·mass-1 were at lower risk of developing EHS when controlling for other potential factors such as age and race. This relationship persisted after adjustment for other anthropometric measures of body size including weight, BMI, and BSA. These data suggest that biophysical factors play an important role in EHS risk, particularly in a healthy military-aged cohort of men and women.NEW & NOTEWORTHY With the impacts of climate change yielding higher average ambient temperatures over time, the incidence of EHS for individuals participating in outdoor activities may consequently increase. With the larger sample size in this study compared with prior research in this field, we were able to use various methods that had not been applied before. For example, we were able to mutually adjust for different measurements of body size to understand which metric had the highest association with EHS risk. Understanding factors that may be modifiable may be important for developing interventions to counteract the increased risk of EHS associated with climate change.
Collapse
Affiliation(s)
- Kathryn M Taylor
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Gabrielle E W Giersch
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Aaron R Caldwell
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Yoram Epstein
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| |
Collapse
|
8
|
Cau R, Muscogiuri G, Pisu F, Mannelli L, Sironi S, Suri JS, Pontone G, Saba L. Effect of late gadolinium enhancement on left atrial impairment in myocarditis patients. Eur Radiol 2024; 34:1846-1853. [PMID: 37658889 PMCID: PMC10873434 DOI: 10.1007/s00330-023-10176-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/13/2023] [Accepted: 07/04/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE The aims of our study were to investigate the effect of the extent and location of late gadolinium enhancement (LGE) on the left atrium (LA) function in patients with acute myocarditis (AM) using cardiovascular magnetic resonance (CMR). METHOD This retrospective study performed CMR scans in 113 consecutive patients (89 males, 24 females; mean age 45.8 ± 17.3 years) with AM that met the updated Lake Louise criteria. Reservoir, conduit, and booster LA functions were analyzed by CMR feature tracking using dedicated software. Besides LA strain measurements, myocardial scar location and extent were assigned and quantified by LGE imaging. RESULTS AM patients with septal LGE had impaired reservoir, conduit, and conduit strain rate function in comparison with AM patients with non-septal LGE (p = 0.001, for all). In fully adjusted multivariable linear regression, reservoir and conduit were significantly associated with left ventricle (LV) LGE location (β coefficient = 8.205, p = 0.007; β coefficient = 5.185, p = 0.026; respectively). In addition, LA parameters decreased according to the increase in the extent of LV fibrosis (LGE ≤ 10%; LGE 11-19%; LGE ≥ 20%). After adjustment in multivariable linear regression, the association with LV LGE extent was no longer statistically significant. CONCLUSION In patients with acute myocarditis, LA function abnormalities are significantly associated with LV LGE location, but not with LGE extent. Septal LGE is paralleled by a deterioration of LA reservoir and conduit function. CLINICAL RELEVANCE STATEMENT Left atrium dysfunction is associated with the presence of late gadolinium enhancement in the left ventricle septum and can be useful in the clinical prognostication of patients with acute myocarditis, allowing individually tailored treatment. KEY POINTS • Myocardial fibrosis is related to atrial impairment. • The location of myocardial fibrosis is the main determinant of atrial dysfunction in myocarditis patients. • The quantification of atrial mechanisms may provide more in-depth insight into myocarditis pathophysiology.
Collapse
Affiliation(s)
- Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato, 09045, Cagliari, Italy
| | - Giuseppe Muscogiuri
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
| | - Francesco Pisu
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato, 09045, Cagliari, Italy
| | - Lorenzo Mannelli
- Department of Radiology, IRCCS Istituto Auxologico Italiano, San Luca Hospital, Milan, Italy
| | - Sandro Sironi
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Jasjit S Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA, USA
| | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato, 09045, Cagliari, Italy.
| |
Collapse
|
9
|
Botros M, Guirguis P, Balkissoon R, Myers TG, Thirukumaran CP, Ricciardi BF. Is Morbid Obesity a Modifiable Risk Factor in Patients Who Have Severe Knee Osteoarthritis and do Not Have a Formal Perioperative Optimization Program? J Arthroplasty 2024; 39:658-664. [PMID: 37717836 DOI: 10.1016/j.arth.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/25/2023] [Accepted: 09/03/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Obesity is considered a modifiable risk factor prior to total knee arthroplasty (TKA); however, little data support this hypothesis. Our purpose was to evaluate patients who have a body mass index (BMI) >40 presenting for TKA to determine the incidence of: (1) patients who achieved successful weight loss through nutritional modification or bariatric surgery and (2) patients who underwent TKA over the study period without the presence of a formal optimization program. METHODS This was a retrospective, single-center analysis. Inclusion criteria included: Kellgren and Lawrence grade 3 or 4 knee osteoarthritis, BMI >40 at presentation, and minimum 1-year follow-up (mean 45 months) (N = 624 patients). Demographics, weight loss interventions, pursuit of TKA, maximum BMI change, and Patient-Reported Outcomes Measurement Information System scores were collected. Multivariable logistic and linear regressions evaluated associations of underlying demographic and treatment characteristics with outcomes. RESULTS There were 11% of patients who ended up pursuing TKA over the study period. Bariatric surgery was 3.7 times more likely to decrease BMI by minimum 10 compared to nonsurgical intervention (95% confidence interval [CI] [1.7, 8.1]; P = .001). Bariatric surgery resulted in mean BMI change of -3.3 (range, 0 to 22) compared to nonsurgical interventions (-2.6 [range, 0 to 12]) and no intervention (0.4 [range, 0 to 15]; P < .0001). Bariatric surgery patients were 3.1 times more likely to undergo TKA (95% CI [1.3, 7.1]; P = .008), and nonsurgical interventions were 2.4 times more likely to undergo TKA (95% CI [1.3, 4.5]; P = .006) compared to no intervention. Non-White patients across all interventions were less likely to experience loss >5 BMI compared to White patients (95% CI [0.2, 0.9]; P = .018). CONCLUSIONS Most patients were unable to reduce BMI more than 5 to 10 over a mean 4-year period without a formal weight optimization program. Utilization of bariatric surgery was most successful compared to nonsurgical interventions, although ultimate pursuit of TKA remained low in all cohorts.
Collapse
Affiliation(s)
- Mina Botros
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York
| | - Paul Guirguis
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York
| | - Rishi Balkissoon
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York
| | - Thomas G Myers
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York
| | - Caroline P Thirukumaran
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York; Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York
| | - Benjamin F Ricciardi
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York; Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
10
|
Cau R, Pisu F, Suri JS, Pontone G, D’Angelo T, Zha Y, Salgado R, Saba L. Atrial and Ventricular Strain Imaging Using CMR in the Prediction of Ventricular Arrhythmia in Patients with Myocarditis. J Clin Med 2024; 13:662. [PMID: 38337355 PMCID: PMC10856157 DOI: 10.3390/jcm13030662] [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: 12/01/2023] [Revised: 01/12/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Objective: Myocarditis can be associated with ventricular arrhythmia (VA), individual non-invasive risk stratification through cardiovascular magnetic resonance (CMR) is of great clinical significance. Our study aimed to explore whether left atrial (LA) and left ventricle (LV) myocardial strain serve as independent predictors of VA in patients with myocarditis. (2) Methods: This retrospective study evaluated CMR scans in 141 consecutive patients diagnosed with myocarditis based on the updated Lake Louise criteria (29 females, mean age 41 ± 20). The primary endpoint was VA; this encompassed ventricular fibrillation, sustained ventricular tachycardia, nonsustained ventricular tachycardia, and frequent premature ventricular complexes. LA and LV strain function were performed on conventional cine SSFP sequences. (3) Results: After a median follow-up time of 23 months (interquartile range (18-30)), 17 patients with acute myocarditis reached the primary endpoint. In the multivariable Cox regression analysis, LA reservoir (hazard ratio [HR] and 95% confidence interval [CI]: 0.93 [0.87-0.99], p = 0.02), LA booster (0.87 95% CI [0.76-0.99], p = 0.04), LV global longitudinal (1.26 95% CI [1.02-1.55], p = 0.03), circumferential (1.37 95% CI [1.08-1.73], p = 0.008), and radial strain (0.89 95% CI [0.80-0.98], p = 0.01) were all independent determinants of VA. Patients with LV global circumferential strain > -13.3% exhibited worse event-free survival compared to those with values ≤ -13.3% (p < 0.0001). (4) Conclusions: LA and LV strain mechanism on CMR are independently associated with VA events in patients with myocarditis, independent to LV ejection fraction, and late gadolinium enhancement location. Incorporating myocardial strain parameters into the management of myocarditis may improve risk stratification.
Collapse
Affiliation(s)
- Riccardo Cau
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari—Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy;
| | - Francesco Pisu
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari—Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy;
| | - Jasjit S. Suri
- Stroke Monitoring and Diagnostic Division, AtheroPoint™, Roseville, CA 95661, USA;
| | - Gianluca Pontone
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy;
| | - Tommaso D’Angelo
- Department of Biomedical Sciences and Morphological and Functional Imaging, G. Martino University Hospital, University of Messina, 98124 Messina, Italy;
- Department of Radiology and Nuclear Medicine, Erasmus MC, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Yunfei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei General Hospital, Wuhan 430064, China;
| | - Rodrigo Salgado
- Department of Radiology, Universitair Ziekenhuis Antwerpen, 2650 Edegem, Belgium;
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari—Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy;
| |
Collapse
|
11
|
Sutton CA, Stratton M, L'Insalata AM, Fazzino TL. Ultraprocessed, hyper-palatable, and high energy density foods: Prevalence and distinction across 30 years in the United States. Obesity (Silver Spring) 2024; 32:166-175. [PMID: 37794529 DOI: 10.1002/oby.23897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/11/2023] [Accepted: 08/08/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Ultraprocessed foods (UPF), hyper-palatable foods (HPF), and high energy density (HED) foods may contribute to obesity risk. All have distinct definitions; however, it is unknown the degree to which they may identify overlapping or distinct foods. This study examined the availability of UPF, HPF, and HED foods in the US food system from 1988 to 2018 and the degree of distinction across definitions. METHODS Four data sets representing the US food system (1988, 2001, 2006, 2018) from the US Department of Agriculture were analyzed. UPF were identified based on the extent of industrialized processing. HPF were identified using the standardized definition that specifies palatability-inducing nutrient combinations. HED was characterized as >2.0 kcal/g. RESULTS Across years, 58% to 65% of foods were classified as UPF, 55% to 69% as HPF, and 37% to 47% as HED. Prevalence of UPF, HPF, and HED foods was higher in 2018 versus 1988 (p values < 0.001); HPF evidenced the largest increase (14%) and UPF evidenced the smallest (4%) over time. There was moderate to high overlap in foods (40%-70%) across definitions. CONCLUSIONS Together, UPF, HPF, and HED foods comprise most foods in the US food supply. Changes in availability varied across definitions, with substantial increases in HPF and HED and relative stability of UPF.
Collapse
Affiliation(s)
- Cassandra A Sutton
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Matthew Stratton
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Alexa M L'Insalata
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| | - Tera L Fazzino
- Department of Psychology, University of Kansas, Lawrence, Kansas, USA
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, Kansas, USA
| |
Collapse
|
12
|
Mayfield CK, Mont MA, Lieberman JR, Heckmann ND. Medical Weight Optimization for Arthroplasty Patients: A Primer of Emerging Therapies for the Joint Arthroplasty Surgeon. J Arthroplasty 2024; 39:38-43. [PMID: 37531983 DOI: 10.1016/j.arth.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/13/2023] [Accepted: 07/24/2023] [Indexed: 08/04/2023] Open
Abstract
The obesity epidemic in the United States continues to grow with more than 40% of individuals now classified as obese (body mass index >30). Obesity has been readily demonstrated to increase the risk of developing hip and knee osteoarthritis and is known to increase the risk of complications following joint arthroplasty. Weight loss prior to arthroplasty may mitigate this risk of complications; however, the existing evidence remains mixed with no clear consensus on the optimal method of weight loss and timing prior to arthroplasty. Treatment options for weight loss have included nonsurgical lifestyle modifications consisting of structured diet, physical activity, and behavioral modification, as well as bariatric and metabolic surgery (ie, sleeve gastrectomy, Roux-en-Y gastric bypass, and the adjustable gastric band). Recently, glucagon-like peptide-1 receptor agonists have gained notable popularity within the scientific literature and media for their efficacy in weight loss. The aim of this review is to provide a foundational primer for joint arthroplasty surgeons regarding the current and emerging options for weight loss to aid surgeons in shared decision-making with patients prior to arthroplasty.
Collapse
Affiliation(s)
- Cory K Mayfield
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California
| | - Michael A Mont
- Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland
| | - Jay R Lieberman
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California
| | - Nathanael D Heckmann
- Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, California
| |
Collapse
|
13
|
Garrett LR, Harveson AT, Ayars C. Shift schedule effects on firefighter health and fitness. Work 2023:WOR230388. [PMID: 38143416 DOI: 10.3233/wor-230388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Firefighter health is of utmost importance both to first responders and the individuals they serve daily. The impact of shift schedule on firefighter health remains poorly understood. OBJECTIVE The purpose of this study was to examine differences in health and performance outcomes in firefighters across two different shift schedules. METHODS Firefighter (N = 1995) body composition, muscular strength, endurance, flexibility, and cardiorespiratory endurance were assessed and described. A Mann-Whitney U test was conducted to compare differences between shift schedules (48/96 and 4's and 6's). RESULTS There was a statistically significant difference in BMI (U = 70115, z=-1.988, p = .047), BF% (U = 67341, z=-2.779, p = .005), and trunk flexion score (U = 81362, z = 1.979, p = .048) favoring the 48/96 shift schedule. CONCLUSION Firefighters following a 48/96 shift schedule exhibited improved body composition and fitness performance in comparison to peers who followed a 4's and 6's shift schedule. Findings may guide regional firefighter scheduling to optimize health and performance.
Collapse
|
14
|
Muscogiuri G, Verde L, Colao A. Body Mass Index (BMI): Still be used? Eur J Intern Med 2023; 117:50-51. [PMID: 37709557 DOI: 10.1016/j.ejim.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
| | - Ludovica Verde
- Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Unità di Endocrinologia, Diabetologia e Andrologia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, Naples 80131, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy.
| |
Collapse
|
15
|
Yin YH, Zhou SY, Lu DF, Chen XP, Liu B, Lu S, Han XD, Wu AH. Higher waist circumference is associated with increased likelihood of female infertility: NHANES 2017-2020 results. Front Endocrinol (Lausanne) 2023; 14:1216413. [PMID: 37937052 PMCID: PMC10627239 DOI: 10.3389/fendo.2023.1216413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/27/2023] [Indexed: 11/09/2023] Open
Abstract
Background Waist circumference can be used as an anthropometric measure to assess central obesity and is easier and more convenient than the waist-to-hip ratio in identifying the risk of obesity and medical problems. Most studies showing an association between obesity and infertility in women have used BMI to measure obesity. Our goal was to examine any potential association between waist circumference and infertility. Methods This cross-sectional study, which formed part of the National Health and Nutrition Examination Survey (NHANES), comprised women ages 18 to 45 between 2017 and 2020. Participants without waist circumference data or information on infertility were removed from the study. The independent relationship between waist circumference and infertility was investigated using weighted binary logistic regression and subgroup analysis. Results We investigated 1509 participants and discovered that the prevalence of infertility rose as the WC trisection rose. (tertile 1, 7.55%; tertile 2, 10.56%; tertile 3, 15.28%; trend < 0.001). Multivariate logistic regression showed that after total adjustment, higher WC levels were associated with an increased likelihood of infertility in women (OR1.02; 95% CI 1.01-1.03), and There was a 2% rise in the incidence of infertility for every unit (cm) increased WC. Subgroup analysis and interaction tests showed no significant dependence of the effects of marital status, diabetes, hypertension, and high cholesterol on the association between WC and infertility (p for all interaction tests > 0.05). The inflection point of the positive non-linear relationship between WC and infertility was 116.6 cm. Conclusion Excessive waist circumference assessment may increase the probability of infertility, and more attention should be paid to the management of waist circumference should be given more attention.
Collapse
Affiliation(s)
- Ying-Hua Yin
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Su-Yu Zhou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dong-Fang Lu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiu-Ping Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bo Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangzhou, China
| | - Shan Lu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Center for Reproductive Medicine, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Xiao-Dong Han
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ai-Hua Wu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Center for Reproductive Medicine, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
| |
Collapse
|
16
|
Wu SY, Jensen JL. Association Between Motor Competence and Percentage of Body Fat in Late Childhood: Comparing Proficiency in Fundamental Motor Skills and Advanced Movement Skills. Child Obes 2023; 19:452-460. [PMID: 36219742 DOI: 10.1089/chi.2022.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: To solve the problem of a weakening relationship between motor competence and body adiposity from late childhood to adolescence, we defined and utilized advanced movement skills (AMS) characterized by higher biomechanical, physiological, and cognitive processing demands compared with fundamental motor skills (FMS). Methods: As a cross-sectional study, the proficiency in FMS and AMS for participants (43 boys and 45 girls) aged 9-12 years was measured by the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) and Test of Advanced Movement Skills (TAMS), respectively. Density plots and skewness of scoring distributions between assessments were inspected to examine test scalability. We also compared the incremental validity of BOT-2 and TAMS scores in the multiple linear regression models predicting the percentage of body fat (%BF, measured by Tanita BF-689 body scale). Results: The TAMS outcomes produced a more positively/right-skewed scoring distribution with a skewness of 0.09 compared with -0.49 for the BOT-2 scores, indicating a better test discrimination ability. The TAMS total scores were a significant predictor (B = -0.92, p = 0.03) in the model predicting %BF (R2 = 0.39, p < 0.001) and provided a greater degree of incremental validity (f2 = 0.058) compared with the BOT-2 (f2 = 0.018). Conclusions: This study provides supportive evidence that the proficiency in AMS is more appropriate, compared with FMS, at tracking the increasing motor competence and body adiposity in late childhood, which is helpful for motor skills training, physical activity promotion, and overweight/obesity prevention.
Collapse
Affiliation(s)
- Sz-Yan Wu
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| | - Jody L Jensen
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
17
|
Zheng X, Ge YZ, Ruan GT, Lin SQ, Chen Y, Liu CA, Xie HL, Song MM, Liu T, Wang ZW, Shi JY, Zhang HY, Yang M, Liu XY, Deng L, Shi HP. Association between the Dietary Inflammatory Index and All-Cause Mortality in Adults with Obesity. ANNALS OF NUTRITION & METABOLISM 2023; 79:434-447. [PMID: 37690445 DOI: 10.1159/000533380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/02/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION The dietary inflammatory index (DII) is associated with numerous chronic noncommunicable diseases. Previous studies have shown that the pro-inflammatory DII categories are associated with abdominal and simple obesity. However, the association between DII and mortality in patients with abdominal obesity and simple overweight or obesity remains unclear. METHODS We used data from the US National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. A DII >0 (positive DII) was defined as a pro-inflammatory diet. A restricted cubic spline curve was used to describe the trend between DII and all-cause mortality. We then examined the association between DII and all-cause mortality in different body types using a Cox regression analysis and investigated the differences between sexes. Finally, the mediating effects of systemic inflammation were explored. RESULTS A pro-inflammatory diet increased all-cause mortality in adults with abdominal obesity (aHR: 1.31, 95% confidence interval [CI]: 1.11-1.54; p < 0.001) and with simple overweight or obesity (aHR: 1.30, 95% CI: 1.11-1.53; p < 0.001). In addition, the most pro-inflammatory DII increased the risk of mortality by 43% (hazard ratio [HR]: Q4 vs. Q1 = 1.43, 95% CI = 1.14-1.79; p = 0.002; p for trend = 0.003) and 39% (HR: Q4 vs. Q1 = 1.39, 95% CI = 1.13-1.74; p = 0.003; p for trend = 0.009) in participants with abdominal obesity and with simple overweight or obesity, respectively. However, this association was not present in normal-sized participants. Compared with men, women resisted the effects of a pro-inflammatory diet. Mediation analysis showed that white blood cell and neutrophil were mediators of the association between DII and all-cause mortality (p < 0.001). CONCLUSION A pro-inflammatory diet is associated with all-cause mortality in adults with abdominal obesity and simple overweight or obesity, and this effect differs between men and women. Systemic inflammation may mediate the association between DII and all-cause mortality.
Collapse
Affiliation(s)
- Xin Zheng
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Yi-Zhong Ge
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guo-Tian Ruan
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Shi-Qi Lin
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yue Chen
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chen-An Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Hai-Lun Xie
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Meng-Meng Song
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Tong Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Zi-Wen Wang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Jin-Yu Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - He-Yang Zhang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Ming Yang
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiao-Yue Liu
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Li Deng
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Han-Ping Shi
- Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| |
Collapse
|
18
|
Ren Y, Wu J, Wang Y, Zhang L, Ren J, Zhang Z, Chen B, Zhang K, Zhu B, Liu W, Li S, Li X. Lifestyle patterns influence the composition of the gut microbiome in a healthy Chinese population. Sci Rep 2023; 13:14425. [PMID: 37660184 PMCID: PMC10475076 DOI: 10.1038/s41598-023-41532-4] [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: 03/23/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023] Open
Abstract
High-throughput sequencing allows for the comprehensive analysis of the human intestinal microbiota. However, extensive association analyses between the microbiome and lifestyle differences in the Chinese population are limited. Here, we carried out an independent cohort study-the Chinese Healthy Gut Project (n = 483)-where correlations between the gut microbiota and dietary and lifestyle variables in a healthy Chinese population are defined. We collected both questionnaire data, including basic information and lifestyle and dietary variables, and fecal stools from the enrolled volunteers. We then performed 16S rRNA sequencing on the microbial DNA isolated from the stools to assess the composition of the intestinal microbiota. We found that Prevotella and Bacteroides were the most abundant genera in the healthy Chinese gut microbiome. Additionally, 9 out of 29 clinical and questionnaire-based phenotype covariates were found to be associated with the variation in the composition of the gut microbiota. Among these lifestyle phenotypes, sleep procrastination, negative mood, and drinking habits had the largest effect size. Additionally, an appreciable effect of urbanization was observed, resulting in decreased intra-individual diversity, increased inter-individual diversity, and an increased abundance of the Bacteroides enterotype. The results of this study provide a foundation for assessing the healthy Chinese gut microbiota community structure at baseline in a healthy Chinese population. Furthermore, this study also provides insights into understanding how distinctive living habits influence the relationships between the Chinese gut microbiome and systemic health state.
Collapse
Affiliation(s)
- Yi Ren
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Jiawei Wu
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Yilin Wang
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Lanying Zhang
- Coyote Diagnostics Lab (Beijing) Co., Ltd., Beijing, China
| | - Jing Ren
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Zhiming Zhang
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Binghan Chen
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Kejian Zhang
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Baoli Zhu
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
| | - Sabrina Li
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China.
- Coyote Diagnostics Lab (Beijing) Co., Ltd., Beijing, China.
| | - Xu Li
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China.
| |
Collapse
|
19
|
Gulkas S, Aydin FO, Turhan SA, Toker AE. In vivo corneal confocal microscopy as a non-invasive test to assess obesity induced small fibre nerve damage and inflammation. Eye (Lond) 2023; 37:2226-2232. [PMID: 36443498 PMCID: PMC10366092 DOI: 10.1038/s41433-022-02321-x] [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: 08/15/2022] [Revised: 10/20/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To investigate small nerve fibre damage and inflammation at the level of the sub-basal nerve plexus (SNP) of severe obese patients and compare the results with those of healthy subjects. METHODS This cross-sectional, observational study investigated the data of 28 patients (14 out of 28 prediabetic or diabetic) with severe obesity (Body Mass Index; BMI ≥ 40) and 20 healthy subjects. Corneal nerve fibre density (CNFD), branch density (CNBD), fibre length (CNFL), nerve fibre area (CNFA), nerve fibre width (CNFW), and nerve fractal dimension (CNFrD) and dendritic cell (DC) density were evaluated using in vivo confocal microscopy (IVCM, Heidelberg Retinal Tomograph III Rostock Cornea Module). Automatic CCMetrics software (University of Manchester, UK) was used for quantitative analysis of SNP. RESULTS Mean age was 48.4±7.4 and 45.1 ± 5.8 in the control and obese group, respectively (p = 0.09). Mean BMI were 49.1 ± 7.8 vs. 23.3 ± 1.4 in obese vs. control group, respectively (p < 0.001). Mean CNFD, CNBD, CNFL, CNFA, CNFW were significantly reduced in obese group compared with those in the control group (always p < 0.05, respectively). There were no significant differences in any ACCMetrics parameters between prediabetic/diabetic and non-diabetic obese patients. Increased DC densities were detected in obese group compared with those in control group (p < 0.0001). There were significant correlations between BMI scores and SNP parameters. CONCLUSION Imaging with IVCM is a feasible, non-invasive method to detect and quantify occult corneal nerve damage and increased inflammation in patients with obesity. This study suggests that obesity may be a separate risk factor for peripheral neuropathy regardless of DM.
Collapse
Affiliation(s)
- Samet Gulkas
- Department of Ophthalmology, Abdulkadir Yuksel State Hospital, Gaziantep, Turkey.
| | - Fahri Onur Aydin
- Department of Ophthalmology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Semra Akkaya Turhan
- Department of Ophthalmology, Marmara University School of Medicine, Pendik Training and Research Hospital, Istanbul, Turkey
| | - Ayse Ebru Toker
- Department of Ophthalmology and Visual Sciences, West Virginia University Eye Institute, Morgantown, WV, USA
| |
Collapse
|
20
|
Huangfu Y, Palloni A, Beltrán-Sánchez H, McEniry MC. Gene-environment interactions and the case of body mass index and obesity: How much do they matter? PNAS NEXUS 2023; 2:pgad213. [PMID: 37441616 PMCID: PMC10335730 DOI: 10.1093/pnasnexus/pgad213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/07/2022] [Accepted: 06/13/2023] [Indexed: 07/15/2023]
Abstract
We investigate the demographic and population health implications of gene-environment interactions (GxE) in the case of body mass index (BMI) and obesity. We seek to answer two questions: (a) what is the first-order impact of GxE effects on BMI and probability of obesity, e.g. the direct causal effect of G in different E's? and (b) how large is the impact of GxE effects on second-order health outcomes associated with BMI and obesity, such as type 2 diabetes (T2D) and disability? In contrast to most of the literature that focuses on estimating GxE effects, we study the implications of GxE effects for population health outcomes that are downstream of a causal chain that includes the target phenotype (in this case BMI) as the initial cause. To limit the scope of the paper, we focus on environments defined by birth cohorts. However, extensions to other environments (education, socioeconomic status (SES), early conditions, and physical settings) are straightforward.
Collapse
Affiliation(s)
- Yiyue Huangfu
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Alberto Palloni
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI 53706, USA
- Instituto de Economía, Geografía y Demografía (IEGD), Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Madrid 28006, Spain
| | - Hiram Beltrán-Sánchez
- Fielding School of Public Health and California Center for Population Research, UCLA, CA 90095, USA
| | - Mary C McEniry
- Center for Demography and Health of Aging, University of Wisconsin-Madison, Madison, WI 53706, USA
| |
Collapse
|
21
|
Klintschar M, Wöllner K, Hagemeier L, Engelmann TA, Mahlmann J, Lunow A, Wolff-Maras R. Pulmonary thromboembolism and obesity in forensic pathologic case work. Forensic Sci Med Pathol 2023; 19:192-197. [PMID: 36943647 PMCID: PMC10329082 DOI: 10.1007/s12024-023-00602-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/23/2023]
Abstract
328 autopsy cases of fatal pulmonary thromboembolism (PE) were compared to 984 age- and sex-matched controls to evaluate the association between obesity and PE in a forensic context. Both PE and control cases had a mean age of 67,8 years (male 62,9 years, females 71,7 years). The percentage of morbidly obese persons with a body mass index (BMI) of above 40 or abdominal subcutaneous adipose tissue of above 4 cm was higher in the PE group (8,39% vs. 4,67% and 29.45% vs. 23.40%, respectively). On the other side, that of very slim persons (BMI below 18.5 or adipose tissue below 3 cm) was significantly smaller (4,27% vs. 7,52% and 47.55% vs. 56,60%). We thus found a strong association between being overweight and death from PE, while slim persons seem to be at an advantage. As the group of underweight persons includes those suffering from chronic diseases with reduced mobility or hypercoagulability (e.g. tumor kachexia or sarkopenia due to immobilisation), this finding is to some extent unexpected.
Collapse
Affiliation(s)
- Michael Klintschar
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Kirsten Wöllner
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Lars Hagemeier
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Theresa A Engelmann
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Jan Mahlmann
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Alessia Lunow
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Roman Wolff-Maras
- Institute of Forensic Medicine, Hanover Medical School, Department of Legal Medicine, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| |
Collapse
|
22
|
Pacifico A. Obesity and labour market outcomes in Italy: a dynamic panel data evidence with correlated random effects. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:557-574. [PMID: 35867310 PMCID: PMC9304812 DOI: 10.1007/s10198-022-01493-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/21/2022] [Indexed: 05/12/2023]
Abstract
This paper investigates the effects of obesity, socio-economic variables, and individual-specific factors on work productivity across Italian regions. A dynamic panel data with correlated random effects is used to jointly deal with incidental parameters, endogeneity issues, and functional forms of misspecification. Methodologically, a hierarchical semiparametric Bayesian approach is involved in shrinking high dimensional model classes, and then obtaining a subset of potential predictors affecting outcomes. Monte Carlo designs are addressed to construct exact posterior distributions and then perform accurate forecasts. Cross-sectional Heterogeneity is modelled nonparametrically allowing for correlation between heterogeneous parameters and initial conditions as well as individual-specific regressors. Prevention policies and strategies to handle health and labour market prospects are also discussed.
Collapse
Affiliation(s)
- Antonio Pacifico
- Applied Statistics and Econometrics, University of Macerata, Macerata, Italy.
| |
Collapse
|
23
|
Zhu D, Vernon ST, D'Agostino Z, Wu J, Giles C, Chan AS, Kott KA, Gray MP, Gholipour A, Tang O, Beyene HB, Patrick E, Grieve SM, Meikle PJ, Figtree GA, Yang JYH. Lipidomics Profiling and Risk of Coronary Artery Disease in the BioHEART-CT Discovery Cohort. Biomolecules 2023; 13:917. [PMID: 37371497 DOI: 10.3390/biom13060917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
The current coronary artery disease (CAD) risk scores for predicting future cardiovascular events rely on well-recognized traditional cardiovascular risk factors derived from a population level but often fail individuals, with up to 25% of first-time heart attack patients having no risk factors. Non-invasive imaging technology can directly measure coronary artery plaque burden. With an advanced lipidomic measurement methodology, for the first time, we aim to identify lipidomic biomarkers to enable intervention before cardiovascular events. With 994 participants from BioHEART-CT Discovery Cohort, we collected clinical data and performed high-performance liquid chromatography with mass spectrometry to determine concentrations of 683 plasma lipid species. Statin-naive participants were selected based on subclinical CAD (sCAD) categories as the analytical cohort (n = 580), with sCAD+ (n = 243) compared to sCAD- (n = 337). Through a machine learning approach, we built a lipid risk score (LRS) and compared the performance of the existing Framingham Risk Score (FRS) in predicting sCAD+. We obtained individual classifiability scores and determined Body Mass Index (BMI) as the modifying variable. FRS and LRS models achieved similar areas under the receiver operating characteristic curve (AUC) in predicting the validation cohort. LRS enhanced the prediction of sCAD+ in the healthy-weight group (BMI < 25 kg/m2), where FRS performed poorly and identified individuals at risk that FRS missed. Lipid features have strong potential as biomarkers to predict CAD plaque burden and can identify residual risk not captured by traditional risk factors/scores. LRS compliments FRS in prediction and has the most significant benefit in healthy-weight individuals.
Collapse
Affiliation(s)
- Dantong Zhu
- School of Mathematics and Statistics, The University of Sydney, Sydney, NSW 2006, Australia
- Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
| | - Stephen T Vernon
- Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
- Department of Cardiology, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Zac D'Agostino
- School of Mathematics and Statistics, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jingqin Wu
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Corey Giles
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Adam S Chan
- School of Mathematics and Statistics, The University of Sydney, Sydney, NSW 2006, Australia
| | - Katharine A Kott
- Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
- Department of Cardiology, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Michael P Gray
- Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
| | - Alireza Gholipour
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Owen Tang
- Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Habtamu B Beyene
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
| | - Ellis Patrick
- School of Mathematics and Statistics, The University of Sydney, Sydney, NSW 2006, Australia
| | - Stuart M Grieve
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Department of Cardiovascular Research Translation and Implementation, La Trobe University, Melbourne, VIC 3086, Australia
| | - Gemma A Figtree
- Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
- Department of Cardiology, Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Jean Y H Yang
- School of Mathematics and Statistics, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| |
Collapse
|
24
|
Blalock DV, Pura JA, Stechuchak KM, Dennis PA, Maciejewski ML, Smith VA, Hung A, Hoerster KD, Wong ES. BMI Trends for Veterans Up to 10 Years After VA Enrollment Following Military Discharge. J Gen Intern Med 2023; 38:1423-1430. [PMID: 36219304 PMCID: PMC9552734 DOI: 10.1007/s11606-022-07818-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/15/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Obesity (body mass index [BMI]≥30kg/m2) among US adults has tripled over the past 45 years, but it is unclear how this population-level weight change has occurred. OBJECTIVE We sought to identify distinct long-term BMI trajectories and examined associations with demographic and clinical characteristics. DESIGN The design was latent trajectory modeling over 10 years of a retrospective cohort. Subgroups were identified via latent class growth mixture models, separately by sex. Weighted multinomial logistic regressions identified factors associated with subgroup membership. PARTICIPANTS Participants were a retrospective cohort of 292,331 males and 62,898 females enrolled in VA. MAIN MEASURES The main outcome measure was 6-month average VA-measured BMI over the course of 10 years. Additional electronic health record measures on demographic, clinical, and services utilization characteristics were also used to characterize latent trajectories. KEY RESULTS Four trajectories were identified for men and for women, corresponding to standard BMI categories "normal weight" (BMI <25), "overweight" (BMI 25-29.99), and "with obesity" (BMI ≥30): "normal weight" and increasing (males: 28.4%; females: 22.8%), "overweight" and increasing (36.4%; 35.6%), "with obesity" and increasing (33.6%; 40.0%), and "with obesity" and stable (males: 1.6%) or decreasing (females: 1.6%). Race, ethnicity, comorbidities, mental health diagnoses, and mental health service utilization discriminated among classes. CONCLUSIONS BMI in the 10 years following VA enrollment increased modestly. VA should continue prioritizing weight management interventions to the large number of veterans with obesity upon VA enrollment, because the majority remain with obesity.
Collapse
Affiliation(s)
- Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - John A Pura
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Karen M Stechuchak
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Paul A Dennis
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Matthew L Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA.
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA.
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, USA.
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, USA.
| | - Valerie A Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, USA
| | - Anna Hung
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Katherine D Hoerster
- Seattle-Denver Center for Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Edwin S Wong
- Seattle-Denver Center for Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| |
Collapse
|
25
|
Davis DM, Wilson L, Salas J, Gilman RH. Obesity Epidemic in U.S. Prison Populations: A Meta-Analysis and Review of the Literature. JOURNAL OF CORRECTIONAL HEALTH CARE 2023; 29:121-134. [PMID: 36880877 DOI: 10.1089/jchc.21.06.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Limited existing evidence and health provider perceptions suggest that prevalence of obesity among incarcerated people residing in U.S. correctional institutions is high. Evaluating evidence of obesity and weight change during incarceration will allow for the determination of whether people are subject to weight gain during incarceration. A systematic review of three online databases, gray literature, and reference lists of articles of interest was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A meta-analysis to obtain pooled prevalence estimates of obesity among U.S. incarcerated people was then completed. A total of 11 studies met our inclusion criteria. Results show the estimated pooled prevalence of obesity in incarcerated men (30.0%) was less than the national average. The estimated pooled prevalence of obesity in females (39.8%) was similar to the national average.
Collapse
Affiliation(s)
- Dawn M Davis
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Lauren Wilson
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
26
|
Giersch GEW, Taylor KM, Caldwell AR, Charkoudian N. Body mass index, but not sex, influences exertional heat stroke risk in young healthy men and women. Am J Physiol Regul Integr Comp Physiol 2023; 324:R15-R19. [PMID: 36342147 DOI: 10.1152/ajpregu.00168.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Exertional heat stroke (EHS) remains a persistent threat for individuals working or playing in the heat, including athletes and military and emergency service personnel. However, influence of biological sex and/or body mass index (BMI) on the risk of EHS remain poorly understood. The purpose of this study was to retrospectively assess the influence of sex and BMI on risk of EHS in the active-duty US Army. We analyzed data from 2016 to 2021, using a matched case-control approach, where each individual with a diagnosis of EHS was matched to five controls based on calendar time, unit ID, and job category, to capture control individuals who were matched to EHS events by location, time, and activity. We used a multivariate logistic regression model mutually adjusted for sex, BMI, and age to compare 745 (n = 61 F) individuals (26 ± 7 yr) with a diagnosed EHS to 4,290 (n = 384 F) case controls (25 ± 5 yr). Group average BMI were similar: 26.6 ± 3.1 (EHS) and 26.5 ± 3.6 kg/m2 (CON). BMI was significantly (P < 0.0001) associated with higher risk of EHS with a 3% increase in risk of EHS for every unit increase in BMI. Notably, sex was not associated with any difference in risk for EHS (P = 0.54). These data suggest that young healthy people with higher BMI have significantly higher risk of EHS, but, contrary to what some have proposed, this risk was not higher in young women.
Collapse
Affiliation(s)
- Gabrielle E W Giersch
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Kathryn M Taylor
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Aaron R Caldwell
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| |
Collapse
|
27
|
Nielsen J, Narayan KV, Cunningham SA. Incidence of obesity across adulthood in the United States, 2001-2017-a national prospective analysis. Am J Clin Nutr 2023; 117:141-148. [PMID: 36789933 PMCID: PMC10196588 DOI: 10.1016/j.ajcnut.2022.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/13/2022] [Accepted: 10/28/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In the United States, the prevalence of obesity among adults has increased 3-fold since the 1980s, but patterns of incidence of new cases of obesity are not known. OBJECTIVES To examine the incidence of new cases of obesity: overall, by demographic and educational subgroups, by weight status, and changes during this century. METHODS We analyzed adult (≥20 y) anthropometric records from the US nationally representative Panel Study of Income Dynamics from 2001 to 2017. Among those not having obesity (body mass index, BMI, ≥30 kg/m2) at first observation, we used Poisson models to estimate the incidence of obesity [cases/1000 person-years (PYs)] and incidence rate ratio (IRR). RESULTS Among 13,888 adults followed for 115,797 PYs, the incidence of obesity in 2001-2017 was 28.1/1000 PYs (95% CI: 26.7, 29.7). Over the periods 2001-2005, 2005-2009, and 2009-2013, the incidence of obesity was stable, but in 2013-2017 the incidence increased by 18% compared to 2009-2013 [IRR: 1.18 (95% CI: 1.06, 1.30)]. Blacks had higher obesity incidence [47.9/1000 PYs (95% CI: 42.7, 53.1)] than Whites [26.2/1000 PYs (95% CI: 24.6, 27.9)]. Risk was particularly high among Black females [57.9/1000 PYs (95% CI: 49.1, 66.8)] and Black young adults (20-29 y) [65.5/1000 PYs (95% CI: 54.2, 76.7)]. Across race, obesity incidence was highest in young adults (20-29 y) [34.1/1000 PYs (95% CI: 31.5, 36.7)] and declined with age [age 70+ y: 18.9/1000 PYs (95% CI: 16.6, 21.8)]. Those with overweight had an obesity risk 7 times higher than those with normal weight [62.1/1000 PYs (95% CI: 58.8, 65.3) vs. 8.8/1000 PYs (95% CI: 8.1, 9.6)]. Those with less than high-school education had higher obesity incidence than those with education beyond high-school [39.4/1000 PYs (95% CI: 34.4, 44.4) vs. 24.7/1000 PYs (95% CI: 23.1, 26.3)]. CONCLUSIONS Incidence of obesity was stable over the first 13 y of the last 2 decades but increased by 18% in 2013-2017. Blacks and younger adults were at highest risk, and those with overweight were also at high risk for developing obesity.
Collapse
Affiliation(s)
- Jannie Nielsen
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Km Venkat Narayan
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Solveig A Cunningham
- Emory Global Diabetes Research Center, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
28
|
Li M, Gong W, Wang S, Li Z. Trends in body mass index, overweight and obesity among adults in the USA, the NHANES from 2003 to 2018: a repeat cross-sectional survey. BMJ Open 2022; 12:e065425. [PMID: 36526312 PMCID: PMC9764609 DOI: 10.1136/bmjopen-2022-065425] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To analyse detailed trends in adult obesity from 2003 to 2018 in the USA, and provide the latest national estimates of adult obesity in 2017-2018. DESIGN, SETTING AND PARTICIPANTS Analysis of data, including measured height and weight, obtained from 42 266 adults aged ≥20 years from the National Health and Nutrition Examination Survey, a cross-sectional, nationally representative sample of the US population. EXPOSURE Survey period. PRIMARY OUTCOME MEASURES The mean body mass index (BMI) and prevalence of overweight and obesity. RESULTS In 2017-2018, the prevalence of overweight (including obesity, BMI ≥25 kg/m2) and obesity (BMI ≥30 kg/m2) was 73.8% (95% CI 71.1% to 76.4%) and 42.8% (95% CI 39.5% to 46.1%), respectively. From 2003 to 2018, a significant increase in the prevalence of overweight (including obesity, overall adjusted OR for 2017-2018 vs 2003-2004, 1.08 (95% CI 1.04 to 1.13) and obesity (overall adjusted OR for 2017-2018 vs 2003-2004, 1.15 (95% CI 1.10 to 1.21) was found among American adults. However, annual changes in mean BMI and the prevalence of overweight and obesity did not differ significantly before and after 2009-2010. The prevalence of overweight and obesity varied significantly by age, sex, race, education, daily total energy intake, economic conditions and physical activity status (all p<0.05). CONCLUSIONS Although the prevalence of adult obesity continues to rise, there have been no significant changes in the annual growth of adult obesity prevalence between 2003-2004 and 2017-2018. In 2017-2018, the prevalence of obesity was 42.8%, which equates to 76 million American adults at risk for serious and costly chronic conditions. The prevalence of obesity was higher among older adults (aged 60-69 years), females, non-Hispanic blacks, and those who did not graduate college, were physically inactive, reported lower daily total energy intake and had poor economic status.
Collapse
Affiliation(s)
- Mingxi Li
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital, Capital medical University, Beijing, China
| | - Weijun Gong
- Department of Traditional Chinese Medicine, Beijing Rehabilitation Hospital, Capital medical University, Beijing, China
| | - Shidong Wang
- Department of Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhe Li
- Department of Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|
29
|
Fugiel J, Kochan-Jacheć K, Koźlenia D, Domaradzki J. Changes in Anthropometric Measurements and Physical Fitness of Polish Students in 20-Year Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416885. [PMID: 36554765 PMCID: PMC9778732 DOI: 10.3390/ijerph192416885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Intergenerational changes are still being recorded worldwide, although their magnitude and direction may vary in different countries. The aim of this study was to determine changes in the magnitude and direction of changes in the body morphology and motor abilities of physically active adults over 20 years. METHODS Two hundred and fifty-two individuals aged 18-28 years volunteered to participate in the study. The changes were analyzed over a 20-year period (March 2001; P1 vs. March 2022; P2). The measured parameters were body height, weight, and body fat. Further, hand grip strength with dynamometer measurement, a sit-up test, a sit and reach test, and a standing long jump were performed to examine motor abilities. The results of the conducted tests were compared between subjects from both periods. RESULTS Our study confirms changes in trends concerning body morphology and motor ability performance. Higher values of body mass index and body fat were observed in P2 women, whereas these differences were not significant in men. Additionally, in terms of physical performance, the P2 group noted worse results than their peers from the past. CONCLUSION Despite young adults claiming to have similar physical activity levels to those observed in the past, they demonstrate poorer physical performance and higher body fat levels. The observed changes can be considered negative.
Collapse
|
30
|
O’Neill LM, Phang YX, Liu Z, Lewis SA, Aljohani A, McGahee A, Wade G, Kalyesubula M, Simcox J, Ntambi JM. Hepatic Oleate Regulates Insulin-like Growth Factor-Binding Protein 1 Partially through the mTORC1-FGF21 Axis during High-Carbohydrate Feeding. Int J Mol Sci 2022; 23:14671. [PMID: 36498997 PMCID: PMC9737156 DOI: 10.3390/ijms232314671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
Stearoyl-CoA desaturase-1 (SCD1) catalyzes the rate-liming step of monounsaturated fatty acid biosynthesis and is a key regulator of systemic glucose metabolism. Mice harboring either a global (GKO) or liver-specific deletion (LKO) of Scd1 display enhanced insulin signaling and whole-body glucose uptake. Additionally, GKO and LKO mice are protected from high-carbohydrate diet-induced obesity. Given that high-carbohydrate diets can lead to chronic metabolic diseases such as obesity, diabetes, and hepatic steatosis, it is critical to understand how Scd1 deficiency confers metabolically beneficial phenotypes. Here we show that insulin-like growth factor-binding protein 1 (IGFBP1), a hepatokine that has been reported to enhance insulin signaling, is significantly elevated in the liver and plasma of GKO and LKO mice fed a low-fat high-carbohydrate diet. We also observed that the expression of hepatic Igfbp1 is regulated by oleic acid (18:1n9), a product of SCD1, through the mTORC1-FGF21 axis both in vivo and in vitro.
Collapse
Affiliation(s)
- Lucas M. O’Neill
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Yar Xin Phang
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Zhaojin Liu
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Sarah A. Lewis
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Ahmed Aljohani
- College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11564, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh 11564, Saudi Arabia
| | - Ayren McGahee
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Gina Wade
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Mugagga Kalyesubula
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
| | - Judith Simcox
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
- Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI 53706, USA
| | - James M. Ntambi
- Department of Biochemistry, University of Wisconsin-Madison, 433 Babcock Drive, Madison, WI 53706, USA
- Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI 53706, USA
| |
Collapse
|
31
|
Sun JY, Huang WJ, Hua Y, Qu Q, Cheng C, Liu HL, Kong XQ, Ma YX, Sun W. Trends in general and abdominal obesity in US adults: Evidence from the National Health and Nutrition Examination Survey (2001-2018). Front Public Health 2022; 10:925293. [PMID: 36276394 PMCID: PMC9582849 DOI: 10.3389/fpubh.2022.925293] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/15/2022] [Indexed: 01/24/2023] Open
Abstract
Aim This study investigates the trend in general obesity and abdominal obesity in US adults from 2001 to 2018. Methods We included 44,184 adults from the nine cycles of the continuous NHANES (2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018). The age-adjusted mean body mass index and waist circumference were calculated, and the sex-specific annual change was estimated by the survey cycle. We used the weighted sex-specific logistic regression models to analyze the prevalence of general obesity and abdominal obesity from 2001 to 2018. The weighted adjusted odds ratio (OR) with a 95% confidence interval (CI) was calculated. Results Our study showed that general obesity and abdominal obesity account for about 35.48 and 53.13% of the US population. From 2001-2002 to 2017-2018, the age-adjusted prevalence of general obesity increased from 33.09 to 41.36% in females and from 26.88 to 42.43% in males. During 2001-2018, the age-adjusted prevalence of abdominal obesity increased from 57.58 to 67.33% in females and from 39.07 to 49.73% in males. A significant time-dependent increase was observed in the prevalence of general obesity (adjusted OR, 1.007; 95% CI 1.005-1.009, P < 0.001) and abdominal obesity (adjusted OR, 1.006; 95% CI, 1.004-1.008; P < 0.001). Conclusion General obesity and abdominal obesity are a heavy health burden among US adults, and the increasing trend remains in both males and females from 2001 to 2018.
Collapse
Affiliation(s)
- Jin-Yu Sun
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China,Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen-Jun Huang
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Yang Hua
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Qiang Qu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Cheng
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Heng-Li Liu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang-Qing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yong-Xiang Ma
- Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China,*Correspondence: Yong-Xiang Ma
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China,Wei Sun
| |
Collapse
|
32
|
Vaidya R, Till C, Greenlee H, Hershman DL, Unger JM. Trends in Obesity Prevalence Among Patients Enrolled in Clinical Trials for Obesity-Related Cancers, 1986 to 2016. JAMA Netw Open 2022; 5:e2234445. [PMID: 36215073 PMCID: PMC9552895 DOI: 10.1001/jamanetworkopen.2022.34445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Obesity rates have risen in the United States since the 1980s. Several studies have shown links between obesity and the incidence of specific cancer types, but none have systematically examined obesity prevalence at the time of cancer diagnosis, or among clinical trial participants, all of which may affect clinical outcomes. OBJECTIVE To examine the prevalence of obesity and, separately, overweight and obesity over 30 years among patients with cancer enrolled in clinical treatment trials for obesity-related cancers; and to compare trends with corresponding trends in the US. DESIGN, SETTING, AND PARTICIPANTS This cohort study examined clinical treatment trials for obesity-related cancers conducted by the SWOG Cancer Research Network at community and academic sites. Participants included adult patients enrolled in phase 2 or phase 3 clinical treatment trials in obesity-related cancers between 1986 and 2016. Statistical analysis was performed from June 2020 to July 2022. EXPOSURES Year of enrollment to a clinical trial. MAIN OUTCOMES AND MEASURES Prevalence of obesity (body mass index [BMI] ≥ 30) and overweight or obesity (BMI > 25) at the time of clinical trial enrollment. Multivariable logistic regression analysis, adjusted for demographic and clinical factors, was used to analyze patient height and weight collected at clinical trial enrollment. RESULTS Among 23 926 patients (median [IQR] age, 58 [51-66] years; 17 594 [73.5%] female; 969 [4.0%] Hispanic, 2173 [9.1%] non-Hispanic Black, 19 890 [83.1%] non-Hispanic White) enrolled between 1986 and 2016, unadjusted obesity rates increased from 23.5% (in 1986 to 1990 [n = 657]) to 42.3% (in 2011 to 2016 [n = 836]). There was an increasing linear trend in obesity (odds ratio [OR], 1.23 for each 5-year increase; 95% CI, 1.21-1.26; P < .001), which persisted after covariate adjustment for demographic and clinical characteristics. Findings were consistent for the combined prevalence of overweight and obesity. The observed overall increasing trend in obesity prevalence from 1999-2000 to 2015-2016 was greater in trial patients (21.3% [SE = 0.7] to 49.1% [SE = 1.6]) than in US adults (30.5% [SE = 1.5] to 39.6% [SE = 1.6]) (P for trend = .03), but was similar to US cancer survivors (18.9% [SE = 1.9] to 42.2% [SE = 2.1]; P for trend = .31). CONCLUSIONS AND RELEVANCE This cohort study found that patients with cancer and obesity are currently well-represented in cancer clinical trials, increasing confidence that trial findings are generalizable to patients with obesity in clinical practice. Availability of data on height and weight at diagnosis through cancer registries will enable a more rigorous analysis of obesity prevalence among patients with cancer.
Collapse
Affiliation(s)
- Riha Vaidya
- SWOG Statistics and Data Management Center, Seattle, Washington
- Fred Hutchinson Cancer Center, Seattle, Washington
| | - Cathee Till
- SWOG Statistics and Data Management Center, Seattle, Washington
- Fred Hutchinson Cancer Center, Seattle, Washington
| | | | | | - Joseph M. Unger
- SWOG Statistics and Data Management Center, Seattle, Washington
- Fred Hutchinson Cancer Center, Seattle, Washington
| |
Collapse
|
33
|
Inwood K, Oxley L, Roberts E. The mortality risk of being overweight in the twentieth century: Evidence from two cohorts of New Zealand men. EXPLORATIONS IN ECONOMIC HISTORY 2022; 86:101472. [PMID: 37637008 PMCID: PMC10448784 DOI: 10.1016/j.eeh.2022.101472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
How have health and social mortality risks changed over time? Evidence from pre-1945 cohorts is sparse, mostly from the United States, and evidence is mixed on long-term changes in the risk of being overweight. We develop a dataset of men entering the NZ army in the two world wars, with objectively measured height and weight, and socioeconomic status in early adulthood. Our sample includes significant numbers of indigenous Māori, providing estimates of weight and mortality risk in an indigenous population. We follow men from war's end until death, with data on more than 12,000 men from each war. Overweight and obesity were important risk factors for mortality, and associated with shorter life expectancy. However, the reduction in life expectancy associated with being overweight declined from 5 to 3 years between the two cohorts, consistent with the hypothesis that being overweight became less risky during the twentieth century.
Collapse
Affiliation(s)
- Kris Inwood
- Departments of Economics and History, University of Guelph, Mackinnon Building, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Les Oxley
- Department of Economics, University of Waikato, Private Bag 3105, Hamilton, New Zealand
| | - Evan Roberts
- History of Medicine Program and Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 19th Ave S, Minneapolis, MN 55455, United States
| |
Collapse
|
34
|
Chiang JK, Lin YC, Lu CM, Kao YH. Correlation between snoring sounds and obstructive sleep apnea in adults: a meta-regression analysis. Sleep Sci 2022; 15:463-470. [PMID: 36419807 PMCID: PMC9670768 DOI: 10.5935/1984-0063.20220068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/07/2022] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE Snoring is a dominant clinical symptom in patients with obstructive sleep apnea (OSA), and analyzing snoring sounds might be a potential alternative to polysomnography (PSG) for the assessment of OSA. This study aimed to systematically examine the correlation between the snoring sounds and the apnea-hypopnea index (AHI) as the measures of OSA severity. MATERIAL AND METHODS A comprehensive literature review using the MEDLINE, Embase, Cochrane Library, Scopus, and PubMed databases identified the published studies reporting the correlations between and severity of snoring and the AHI values by meta-regression analysis. RESULTS In total, 13 studies involving 3,153 adult patients were included in this study. The pooled correlation coefficient for snoring sounds and AHI values was 0.71 (95%CI: 0.49, 0.85) from the random-effects meta-analysis with the Knapp and Hartung adjustment. The I 2 and chi-square Q test demonstrated significant heterogeneity (97.6% and p<0.001). After adjusting for the effects of the other covariates, the mean value of the Fisher's r-to-z transformed correlation coefficient would have 0.80 less by the snoring rate (95%CI = -1.02, -0.57), 1.46 less by the snoring index (95%CI = -1.85, -1.07), and 0.21 less in the mean body mass index (95%CI = -0.31, -0.11), but 0.15 more in the mean age (95%CI = 0.10, 0.20). It fitted the data very well (R 2=0.9641). CONCLUSION A high correlation between the severity of snoring and the AHI was found in the studies with PSG. As compared to the snoring rate and the snoring index, the snoring intensity, the snoring frequency, and the snoring time interval index were more sensitive measures for the severity of snoring.
Collapse
Affiliation(s)
- Jui-Kun Chiang
- Dalin Tzu Chi Hospital, Family Medicine - Chiayi - Taiwan
| | - Yen-Chang Lin
- Nature Dental Clinic, Dental department - Puli - Taiwan
| | - Chih-Ming Lu
- Dalin Tzu Chi Hospital, Department of Urology - Chiayi - Taiwan
| | - Yee-Hsin Kao
- Tainan Municipal Hospital (Managed by Show Chwan Medical Care
Corporation), Family Medicine - Tainan - Taiwan
| |
Collapse
|
35
|
Berry KM, Garcia S, Warren JR, Stokes AC. Association of Weight at Different Ages and All-Cause Mortality Among Older Adults in the US. J Aging Health 2022; 34:705-719. [PMID: 35220792 PMCID: PMC9411264 DOI: 10.1177/08982643211059717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Objective: Assess the association of BMI and BMI change with mortality. Methods: Using data from the Wisconsin Longitudinal Study (WLS) on participants born mainly in 1939 (n=4922), we investigated the associations between various measures of BMI across the life course (age 54 BMI; age 65 BMI; age 72 BMI; lifetime maximum BMI; BMI change between ages 54 and 65; BMI change between ages 65 and 72) and mortality. We also assessed whether these associations are mediated by late life health. Results: BMI at age 54 was more strongly associated with late life mortality than BMI at older ages. The association between BMI change and mortality varied based on the timing of weight change. Health at age 72, particularly self-rated health, diabetes, and physical functioning, mediated the observed associations. Conclusion: Knowing older people's weight at midlife and how their weight has changed may be more important in assessing late life mortality risk than their current weight.
Collapse
Affiliation(s)
- Kaitlyn M. Berry
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | | | | | | |
Collapse
|
36
|
Baik SM, Cynn HS, Yi CH, Lee JH, Choi JH, Lee KE. Effect of side-sling plank exercise on trunk and hip muscle activation in subjects with gluteus medius weakness. J Back Musculoskelet Rehabil 2022; 35:849-857. [PMID: 34806596 DOI: 10.3233/bmr-210061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The effectiveness of side-sling plank (SSP) exercises on trunk and hip muscle activation in subjects with gluteus medius (Gmed) weakness is unclear. OBJECTIVE To quantify muscle activation of the rectus abdominis (RA), external oblique (EO), erector spinae (ES), lumbar multifidus (LM), Gmed, gluteus maximus (Gmax), and tensor fasciae latae (TFL) during SSP with three different hip rotations compared to side-lying hip abduction (SHA) exercise in subjects with Gmed weakness. METHODS Twenty-two subjects with Gmed weakness were recruited. SHA and three types of SSP exercises were performed: SSP with neutral hip (SSP-N), hip lateral rotation (SSP-L), and hip medial rotation (SSP-M). Surface electromyography was used to measure the activation of the trunk and hip muscles. RESULTS The trunk and hip muscles activations were generally significantly higher level during three SSP than SHA. SSP-M showed significantly lower EO activation while significantly higher ES and LM activation than SSP-L. Gmed activation was significantly higher during SSP-M than during SSP-L. TFL activation was significantly lower during SSP-M than during SSP-N and SSP-L. CONCLUSIONS SSP could be prescribed for patients who have reduced Gmed strength after injuries. Especially, SSP-M could be applied for patients who have Gmed weakness with dominant TFL.
Collapse
Affiliation(s)
- Seung-Min Baik
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Kangwon-do, Korea.,Departement of Physical Therapy, Baekseok University, Cheonan-si, Chungcheongnam-do, Korea
| | - Heon-Seock Cynn
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Kangwon-do, Korea.,Department of Physical Therapy, College of Health Science, Yonsei University, Wonju-si, Kangwon-do, Korea
| | - Chung-Hwi Yi
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju-si, Kangwon-do, Korea
| | - Ji-Hyun Lee
- Departement of Physical Therapy, Baekseok University, Cheonan-si, Chungcheongnam-do, Korea
| | - Jung-Hoon Choi
- Applied Kinesiology and Ergonomic Technology Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Kangwon-do, Korea.,Department of Rehabilitation Team, Yongin Severance Hospital, Yongin-si, Gyeonggi-do, Korea
| | - Kyung-Eun Lee
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju-si, Kangwon-do, Korea
| |
Collapse
|
37
|
Investigating the association between the socioeconomic environment of the service area and fast food visitation: A context-based crystal growth approach. Health Place 2022; 76:102855. [PMID: 35834903 DOI: 10.1016/j.healthplace.2022.102855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/21/2022] [Accepted: 06/27/2022] [Indexed: 01/21/2023]
Abstract
Fast food consumption is one of the major causes of rising obesity rates. Fast food consumers are mostly residents located in the service area-the fast food outlet's surrounding area. Conventional buffer approaches may exhibit bias in measuring service areas by ignoring the local community's detailed spatial configuration and transportation preferences. This study uses fast food outlets and their visits provided by a mobile phone-based dataset named SafeGraph and applies a novel context-based crystal growth algorithm (CG) to delineate improved service areas of fast food outlets in Chicago. We also explore how socioeconomic variables in service areas by CG and buffer-based approaches are related to visits to fast food outlets. Results show that compared to conventional buffers, CG produces improved service areas as it excludes inaccessible barriers and adjusts the accessible areas by transportation preferences. Further, the model using service areas of public transport users by CG yields the best performance. Additionally, the rate of single-mother households and the number of other fast food outlets nearby are positively related to fast food visits in all models. Findings acknowledge the advantages of CG and help make policy interventions to reduce fast food consumption.
Collapse
|
38
|
Hirase T, Ling JF, Haghshenas V, Fuld R, Dong D, Hanson DS, Meyer BC, Marco RAW. Obesity and perioperative adverse events in patients undergoing complex revision surgery for the thoracolumbar spine. BMC Musculoskelet Disord 2022; 23:534. [PMID: 35659650 PMCID: PMC9166525 DOI: 10.1186/s12891-022-05505-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 06/01/2022] [Indexed: 12/03/2022] Open
Abstract
Background There are no previous studies that evaluate the effect of obesity on patients undergoing complex revision thoracolumbar spine surgery. The primary objective was to determine the relationship between obesity and perioperative adverse events (AEs) with patients undergoing complex revision thoracolumbar spine surgery while controlling for psoas muscle index (PMI) as a confounding variable. The secondary objective was to determine the relationship between obesity and 30-day readmission rates, 30-day re-operation rates, rate of discharge to a facility, and post-operative length of stay (LOS). Methods Between May 2016 and February 2020, a retrospective analysis of individuals undergoing complex revision surgery of the thoracolumbar spine was performed at a single institution. Obesity was defined as BMI ≥ 30.0 kg/m2. PMI < 500 mm2/m2 for males and < 412 mm2/m2 for females were used to define low muscle mass. A Spine Surgical Invasiveness Index (SSII) > 10 was used to define complex revision surgery. A multivariable logistic regression model was used to ascertain the effects of low muscle mass, obesity, age, and gender on the likelihood of the occurrence of any AE. Results A total of 114 consecutive patients were included in the study. Fifty-four patients were in the obese cohort and 60 patients in the non-obese cohort. There was not a significant difference in perioperative outcomes of both the obese and non-obese patients. There were 22 obese patients (40.7%) and 33 non-obese patients (55.0%) that experienced any AE (p = 0.130). Multivariable analysis demonstrated that individuals with low muscle mass had a significantly higher likelihood for an AE than individuals with normal or high muscle mass (OR: 7.53, 95% CI: 3.05-18.60). Obesity did not have a significant effect in predicting AEs. Conclusions Obesity is not associated with perioperative AEs, 30-day readmission rates, 30-day re-operation rates, rate of discharge to a facility, or post-operative length of stay (LOS) among patients undergoing complex revision thoracolumbar spine surgery. Level of evidence III
Collapse
Affiliation(s)
- Takashi Hirase
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA. .,Texas A&M University Health Science Center College of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA.
| | - Jeremiah F Ling
- Texas A&M University Health Science Center College of Medicine, 8447 Riverside Pkwy, Bryan, TX, 77807, USA
| | - Varan Haghshenas
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - Richard Fuld
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - David Dong
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - Darrell S Hanson
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - B Christoph Meyer
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| | - Rex A W Marco
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, 6445 Main St Suite 2500, Houston, TX, 77030, USA
| |
Collapse
|
39
|
Hajek A, Kretzler B, König HH. Prevalence and correlates of obesity among the oldest old. A systematic review, meta-analysis and meta-regression. Geriatr Gerontol Int 2022; 22:373-383. [PMID: 35362258 DOI: 10.1111/ggi.14382] [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: 11/15/2021] [Revised: 01/14/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
Thus far, the prevalence and correlates of obesity among the oldest have been identified in several studies. Nevertheless, there is a lack of a systematic review, meta-analysis and meta-regression synthesizing the existing observational studies. Consequently, our aim was to fill this knowledge gap. Three electronic databases were searched (Medline, PsycINFO, CINAHL) and an additional hand search was performed. Observational studies (both, cross-sectional and longitudinal) determining the prevalence and (preferably) the correlates of obesity in the oldest old (≥80 years) were included. Data extraction covered study design, measurement of obesity, analytical approach, sample characteristics and main results. In total, 19 studies were included. Reported prevalence of obesity in the community varied greatly (range 0.7%-71.5%). The pooled prevalence of obesity was 17.8% (95% CI: 13.3%-22.2%), with significant heterogeneity between studies (I2 = 99.7%, P < 0.001). There is evidence of a publication bias. Meta-regressions showed that some of the heterogeneity was explained by the types of measures of obesity and country of the respective sample. In conclusion, obesity remains a key challenge among the oldest old. Future research in this age bracket is urgently required in regions mostly neglected thus far (e.g., South America, Africa or Asia). Moreover, studies based on longitudinal data are required to clarify the determinants of obesity among the oldest old. Furthermore, studies based on objectively recorded obesity (e.g., waist circumference) are also required. Geriatr Gerontol Int 2022; 22: 373-383.
Collapse
Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| |
Collapse
|
40
|
MATERNAL AND NEONATAL OUTCOMES OF CESAREAN SECTION IN OBESE AND MORBID OBESE TERM PREGNANT WOMEN. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2022. [DOI: 10.33457/ijhsrp.991134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
41
|
Chao YP, Fang WH, Chen WL, Peng TC, Yang WS, Kao TW. Exploring Muscle Health Deterioration and Its Determinants Among Community-Dwelling Older Adults. Front Nutr 2022; 9:817044. [PMID: 35571885 PMCID: PMC9101463 DOI: 10.3389/fnut.2022.817044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Age-related muscle mass and function decline are critical issues that have gained attention in clinical practice and research. Nevertheless, little is known regarding the time course of muscle health progression, and its determinants during this transition should be estimated. Methods We enrolled community-dwelling adults aged ≥65 years during their regular health checkup. The participants’ body composition and muscle function were measured annually from 2015 to 2021. Presarcopenia was characterized by the loss of muscle mass only; dynapenia was defined as low muscle function without changes in muscle mass; and sarcopenia was indicated as a decline in both muscle mass and muscle function. We observed the natural course of muscle health progression during aging. The relationship between muscle health decline and different determinants among old adults was examined. Results Among 568 participants, there was 18.49%, 3.52%, and 1.06% of healthy individuals transited to dynapenia, presarcopenia, and sarcopenia, respectively. Significant positive correlations between age, fat-to-muscle ratio (FMR) and the dynapenia transition were existed [hazard ratio (HR) = 1.08 and HR = 1.73, all p < 0.05]. Serum albumin level had negative correlation with the dynapenia transition risk (HR = 0.30, p = 0.004). Participants with these three risk factors had the highest HR of dynapenia transition compared to those without (HR = 8.67, p = 0.001). A dose-response effect existed between risk factors numbers and the risk of dynapenia transition (p for trend < 0.001). This positive association and dose-response relationship remains after multiple covariates adjustment (HR = 7.74, p = 0.002, p for trend < 0.001). Participants with two or more than two risk factors had a higher risk of dynapenia transition than those with low risk factors (p = 0.0027), and the HR was 1.96 after multiple covariate adjustment (p = 0.029). Conclusion Healthy community-dwelling old adults tended to transit to dynapenia during muscle health deterioration. Individuals with older age, higher FMR, lower albumin level had a higher risk of dynapenia transition; and a positive dose-response effect existed among this population as well.
Collapse
Affiliation(s)
- Yuan-Ping Chao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Shiung Yang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Center for Obesity, Life Style and Metabolic Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- *Correspondence: Tung-Wei Kao,
| |
Collapse
|
42
|
The Relationship between F 2-Isoprostanes Plasma Levels and Depression Symptoms in Healthy Older Adults. Antioxidants (Basel) 2022; 11:antiox11050822. [PMID: 35624687 PMCID: PMC9137659 DOI: 10.3390/antiox11050822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 12/20/2022] Open
Abstract
The increasing proportion of older citizens in our society reflects a need to better understand age-related biological underpinnings of mood, as depression in older age may be under-diagnosed. Pre-clinical and human studies evidence a relationship between oxidative stress (OS) biomarkers in depression symptoms, and an influence of biological factors such as Body Mass Index (BMI), but focus has been clinical or younger samples, and less is known about patterns in healthy older adults. We investigated these associations with data derived from the Australian Research Council Longevity Study (ARCLI; ANZCTR12611000487910), in 568 healthy adults aged 60–75 years using F2-Isoprostanes plasma levels, and controlling for demographic factors, in assessing mood via the Beck Depression Inventory-II, Chalder Fatigue Scale, and General Health Questionnaire 12. Elevated F2-Isoprostanes contributed to depressed mood on the BDI-II and reduced general health on the GHQ-12. BMI was positively associated with Chalder Fatigue scores, yet better ratings on the GHQ-12. Females had significantly higher F2-Isoprostanes than males. The results suggest that in otherwise healthy older adults, mood and mental health are reduced with increases in oxidative stress markers, exhibiting similar patterns observed in clinical groups. Sex as a factor should be considered when assessing OS levels in systemic pathologies. BMI as a modifiable risk factor for maintenance of mental health, and OS modification through nutrient supplementation, are discussed. The findings contribute to understanding oxidative stress marker patterns in healthy older adults and their potential role in mood symptoms and mental health.
Collapse
|
43
|
Seyni-Boureima R, Zhang Z, Antoine MMLK, Antoine-Frank CD. A review on the anesthetic management of obese patients undergoing surgery. BMC Anesthesiol 2022; 22:98. [PMID: 35382771 PMCID: PMC8985303 DOI: 10.1186/s12871-022-01579-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/27/2022] [Indexed: 12/01/2022] Open
Abstract
There has been an observed increase in theprevalence of obesity over the past few decades. The prevalence of anesthesiology related complications is also observed more frequently in obese patients as compared to patients that are not obese. Due to the increased complications that accompany obesity, obese patients are now more often requiring surgical interventions. Therefore, it is important that anesthesiologists be aware of this development and is equipped to manage these patients effectively and appropriately. As a result, this review highlights the effective management of obese patients undergoing surgery focusing on the preoperative, perioperative and postoperative care of these patients.
Collapse
Affiliation(s)
- Rimanatou Seyni-Boureima
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China
| | - Zongze Zhang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China.
| | - Malyn M L K Antoine
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China
| | - Chrystal D Antoine-Frank
- Department of Anatomical Sciences, St. George's University, True Blue,Grand Anse, West Indies, St. George, Grenada
| |
Collapse
|
44
|
Kıskaç M, Soysal P, Smith L, Capar E, Zorlu M. What is the Optimal Body Mass Index Range for Older Adults? Ann Geriatr Med Res 2022; 26:49-57. [PMID: 35368193 PMCID: PMC8984168 DOI: 10.4235/agmr.22.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background Obesity is pathophysiologically complex in older adults compared to that in young and middle-aged adults. The aim of the present study was to determine the appropriate body mass index (BMI) range based on geriatric evaluation parameters in which complications can be minimized in older adults. Methods A total of 1,051 older adult patients who underwent comprehensive geriatric assessment were included. The patients’ demographic characteristics, comorbid diseases, number of drugs, BMI, basic and instrumental activities of daily living (BADL and IADL), Tinetti balance and walking scale, Mini Nutritional Assessment, Geriatric Depression Scale-15, Mini-Mental State Examination, Time Up and Go test, and handgrip strength measurement were extracted from patient records. Results Of the patients who took part, 73% were female, and the mean age was 77.22±7.10 years. The most negative results were observed in those with a BMI <25 kg/m2 and in those with a BMI >35 kg/m2. Receiver operating characteristic (ROC) analysis of the optimum BMI cutoff levels to detect the desirable values of geriatric assessment parameters was found to be 31–32 and 27–28 kg/m2 for female and male, respectively. Conclusion Older adults with BMI <25 and >35 kg/m2 were at a higher risk of a decrease in functional capacity, and experienced gait and balance problems, fall risk, decrease in muscle strength, and malnutrition. Data from this study suggest that the optimum range of BMI levels for older adults is 31–32 and 27–28 kg/m2 for female and male, respectively.
Collapse
Affiliation(s)
- Muharrem Kıskaç
- Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
- Corresponding Author: Muharrem Kiskac, MD Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Boulevard, Fatih, Istanbul 34093, Turkey Tel: +90 533 6038326 E-mail:
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Emre Capar
- Department of Internal medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Zorlu
- Department of Internal Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| |
Collapse
|
45
|
Langford JT, DiRito JR, Doilicho N, Chickering GR, Stern DA, Ouyang X, Mehal W, Tietjen GT. Revisiting the Principles of Preservation in an Era of Pandemic Obesity. Front Immunol 2022; 13:830992. [PMID: 35432296 PMCID: PMC9011385 DOI: 10.3389/fimmu.2022.830992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022] Open
Abstract
The current obesity epidemic has caused a significant decline in the health of our donor population. Organs from obese deceased donors are more prone to ischemia reperfusion injury resulting from organ preservation. As a consequence, these donors are more likely to be discarded under the assumption that nothing can be done to make them viable for transplant. Our current methods of organ preservation-which remain relatively unchanged over the last ~40 years-were originally adopted in the context of a much healthier donor population. But methods that are suitable for healthier deceased donors are likely not optimal for organs from obese donors. Naturally occurring models of acute obesity and fasting in hibernating mammals demonstrate that obesity and resilience to cold preservation-like conditions are not mutually exclusive. Moreover, recent advances in our understanding of the metabolic dysfunction that underlies obesity suggest that it may be possible to improve the resilience of organs from obese deceased donors. In this mini-review, we explore how we might adapt our current practice of organ preservation to better suit the current reality of our deceased donor population.
Collapse
Affiliation(s)
- John T. Langford
- Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Jenna R. DiRito
- Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Natty Doilicho
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
| | | | - David A. Stern
- Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
| | - Xinshou Ouyang
- Section of Digestive Diseases, Yale University, New Haven, CT, United States
| | - Wajahat Mehal
- Section of Digestive Diseases, Yale University, New Haven, CT, United States
| | - Gregory T. Tietjen
- Department of Surgery, Yale University School of Medicine, New Haven, CT, United States
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
| |
Collapse
|
46
|
The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S. J Clin Med 2022; 11:jcm11061678. [PMID: 35330003 PMCID: PMC8950130 DOI: 10.3390/jcm11061678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/10/2022] [Accepted: 03/06/2022] [Indexed: 12/19/2022] Open
Abstract
Background: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors and increased risk for stroke. However, the evidence of its effect on outcomes in stroke victims have been equivocal. We aimed to investigate the distribution of BMI in a nation-wide cohort of individuals, admitted for a stroke, and the relationship between BMI and in-hospital mortality. Methods: Data from the U.S. National Inpatient Sample (NIS) was collected, to identify hospitalizations for stroke, between October 2015 and December 2016. The patients were sub-divided into six groups based on their BMI: underweight, normal weight, overweight, obese I, obese II and extremely obese groups. Various sociodemographic and clinical parameters were gathered, and incidence of mortality and the length of hospital stay were analyzed. Multivariable analysis was performed to identify independent predictors of in-hospital mortality. Results: A weighted total of 84,185 hospitalizations for stroke were included in the analysis. The approximate mean patients aged was 65.5 ± 31 years, the majority being female (55.3%) and white (63.1%). The overall in-hospital mortality during the study period was 3.6%. A reverse J-shaped relationship between the body mass index and in-hospital mortality was documented, while patients with elevated BMI showed significantly lower in-hospital mortality compared to the underweight and normal weight study participants, 2.8% vs. 7.4%, respectively, p < 0.001. Age and several comorbidities, as well as the Deyo Comorbidity Index, were found to predict mortality in a multivariable analysis. Conclusion: A reverse J-shaped relationship between body mass index and in-hospital mortality was documented in patients admitted for a stroke in the U.S. during the study period. The above findings support the existence of an “obesity paradox” in patients hospitalized following a stroke, similar to that described in other cardiovascular conditions.
Collapse
|
47
|
Margolis G, Elbaz-Greener G, Ruskin JN, Roguin A, Amir O, Rozen G. The Impact of Obesity on Sudden Cardiac Death Risk. Curr Cardiol Rep 2022; 24:497-504. [PMID: 35230617 DOI: 10.1007/s11886-022-01671-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW We aimed to describe the epidemiology of sudden cardiac death (SCD) in the obese, elaborating on the potential pathophysiological mechanisms linking obesity, SCD, and the outcomes in SCD survivors, as well as looking into the intriguing "obesity paradox" in these patients. RECENT FINDINGS Several studies show increased mortality in patients with BMI > 30 kg/m2 admitted to the hospital following SCD. At the same time, other studies have implied that the "obesity paradox," described in various cardiovascular conditions, applies to patients admitted after SCD, showing lower mortality in the obese compared to normal weight and underweight patients. We found a significant body of evidence to support that while obesity increases the risk for SCD, the outcomes of obese patients post SCD are better. These findings should not be interpreted as supporting weight gain, as it is always better to prevent the "disaster" from happening than to improve your chances of surviving it. Obesity is shown to be significantly associated with increased risk for SCD; however, there is a growing body of evidence, supporting the "obesity paradox" in the survival of SCD victims. Prospectively, well-designed studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Gilad Margolis
- Division of Cardiovascular Medicine, Cardiac Electrophysiology Unit, Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Gabby Elbaz-Greener
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jeremy N Ruskin
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA
| | - Ariel Roguin
- Division of Cardiovascular Medicine, Cardiac Electrophysiology Unit, Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Offer Amir
- Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel.,Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Guy Rozen
- Division of Cardiovascular Medicine, Cardiac Electrophysiology Unit, Hillel Yaffe Medical Center, Hadera, Israel. .,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. .,Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, USA.
| |
Collapse
|
48
|
Venigalla S, Straub J, Idigo O, Rinderle C, Stephens JM, Newman JJ. MED12 Regulates Human Adipose-Derived Stem Cell Adipogenesis and Mediator Kinase Subunit Expression in Murine Adipose Depots. Stem Cells Dev 2022; 31:119-131. [PMID: 35018809 PMCID: PMC9206493 DOI: 10.1089/scd.2021.0302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The mediator kinase module plays a critical role in the regulation of transcription during metabolic processes. Here we demonstrate that in human adipose-derived stem cells (hASCs), kinase module subunits have distinct mRNA and protein expression profiles during different stages of adipogenesis. In addition, siRNA-mediated loss of MED12 results in decreased adipogenesis as evident through decreased lipid accumulation and decreased expression of PPARγ, a master regulator of adipogenesis. Moreover, the decrease in adipogenesis and reduced PPARγ expression are observed only during the early stages of MED12 knockdown. At later stages, knockdown of MED12 did not have any significant effects on adipogenesis or PPARγ expression. We also observed that MED12 was present in a protein complex with PPARγ and C/EBPα during all stages of adipogenesis in hASCs. In 3T3-L1 preadipocytes and adipocytes, MED12 is present in protein complexes with PPARγ1, C/EBPα, and STAT5A. CDK8, another member of the kinase module, was only found to interact with C/EBPα. We found that the expression of all kinase module subunits decreased in inguinal, gonadal, and retroperitoneal white adipose tissue (WAT) depots in the fed state after an overnight fast, whereas the expression of kinase module subunits remained consistent in mesenteric WAT (mWAT) and brown adipose tissue. These data demonstrate that the kinase module undergoes physiologic regulation during fasting and feeding in specific mouse adipose tissue depots, and that MED12 likely plays a specific role in initiating and maintaining adipogenesis.
Collapse
Affiliation(s)
- Sree Venigalla
- School of Biological Sciences, Louisiana Tech University, Ruston, Louisiana, USA
| | - Joseph Straub
- School of Biological Sciences, Louisiana Tech University, Ruston, Louisiana, USA
| | - Onyekachi Idigo
- School of Biological Sciences, Louisiana Tech University, Ruston, Louisiana, USA
| | - Caroline Rinderle
- School of Biological Sciences, Louisiana Tech University, Ruston, Louisiana, USA
| | | | - Jamie J. Newman
- School of Biological Sciences, Louisiana Tech University, Ruston, Louisiana, USA.,Address correspondence to: Dr. Jamie J. Newman, School of Biological Sciences, Louisiana Tech University, Ruston, LA 71272, USA
| |
Collapse
|
49
|
Rosas M, Pinneo S, O'Mealy C, Tsang M, Liu C, Kern M, Hooshmand S, Hong MY. Effects of fresh mango consumption on cardiometabolic risk factors in overweight and obese adults. Nutr Metab Cardiovasc Dis 2022; 32:494-503. [PMID: 34953634 DOI: 10.1016/j.numecd.2021.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/13/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND & AIMS In vitro and animal studies show antidiabetic, anti-inflammatory, and cardioprotective properties of mangos. The objective of this study was to examine the effects of fresh mango consumption compared to an isocaloric control snack on body weight, glucose, insulin, lipid profiles, liver function enzymes, inflammation, and antioxidant activity in overweight and obese adults (BMI ≥26 kg/m2). METHODS AND RESULTS In a crossover design, 27 participants consumed 100 kcal/d of fresh mangos or isocaloric low-fat cookies daily for 12 weeks each, separated by a four-week washout period. Blood glucose, C-reactive protein (CRP), and aspartate transaminase activity significantly decreased while total antioxidant capacity significantly increased following mango consumption. There were no significant changes in body weight, body fat %, blood pressure, insulin, or lipid profile following mango consumption. Cookie consumption significantly increased body weight, insulin, CRP, and triglycerides. CONCLUSION These results suggest that relative to the control snack, mangos may improve certain risk factors associated with overweight and obesity including improved glycemic control and reduced inflammation. CLINICAL TRIALS REGISTER NCT03957928.
Collapse
Affiliation(s)
- Martin Rosas
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Sherry Pinneo
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Celeste O'Mealy
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Michelle Tsang
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Changqi Liu
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Mark Kern
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Shirin Hooshmand
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Mee Young Hong
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA.
| |
Collapse
|
50
|
Khanna D, Khanna S, Khanna P, Kahar P, Patel BM. Obesity: A Chronic Low-Grade Inflammation and Its Markers. Cureus 2022; 14:e22711. [PMID: 35386146 PMCID: PMC8967417 DOI: 10.7759/cureus.22711] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/28/2022] [Indexed: 12/15/2022] Open
Abstract
As the prevalence of obesity continues to rise, the world is facing a major public health concern. Obesity is a complex disease associated with an increase in several inflammatory markers, leading to chronic low-grade inflammation. Of multifactorial etiology, it is often used as a measurement of morbidity and mortality. There remains much unknown regarding the association between obesity and inflammation. This review seeks to compile scientific literature on obesity and its associated inflammatory markers in chronic disease and further discusses the role of adipose tissue, macrophages, B-cells, T-cells, fatty acids, amino acids, adipokines, and hormones in obesity. Data were obtained using PubMed and Google Scholar. Obesity, inflammation, immune cells, hormones, fatty acids, and others were search words used to acquire relevant articles. Studies suggest brown adipose tissue is negatively associated with body mass index (BMI) and body fat percentage. Researchers also found the adipose tissue of lean individuals predominantly secretes anti-inflammatory markers, while in obese individuals more pro-inflammatory markers are secreted. Many studies found that adipose tissue in obese individuals showed a shift in immune cells from anti-inflammatory M2 macrophages to pro-inflammatory M1 macrophages, which was also correlated with insulin resistance. Obese individuals generally present with higher levels of hormones such as leptin, visfatin, and resistin. With obesity on the rise globally, it is predicted that severe obesity will become most common amongst low-income adults, black individuals, and women by 2030, making the need for intervention urgent. Further investigation into the association between obesity and inflammation is required to understand the mechanism behind this disease.
Collapse
Affiliation(s)
- Deepesh Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Siya Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Pragya Khanna
- Pediatrics, Gujarat Medical Education and Research Society (GMERS) Medical College, Vadnagar, IND
| | - Payal Kahar
- Department of Health Sciences, Florida Gulf Coast University, Fort Myers, USA
| | - Bhavesh M Patel
- Pediatrics, Gujarat Medical Education and Research Society (GMERS) Medical College, Vadnagar, IND
| |
Collapse
|