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Emrani AS, Beigrezaei S, Zademohammadi F, Salehi-Abargouei A. The effect of whole egg consumption on weight and body composition in adults: a systematic review and meta-analysis of clinical trials. Syst Rev 2023; 12:125. [PMID: 37461099 DOI: 10.1186/s13643-023-02277-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 06/17/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND A limited number of studies have directly examined the effect of whole eggs on body weight and composition in adults, and they have led to inconsistent results. This study aimed to summarize the evidence on the effect of whole egg consumption on body weight and body composition in adults from clinical trials. METHODS Online databases were searched from inception to April 2023 for clinical trials that directly or indirectly assessed the effect of whole eggs consumption on anthropometric measures including body weight, body mass index (BMI), waist circumference (WC), and fat-free mass (FFM) in adults. A random effects model was used for meta-analysis. RESULTS In total, 32 controlled clinical trials were included in the systematic review. The analyses revealed that whole egg consumption has no significant effect on body weight (n = 22), BMI (n = 13), WC (n = 10), and FFM (n = 4, P > 0.05). The subgroup analyses showed that whole egg consumption has an increasing effect on body weight and BMI in studies that lasted more than 12 weeks and in unhealthy participants (P < 0.05). A significant increasing effect on BMI was found in studies that the control group did not receive any egg (P < 0.05). Moreover, in studies that there was no significant difference in energy intake between the intervention and control groups, weight, and WC were significantly increased (P < 0.05). Additionally, in studies that participants in the control group received another food or supplement, studies with calorie restriction, and studies on healthy subjects, whole egg intake significantly decreased BMI (P < 0.05). CONCLUSIONS Although whole egg consumption had no adverse effect on body composition and body weight, in overall, it might increase body weight in long term. Egg consumption beneficially affects BMI in healthy people and during weight loss diet. SYSTEMATIC REVIEW REGISTRATION This systematic review and meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO, Registration number: CRD42022308045).
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Affiliation(s)
- Arezoo Sadat Emrani
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
| | - Sara Beigrezaei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
| | - Faezeh Zademohammadi
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
| | - Amin Salehi-Abargouei
- Research Center for Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran.
- Yazd Cardiovascular Research Center, Non-communicable Deseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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US Obesity Mortality Trends and Associated Noncommunicable Diseases Contributing Conditions Among White, Black, and Hispanic Individuals by Age from 1999 to 2017. ACTA ACUST UNITED AC 2021; 3:1334-1343. [PMID: 33842841 PMCID: PMC8020827 DOI: 10.1007/s42399-021-00850-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/11/2022]
Abstract
This study aims to assess the effect of obesity as an underlying cause of death in association with four main noncommunicable diseases (NCDs) as contributing causes of mortality on the age of death in White, Black, and Hispanic individuals in the USA. To estimate mortality hazard ratios, we ran a Cox regression on the US National Center for Health Statistics mortality integrated datasets from 1999 to 2017, which included almost 48 million cases. The variable in the model was the age of death in years as a proxy for time to death. The cause-of-death variable allowed for the derivation of predictor variables of obesity and the four main NCDs. The overall highest obesity mortality HR when associated with NCD contributing conditions for the year 1999-2017 was diabetes (2.15; 95% CI: 2.11-2.18), while Whites had the highest HR (2.46; 95% CI: 2.41-2.51) when compared with Black (1.32; 95% CI: 1.27-1.38) and Hispanics (1.25; 95% CI: 1.18-1.33). Hispanics had lower mortality HR for CVD (1.21; 95% CI: 1.15-1.27) and diabetes (1.25; 95% CI: 1.18-1.33) of the three studied groups. The obesity death mean was 57.3 years for all groups. People who die from obesity are, on average, 15.4 years younger than those without obesity. Although Hispanics in the USA have a higher prevalence of diabetes and cardiovascular disease (CVD), they also have the lowest mortality HR for obesity as an underlying cause of death when associated with CVD and cancer. While there is no obvious solution for obesity and its complications, continued efforts to address obesity are needed.
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The association between hypertension and other cardiovascular risk factors among non-diabetic Saudis adults-A cross sectional study. PLoS One 2021; 16:e0246568. [PMID: 33621259 PMCID: PMC7901777 DOI: 10.1371/journal.pone.0246568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 01/21/2021] [Indexed: 11/25/2022] Open
Abstract
Population specific associations between cardiovascular disease with various risk factors including pre-hypertension and hypertension were reported. We aimed to investigate the association of higher than optimal blood pressure with measures of dysglycemia, dyslipidemia, and markers of inflammation in non-diabetic Saudi adults hoping to improve current Saudi guidelines to prevent cardiovascular disease. Volunteers were recruited randomly from public healthcare centers in Jeddah. Demographic information, blood pressure (BP), and anthropometric measurements were taken. Fasting blood samples were drawn, then again following 1-hour oral glucose tolerance test. Glycated hemoglobin, fasting plasma glucose (FPG), lipid profile, highly sensitive C- reactive protein, gamma glutamyl transferase, and 1-hour plasma glucose were measured. Complete data was found for 742 men and 592 women. Pre-hypertension was found in 47.2% of men, and 24.7% of women, while 15.1% of men, and 14.6% of women were hypertensive. Means of measured variables differed significantly between normotensive, pre-hypertensive, and hypertensive groups of men and women in gender specific manner. Association between measured variables and elevated BP, and hypertension were assessed using logistic regression models. After adjustment for age, body mass index and waist circumference, elevated blood pressure was associated with elevated triglycerides in men, while hypertension was significantly associated with elevated fasting plasma glucose, total cholesterol, triglycerides, low density lipoprotein- cholesterol, and low high density lipoprotein- cholesterol in men, and elevated triglycerides, and total cholesterol in women. Therefore, it is strongly recommended to measure lipid profile, specifically TG, for all diagnosed pre-hypertensive and hypertensive patients in addition to FPG for men.
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Wahab A, Dey AK, Bandyopadhyay D, Katikineni V, Chopra R, Vedantam KS, Devraj M, Chowdary AK, Navarengom K, Lavie CJ, Kolpakchi A, Jneid H. Obesity, Systemic Hypertension, and Pulmonary Hypertension: A Tale of Three Diseases. Curr Probl Cardiol 2020; 46:100599. [PMID: 32560908 DOI: 10.1016/j.cpcardiol.2020.100599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/06/2020] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease (CVD), especially ischemic heart disease and stroke, is the major cause of death worldwide, accounting for more than one-third of all deaths annually. Hypertension is the most prevalent and modifiable risk factor of CVD-related deaths. The same is true for obesity, which is currently being recognized as a major global epidemic. The prevalence of obesity in the United States has increased dramatically, from 13.4% in 1960 to 36.5% in 2014, with as much as 70.7% of the American adult population being overweight or obese (CDC). Epidemiological studies have shown that obesity predisposes to hypertension and CVD - with the relationship between markers of obesity and blood pressure being almost linear across different populations. In this review, we discuss systemic and pulmonary hypertension in the context of obesity.
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Affiliation(s)
- Abdul Wahab
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Amit K Dey
- National Heart, Lung and Blood Institute, Bethesda, MD
| | | | | | | | | | | | | | | | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-UQ School of Medicine, New Orleans, LA
| | - Anna Kolpakchi
- Section of Cardiology, Baylor College of Medicine and the Michael E. DeBakey VAMC, Houston, TX
| | - Hani Jneid
- Section of Cardiology, Baylor College of Medicine and the Michael E. DeBakey VAMC, Houston, TX.
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Atila D, Dalgic O, Ozturk YK. Bir kardiyoloji polikliniğinde hipertansiyon ve obezite yaygınlığı: Kesitsel bir araştırma. FAMILY PRACTICE AND PALLIATIVE CARE 2019. [DOI: 10.22391/fppc.483544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bräutigam Ewe M, Lydell M, Bergh H, Hildingh C, Baigi A, Månsson J. Characteristics of patients seeking a health promotion and weight reduction program in primary care. J Multidiscip Healthc 2019; 12:235-242. [PMID: 31043787 PMCID: PMC6469485 DOI: 10.2147/jmdh.s195269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose An important task in primary health care (PHC) is to address lifestyle-related diseases. Overweight (OW) individuals make up a large proportion of PHC patients, and they increasingly have lifestyle-related illnesses that influence their quality of life. Structured health promotion and weight reduction programs could help these patients. The objective of this study was to explore the characteristics, lifestyle habits, and health conditions of individuals seeking a health promotion and weight reduction program in PHC. Patients and methods The study involved a comparative cross-sectional design performed in PHC in southwestern Sweden. The study population comprised 286 participants (231 women, aged 40–65 years, body mass index [BMI] 28–35 kg/m2) who were recruited between March 2011 and April 2014 to the 2-year program by adverts in local newspapers and recruitment from three PHC centers. Two reference populations were used: a general population group and an OW group. The study population data were collected using a questionnaire, with validated questions regarding health, lifestyle, illnesses, and health care utilization. Results People seeking a health promotion and weight reduction program were mostly women. They had a higher education level and experienced worse general health than the OW population, and they visited PHC more frequently than both reference groups. They also felt more stressed, humiliated, had more body pain, and smoked less compared to the general population. However, they did not exercise less or had a lower intake of fruits and vegetables than either reference population. Conclusion Individuals seeking a weight reduction program were mostly women with a higher education level and a worse general health than the OW population. They used more health care services compared to the reference groups.
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Affiliation(s)
- Marie Bräutigam Ewe
- Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden,
| | - Marie Lydell
- CVHI-Centre of Research on Welfare, Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Håkan Bergh
- Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden, .,Research and Development Unit Halland, Region of Halland, Halmstad, Sweden
| | - Cathrine Hildingh
- CVHI-Centre of Research on Welfare, Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Amir Baigi
- Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden, .,Research and Development Unit Halland, Region of Halland, Halmstad, Sweden
| | - Jörgen Månsson
- Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden,
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Addison O, Yang R, Serra MC. Body-weight goals, trends, and weight-loss techniques among patients with peripheral arterial disease. Nutr Health 2018; 25:47-52. [PMID: 30582436 DOI: 10.1177/0260106018817190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND: Obesity contributes to negative outcomes in peripheral arterial disease (PAD). Little is known about the body-weight goals and trends among patients with PAD. AIM: The aim of this study was to explore self-reported body-weight trends and methods used to achieve weight loss in patients with PAD. METHODS: Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) was utilized to compare individuals with PAD who were overweight and obese ( n = 240), to matched individuals without PAD ( n = 480). Self-reported body weight at age 25 years, 10 years prior and 1 year prior to the current assessment, and age and weight of heaviest body weight were compared. Self-reported weight-loss techniques during the past year were compared between groups. RESULTS: Individuals with PAD and controls reported similar weights 10 years prior (79.2 kg vs 78.5 kg; p = 0.60) and weight gain over the last 10 years of 5.7 kg. There was no significant difference in reported body weight at age 25 years, 10 years prior, 1 year prior, or heaviest weight. Compared with the control group, fewer participants with PAD reported attempted weight loss in the last year (27.50% vs 36.04%; p = 0.02) and were half as likely to report utilizing exercise as a weight-loss method (12.5% vs 21.7%; p = 0.003). CONCLUSIONS: These data indicate that those with PAD are less inclined to attempt weight loss, especially through means of increased physical activity. Future research is needed regarding the effectiveness of intentional weight-loss programs in this population.
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Affiliation(s)
- O Addison
- 1 Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland, USA.,2 Department of Physical Therapy and Rehabilitation Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - R Yang
- 3 Department of Epidemiology and Public Health, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - M C Serra
- 4 Center for Visual and Neurocognitive Rehabilitation and Geriatric Research and Education Center, Atlanta VA Medical Center, Atlanta, Georgia, USA.,5 Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Abstract
PURPOSE OF REVIEW Obesity is a major risk factor for the development of hypertension (HTN), a leading cause of cardiovascular morbidity and mortality. Growing body of research suggests that adipose tissue function is directly associated with the pathogenesis of obesity-related HTN. In this review, we will discuss recent research on the role of adipose tissue in blood pressure (BP) regulation and activation of brown adipose tissue (BAT) as a potentially new therapeutic means for obesity-related HTN. RECENT FINDINGS Adipose tissue provides mechanical protection of the blood vessels and plays a role in regulation of vascular tone. Exercise and fasting activate BAT and induce browning of white adipose tissue (WAT). BAT-secreted FGF21 lowers BP and protects against HTN. Browning of perivascular WAT improves HTN. New insights on WAT browning and BAT activation can open new avenues of potential therapeutic interventions to treat obesity-related HTN.
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Affiliation(s)
- Eashita Das
- Translational Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, M5G 0A4, Canada
- Department of Microbiology, Siliguri College, North Bengal University, Siliguri, West Bengal, 734001, India
| | - Joon Ho Moon
- Translational Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, M5G 0A4, Canada
| | - Ju Hee Lee
- Translational Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, M5G 0A4, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Nikita Thakkar
- Translational Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, M5G 0A4, Canada
| | - Zdenka Pausova
- Translational Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, M5G 0A4, Canada
- Department of Physiology, University of Toronto, Toronto, Canada
| | - Hoon-Ki Sung
- Translational Medicine Program, The Hospital for Sick Children Research Institute, Toronto, Ontario, M5G 0A4, Canada.
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
- Banting and Best Diabetes Centre, University of Toronto, Toronto, Canada.
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Aranda-González I, Coop-Gamas F, Ávila-Escalante ML, Pérez-Izquierdo O. Riesgo de enfermedades cardiovasculares y su percepción en adolescentes con sobrepeso y obesidad de comunidades mayas de Yucatán. ARCHIVOS LATINOAMERICANOS DE NUTRICIÓN 2018. [DOI: 10.37527/2018.68.3.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Las investigaciones realizadas en adolescentes del área rural y su percepción de salud son escasas, lo que representa un área de oportunidad para prevenir enfermedades de tipo cardiovascular en la vida adulta. El objetivo fue determinar el riesgo de enfermedades cardiovasculares y su percepción en adolescentes con sobrepeso y obesidad de comunidades mayas. Se llevó a cabo en dos etapas: cuantitativatransversal y cualitativa. En el Municipio de Abalá, Yucatán, con estudiantes de secundarias (n = 292). Se registró el peso, talla, edad, circunferencia de cintura, tensión arterial y se calcularon los indicadores Talla/Edad, Índice de Masa Corporal/Edad, Cintura Cadera/Talla y Tensión Arterial sistólica/Talla. Se realizaron grupos focales con adolescentes con sobrepeso u obesidad según Índice de Masa Corporal (IMC) para explorar creencias acerca del sobrepeso/obesidad, alimentos que lo provocan y enfermedades ocasionadas. Se utilizó estadística descriptiva y prueba de Chi-cuadrado. El 96,9% de los adolescentes tuvo talla normal; según IMC, 54,1% peso Normal, 28,4% sobrepeso y 17,1% obesidad. El 30,5% presentó riesgo cardiovascular según Cintura Cadera/Talla y el 8,9% de los adolescentes registró prehipertensión/hipertensión, más frecuente en hombres que en mujeres. Respecto a la percepción del sobrepeso/obesidad, los adolescentes señalaron que no es buena para la salud; los alimentos que ocasionan sobrepeso/obesidad son ricos en hidratos de carbono, grasas, con alto contenido calórico y las enfermedades derivadas del sobrepeso/obesidad son diabetes, anemia, anorexia y desnutrición. Se encontró riesgo cardiovascular en adolescentes, mayor en los hombres. Perciben que no llevan una buena alimentación, lo que podría ocasionarles sobrepeso/obesidad y desarrollar enfermedades cardiovasculares.
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Park K, Lim S, Park Y, Ju W, Shin Y, Yeom H. Cardiovascular Disease Risk Factors and Obesity Levels in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey, 2007-2015. Osong Public Health Res Perspect 2018; 9:150-159. [PMID: 30159220 PMCID: PMC6110324 DOI: 10.24171/j.phrp.2018.9.4.03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Objectives The increase in the obesity rate in adult males in Korea is higher than countries in the Organization for Economic Co-operation and Development and other Asian countries. We examined the trends and prevalence of major risk factors for cardiovascular disease by evaluating the weight status amongst adults from 2007 to 2015. Methods The study included 37,402 adults, who participated in the Korea National Health and Nutrition Examination Survey. The prevalence trends of cardiovascular disease risk factors were estimated for each body mass index group. Results From 2007 to 2015, significant increases in the prevalence of hypertension, diabetes, and hypercholesterolemia were observed in normal weight adults (0.03 percentage point (%p), 0.06%p, and 0.13%p, respectively). Amongst the overweight and obese adults, a significant increase in the prevalence of hypercholesterolemia was observed, During this period, the prevalence of smoking decreased amongst obese adults and no significant changes in drinking habits and physical activity were noted across all body mass index groups. Conclusion The prevalence of obesity in Korean adults is increasing, and it is necessary to implement interventions to prevent further weight gain and obesity-associated cardiovascular disease.
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Affiliation(s)
- Kwanjun Park
- Center for Public Health, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Sunmi Lim
- Department of Preventive Medicine, Soonchunhyang University, Cheonan, Korea
| | - Yoonhyung Park
- Department of Preventive Medicine, Soonchunhyang University, Cheonan, Korea
| | - Woong Ju
- Center for Public Health, Ewha Womans University Mokdong Hospital, Seoul, Korea.,Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yoonhee Shin
- Center for Public Health, Ewha Womans University Mokdong Hospital, Seoul, Korea.,Department of Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hansol Yeom
- Department of Preventive Medicine, Soonchunhyang University, Cheonan, Korea
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Cantu-Jungles TM, McCormack LA, Slaven JE, Slebodnik M, Eicher-Miller HA. A Meta-Analysis to Determine the Impact of Restaurant Menu Labeling on Calories and Nutrients (Ordered or Consumed) in U.S. Adults. Nutrients 2017; 9:E1088. [PMID: 28973989 PMCID: PMC5691705 DOI: 10.3390/nu9101088] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 11/16/2022] Open
Abstract
A systematic review and meta-analysis determined the effect of restaurant menu labeling on calories and nutrients chosen in laboratory and away-from-home settings in U.S. adults. Cochrane-based criteria adherent, peer-reviewed study designs conducted and published in the English language from 1950 to 2014 were collected in 2015, analyzed in 2016, and used to evaluate the effect of nutrition labeling on calories and nutrients ordered or consumed. Before and after menu labeling outcomes were used to determine weighted mean differences in calories, saturated fat, total fat, carbohydrate, and sodium ordered/consumed which were pooled across studies using random effects modeling. Stratified analysis for laboratory and away-from-home settings were also completed. Menu labeling resulted in no significant change in reported calories ordered/consumed in studies with full criteria adherence, nor the 14 studies analyzed with ≤1 unmet criteria, nor for change in total ordered carbohydrate, fat, and saturated fat (three studies) or ordered or consumed sodium (four studies). A significant reduction of 115.2 calories ordered/consumed in laboratory settings was determined when analyses were stratified by study setting. Menu labeling away-from-home did not result in change in quantity or quality, specifically for carbohydrates, total fat, saturated fat, or sodium, of calories consumed among U.S. adults.
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Affiliation(s)
| | - Lacey A McCormack
- Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD 57007, USA.
| | - James E Slaven
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
| | - Maribeth Slebodnik
- Arizona Health Sciences Library, University of Arizona, Tucson, AZ 85724, USA.
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Aronow WS. Association of obesity with hypertension. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:350. [PMID: 28936444 DOI: 10.21037/atm.2017.06.69] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Wilbert S Aronow
- Cardiology Division, Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
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Abstract
Blood pressure management in hypertensive patients with metabolic abnormalities is challenging, since many of the antihypertensive drugs adversely affect metabolism. Besides effective control of blood pressure in patients with hypertension, third-generation beta-blockers such as nebivolol offer additional benefits for central hemodynamics and neutral or beneficial effects on metabolism. Emerging clinical data suggest that nebivolol also has similar effects on metabolism in obese hypertensive and hypertensive diabetic patients. The present article will provide a systematic analysis of the pathophysiological links among hypertension, insulin resistance, and metabolic syndrome. We will also summarize the available clinical evidence regarding the metabolic effects of beta-blockers in hypertensive patients, with an emphasis on nebivolol. Nebivolol exerts neutral or beneficial effects on insulin sensitivity and lipid metabolism in hypertensive patients, owing to its nitric oxide-mediated vasodilatory and antioxidative properties. Thus, nebivolol could be a favorable therapeutic option for the treatment of hypertension in patients with impaired glucose and lipid metabolism.
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Devonshire AL, Hager ER, Black MM, Diener-West M, Tilton N, Snitker S. Elevated blood pressure in adolescent girls: correlation to body size and composition. BMC Public Health 2016; 16:78. [PMID: 26812968 PMCID: PMC4729122 DOI: 10.1186/s12889-016-2717-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 01/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background To improve understanding of the pathophysiology of hypertension in adolescents and pave the way for risk stratification, studies have sought to determine the correlates of blood pressure (BP). Inconsistencies in dependent and independent variables have resulted in an elusive consensus. The aim of this report is to examine an inclusive array of correlates of BP, as a continuous (systolic and diastolic BP) and a dichotomous variable. Methods Subjects were a school-based sample of 730 urban, mostly African American, non-referred 6th and 7th grade girls. To find independent correlates of SBP/DBP, we used a stepwise model selection method based on the Schwarz Bayesian Information Criterion, enabling selection of a parsimonious model among highly correlated covariates. Candidate variables were: age, stature, heart rate, pubertal development, BMI, BMI z-score, waist circumference, waist-to-height ratio (WHtR), body surface area, fat mass (by bioelectrical impedance analysis), fat-free mass (FFM), percentage of body fat, and presence of overweight/obesity. Results The best-fitting models for DBP and SBP (considered separately) included fat-free mass, heart rate and, in the case of SBP, stature. The best-fitting model for high-normal/elevated blood pressure (H-N/EBP) included WHtR with no independent relation of any other variable. The prevalence of H-N/EBP tripled between a WHtR of 0.5 and 0.7. Conclusions The easily obtained and calculated WHtR is the strongest correlate of elevated blood pressure among available variables and is a prime candidate for longitudinal studies of predictors of the development of hypertension. Trial registration ClinicalTrials.gov Identifier, NCT00746083
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Affiliation(s)
- Ashley L Devonshire
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Erin R Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Marie Diener-West
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicholas Tilton
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Soren Snitker
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA. .,Department of Medicine, University of Maryland School of Medicine, 660 West Lombard Street, Rm. 598-B, 21201, Baltimore, Maryland, USA.
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Zabeen B, Tayyeb S, Naz F, Ahmed F, Rahman M, Nahar J, Nahar N, Azad K. Prevalence of obesity and central obesity among adolescent girls in a district school in Bangladesh. Indian J Endocrinol Metab 2015; 19:649-652. [PMID: 26425476 PMCID: PMC4566347 DOI: 10.4103/2230-8210.163193] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The prevalence of childhood obesity has increased over the last two decades. Obesity is a major risk factor for chronic diseases and plays a central role in insulin resistance or metabolic syndrome. METHODS The aim of the study was to assess the prevalence of obesity and abdominal obesity by means of body mass index (BMI) and waist-to-height ratio (WHtR) in adolescent girls in a district school in Bangladesh. Based on age and sex specific BMI percentiles, the students were classified as normal weight (5(th)-<85(th) percentile), overweight (85(th)-<95(th) percentiles), and obese (≥95(th) percentile). Central obesity was categorized as WHtR ≥ 0.5. Adolescent girls (aged 9-17 years) attending the sixth to twelfth grades (n = 501) in a Bengali medium school participated in the study. RESULTS The prevalence of obesity and overweight were 23% and 14% among the girls. The prevalence of central obesity was 26%. Around 14% of girls in the normal weight group were centrally obese. There was a significant relationship between WHtR and BMI status (P = 0.0001). CONCLUSION Our study provides evidence showing a high prevalence of overall and central obesity in adolescent girls in our population. We emphasize the need for further large scale surveillance programs and preventive strategies in our population to reduce the incidence of obesity.
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Affiliation(s)
- Bedowra Zabeen
- Department of CDiC, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Samin Tayyeb
- Department of CDiC, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Farzana Naz
- Department of CDiC, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Farhana Ahmed
- Department of CDiC, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Maftunur Rahman
- Department of CDiC, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Jebun Nahar
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Nazmun Nahar
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Kishwar Azad
- Department of CDiC, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
- Department of Paediatrics, Bangladesh Institute of Research and Rehabilitation of Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
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Body composition indices and predicted cardiovascular disease risk profile among urban dwellers in Malaysia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:174821. [PMID: 25710002 PMCID: PMC4326033 DOI: 10.1155/2015/174821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 01/13/2015] [Accepted: 01/13/2015] [Indexed: 02/03/2023]
Abstract
Objectives. This study aims to compare various body composition indices and their association with a predicted cardiovascular disease (CVD) risk profile in an urban population in Kuala Lumpur, Malaysia. Methods. A cross-sectional survey was conducted in metropolitan Kuala Lumpur, Malaysia, in 2012. Households were selected using a simple random-sampling method, and adult members were invited for medical screening. The Framingham Risk Scoring algorithm was used to predict CVD risk, which was then analyzed in association with body composition measurements, including waist circumference, waist-hip ratio, waist-height ratio, body fat percentage, and body mass index. Results. Altogether, 882 individuals were included in our analyses. Indices that included waist-related measurements had the strongest association with CVD risk in both genders. After adjusting for demographic and socioeconomic variables, waist-related measurements retained the strongest correlations with predicted CVD risk in males. However, body mass index, waist-height ratio, and waist circumference had the strongest correlation with CVD risk in females. Conclusions. The waist-related indicators of abdominal obesity are important components of CVD risk profiles. As waist-related parameters can quickly and easily be measured, they should be routinely obtained in primary care settings and population health screens in order to assess future CVD risk profiles and design appropriate interventions.
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Sabah KMN, Chowdhury AW, Khan HILR, Hasan ATMH, Haque S, Ali S, Kawser S, Alam N, Amin G, Mahabub SMEE. Body mass index and waist/height ratio for prediction of severity of coronary artery disease. BMC Res Notes 2014; 7:246. [PMID: 24742250 PMCID: PMC4000139 DOI: 10.1186/1756-0500-7-246] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 04/04/2014] [Indexed: 12/29/2022] Open
Abstract
Background To determine whether waist-to-height ratio correlates with coronary artery disease (CAD) severity better, than the body mass index (BMI) as assessed by coronary angiography in Bangladeshi population. Methods This cross sectional study was done on patients in Department of Cardiology in DMCH and those referred in the cath-lab of the Department of Cardiology for CAG during November 2009 to October 2010 involving 120 patients. They were divided into group-A (with coronary score ≥7) and group-B (coronary score <7) depending on Gensisni score. Result There were no statistically significant difference regarding the distribution of age, sex and clinical diagnosis and parameters between the two groups. The mean age of patients was 51.7 ± 8.2 years and 48.8 ± 9.1 years in Group A and Group B respectively with a male predominance in both the groups. Patients in group A had higher BMI ≥25 and waist to height ratio (≥0.55) than Group B which showed a statistically significant association (p < 0.001). Though a significant positive correlation (r = 0.296, p = 0.006) was observed between BMI and Coronary artery disease score in group A patients, scenario was reverse fro group B (r = 0.076, p = 0.659). The statement was also true for Waist-to-height ratio and Waist-to-height ratio with BMI. Multivariate analysis also yeilded that a patient with BMI ≥25 kg/m2 and waist-to height ratio of ≥0.55 are 3.06 times and 6.77 times, more likely to develop significant coronary artery disease respectively. Conclusion The waist-to-height ratio showed better correlation with the severity of coronary artery disease than the BMI.
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Wiltink J, Michal M, Wild PS, Zwiener I, Blettner M, Münzel T, Schulz A, Kirschner Y, Beutel ME. Associations between depression and different measures of obesity (BMI, WC, WHtR, WHR). BMC Psychiatry 2013; 13:223. [PMID: 24028572 PMCID: PMC3849983 DOI: 10.1186/1471-244x-13-223] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 09/09/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Growing evidence suggests that abdominal obesity is a more important risk factor for the prognosis of cardiovascular and metabolic diseases than BMI. Somatic-affective symptoms of depression have also been linked to cardiovascular risk. The relationship between obesity and depression, however, has remained contradictory. Our aim was therefore to relate body mass index (BMI) and different measures for abdominal obesity (waist circumference, WC, waist-to-hip ratio, WHR, waist-to-height ratio, WHtR) to somatic vs. cognitive-affective symptoms of depression. METHODS In a cross-sectional population based study, data on the first N = 5000 participants enrolled in the Gutenberg Health Study (GHS) are reported. To analyze the relationship between depression and obesity, we computed linear regression models with the anthropometric measure (BMI, WC, WHR, WHtR) as the dependent variable and life style factors, cardiovascular risk factors and psychotropic medications as potential confounders of obesity/depression. RESULTS We found that only the somatic, but not the cognitive-affective symptoms of depression are consistently positively associated with anthropometric measures of obesity. CONCLUSIONS We could demonstrate that the somatic-affective symptoms of depression rather than the cognitive-affective symptoms are strongly related to anthropometric measures. This is also true for younger obese starting at the age of 35 years. Our results are in line with previous studies indicating that visceral adipose tissue plays a key role in the relationship between obesity, depression and cardiovascular disease.
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Affiliation(s)
- Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Philipp S Wild
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany,Department of Medicine 2, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Isabella Zwiener
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Thomas Münzel
- Department of Medicine 2, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Andreas Schulz
- Department of Medicine 2, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Yvonne Kirschner
- Department of Medicine 2, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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Freitas ERFS, Soares BGO, Cardoso JR, Atallah ÁN. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev 2012; 2012:CD004466. [PMID: 22972072 PMCID: PMC8094624 DOI: 10.1002/14651858.cd004466.pub3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Incentive spirometry (IS) is a treatment technique that uses a mechanical device to reduce pulmonary complications during postoperative care. This is an update of a Cochrane review first published in 2007. OBJECTIVES Update the previously published systematic review to compare the effects of IS for preventing postoperative pulmonary complications in adults undergoing coronary artery bypass graft (CABG). SEARCH METHODS We searched CENTRAL and DARE on The Cochrane Library (Issue 2 of 4 2011), MEDLINE OVID (1948 to May 2011), EMBASE (1980 to Week 20 2011), LILACS (1982 to July 2011) , the Physiotherapy Evidence Database (PEDro) (1980 to July 2011), Allied & Complementary Medicine (AMED) (1985 to May 2011), CINAHL (1982 to May 2011). SELECTION CRITERIA Randomised controlled trials comparing IS with any type of prophylactic physiotherapy for prevention of postoperative pulmonary complications in adults undergoing CABG. DATA COLLECTION AND ANALYSIS Two reviewers independently evaluated trial quality using the guidelines of the Cochrane Handbook for Systematic Reviews and extracted data from included trials. For continuous outcomes, we used the generic inverse variance method for meta-analysis and for dichotomous data we used the Peto Odds Ratio. MAIN RESULTS This update included 592 participants from seven studies (two new and one that had been excluded in the previous review in 2007. There was no evidence of a difference between groups in the incidence of any pulmonary complications and functional capacity between treatment with IS and treatment with physical therapy, positive pressure breathing techniques (including continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP) and intermittent positive pressure breathing (IPPB), active cycle of breathing techniques (ACBT) or preoperative patient education. Patients treated with IS had worse pulmonary function and arterial oxygenation compared with positive pressure breathing. Based on these studies there was no improvement in the muscle strength between groups who received IS demonstrated by maximal inspiratory pressure and maximal expiratory pressure . AUTHORS' CONCLUSIONS Our update review suggests there is no evidence of benefit from IS in reducing pulmonary complications and in decreasing the negative effects on pulmonary function in patients undergoing CABG. In view of the modest number of patients studied, methodological shortcomings and poor reporting of the included trials, these results should still be interpreted cautiously. An appropriately powered trial of high methodological rigour is needed to determine if there are patients who may derive benefit from IS following CABG.
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Affiliation(s)
- Eliane R F S Freitas
- Physical Therapy Department, UNOPAR / Centro Cochrane do Brasil, Londrina, Brazil.
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20
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Mokha JS, Srinivasan SR, Dasmahapatra P, Fernandez C, Chen W, Xu J, Berenson GS. Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children: the Bogalusa Heart Study. BMC Pediatr 2010; 10:73. [PMID: 20937123 PMCID: PMC2964659 DOI: 10.1186/1471-2431-10-73] [Citation(s) in RCA: 213] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Accepted: 10/11/2010] [Indexed: 12/28/2022] Open
Abstract
Background Body Mass Index (BMI) is widely used to assess the impact of obesity on cardiometabolic risk in children but it does not always relate to central obesity and varies with growth and maturation. Waist-to-Height Ratio (WHtR) is a relatively constant anthropometric index of abdominal obesity across different age, sex or racial groups. However, information is scant on the utility of WHtR in assessing the status of abdominal obesity and related cardiometabolic risk profile among normal weight and overweight/obese children, categorized according to the accepted BMI threshold values. Methods Cross-sectional cardiometabolic risk factor variables on 3091 black and white children (56% white, 50% male), 4-18 years of age were used. Based on the age-, race- and sex-specific percentiles of BMI, the children were classified as normal weight (5th - 85th percentiles) and overweight/obese (≥ 85th percentile). The risk profiles of each group based on the WHtR (<0.5, no central obesity versus ≥ 0.5, central obesity) were compared. Results 9.2% of the children in the normal weight group were centrally obese (WHtR ≥0.5) and 19.8% among the overweight/obese were not (WHtR < 0.5). On multivariate analysis the normal weight centrally obese children were 1.66, 2.01, 1.47 and 2.05 times more likely to have significant adverse levels of LDL cholesterol, HDL cholesterol, triglycerides and insulin, respectively. In addition to having a higher prevalence of parental history of type 2 diabetes mellitus, the normal weight central obesity group showed a significantly higher prevalence of metabolic syndrome (p < 0.0001). In the overweight/obese group, those without central obesity were 0.53 and 0.27 times less likely to have significant adverse levels of HDL cholesterol and HOMA-IR, respectively (p < 0.05), as compared to those with central obesity. These overweight/obese children without central obesity also showed significantly lower prevalence of parental history of hypertension (p = 0.002), type 2 diabetes mellitus (p = 0.03) and metabolic syndrome (p < 0.0001). Conclusion WHtR not only detects central obesity and related adverse cardiometabolic risk among normal weight children, but also identifies those without such conditions among the overweight/obese children, which has implications for pediatric primary care practice.
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Affiliation(s)
- Jasmeet S Mokha
- Center for Cardiovascular Health, Department of Epidemiology, Tulane University health Sciences Center, New Orleans, LA, USA
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Flint AJ, Rexrode KM, Hu FB, Glynn RJ, Caspard H, Manson JE, Willett WC, Rimm EB. Body mass index, waist circumference, and risk of coronary heart disease: a prospective study among men and women. Obes Res Clin Pract 2010; 4:e171-e181. [PMID: 21116472 PMCID: PMC2992336 DOI: 10.1016/j.orcp.2010.01.001] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Accepted: 01/10/2010] [Indexed: 11/29/2022]
Abstract
OBJECTIVE: The purpose of the study was to assess the risk of CHD associated with excess weight measured by BMI and waist circumference (WC) in two large cohorts of men and women. DESIGN, SETTING, SUBJECTS: Participants in two prospective cohort studies, the Health Professionals Follow-up Study (N = 27,859 men; age range 39-75 years) and the Nurses' Health Study (N = 41,534 women; 39-65 years) underwent 16-year follow-up through 2004. RESULTS: 1,823 incident cases of CHD among men and 1,173 cases among women were documented. Compared to men with BMI 18.5 to 22.9 kg/m2, those with a BMI > 30.0 kg/m2 had a multivariate-adjusted RR of CHD of 1.81 (95% CI 1.48 - 2.22). Among women, those with a BMI > 30.0 kg/m2 had a RR of CHD of 2.16 (95% CI 1.81 - 2.58). Compared to men with a WC < 84.0 cm, those with WC of greater than 102.0 cm had a RR of 2.25 (95% CI 1.77 - 2.84). Among women, the RR of CHD was 2.75 (95% CI 2.20 - 3.45) for those with WC of greater than 88.0 cm. CONCLUSIONS: In these analyses from two large ongoing prospective cohort studies, both BMI and WC strongly predicted future risk of CHD. Furthermore, WC thresholds as low as 84.0 cm in men and 71.0 cm in women may be useful in identifying those at increased risk of developing CHD. The findings have broad implications in terms of CHD risk assessment in both clinical practice and epidemiologic studies.
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Affiliation(s)
- Alan J. Flint
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Kathryn M. Rexrode
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Frank B. Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Robert J. Glynn
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA
| | - Hervé Caspard
- Department of US Medical Affairs, Sanofi-Aventis, Bridgewater, NJ
| | - JoAnn E. Manson
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Walter C. Willett
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Nutrition, Harvard School of Public Health, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Eric B. Rimm
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Nutrition, Harvard School of Public Health, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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Poland GA, Ovsyannikova IG, Jacobson RM. Application of pharmacogenomics to vaccines. Pharmacogenomics 2009; 10:837-52. [PMID: 19450131 DOI: 10.2217/pgs.09.25] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The field of pharmacogenomics and pharmacogenetics provides a promising science base for vaccine research and development. A broad range of phenotype/genotype data combined with high-throughput genetic sequencing and bioinformatics are increasingly being integrated into this emerging field of vaccinomics. This paper discusses the hypothesis of the 'immune response gene network' and genetic (and bioinformatic) strategies to study associations between immune response gene polymorphisms and variations in humoral and cellular immune responses to prophylactic viral vaccines, such as measles-mumps-rubella, influenza, HIV, hepatitis B and smallpox. Immunogenetic studies reveal promising new vaccine targets by providing a better understanding of the mechanisms by which gene polymorphisms may influence innate and adaptive immune responses to vaccines, including vaccine failure and vaccine-associated adverse events. Additional benefits from vaccinomic studies include the development of personalized vaccines, the development of novel vaccines and the development of novel vaccine adjuvants.
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Affiliation(s)
- Gregory A Poland
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA.
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23
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Schmidt D, Salahudeen A. The obesity-survival paradox in hemodialysis patients: why do overweight hemodialysis patients live longer? Nutr Clin Pract 2007; 22:11-5. [PMID: 17242449 DOI: 10.1177/011542650702200111] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Obesity is increasingly common in the United States, and it frequently coexists with diabetes and hypertension. Given that diabetes and hypertension are the 2 most common causes of end-stage renal disease, it is not surprising that obesity is also highly prevalent in the US hemodialysis population. However, unlike in the general population, obesity is associated with improved survival in hemodialysis patients. This phenomenon, the obesity-survival paradox, is neither universally accepted nor completely understood. In this article, we review the available data and provide potential reasons for the obesity-survival paradox in the dialysis population.
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Affiliation(s)
- Darren Schmidt
- Division of Nephrology, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Hara M, Mori M, Shono N, Higaki Y, Nishizumi M. Lifestyle-related risk factors for total and cancer mortality in men and women. Environ Health Prev Med 2000; 5:90-6. [PMID: 21432191 PMCID: PMC2723578 DOI: 10.1265/ehpm.2000.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2000] [Accepted: 03/30/2000] [Indexed: 11/09/2022] Open
Abstract
We conducted a 14-year follow-up study to analyze the hazard ratio (HR) of mortality regarding lifestyle-related factors in Saga Prefecture, Japan. The subjects included 2,170 people, who were randomly selected from men and women aged from 40 to 69 years old, and who also completed the standardized questionnaire on lifestyle in 1983. Information about death and corresponding data were obtained either by mail and/or through the city offices in 1997. We found that a lower body weight, a lower physical fitness level, not consuming a balanced diet, and cigarette smoking to be significantly elevated risks for all-causes of death in males after adjustment by age and health status. In addition, these results did not change even after excluding subjects for early death. The HR of the female subjects who quit smoking was significantly high, although it changed to insignificant after excluding subjects for early death. These results suggested that being underweight might be an index of a positive risk of death, while maintaining a higher physical fitness level, being careful to consume a more balanced diet, and non smoking all appear to be indexes of a negative risk of death. In addition, these results might also be considered good evidence for improving poor health habits in health promotion activities.
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Affiliation(s)
- M Hara
- Department of Community Health Science, Saga Medical School, Saga, Japan,
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25
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Abstract
Factors that influence low birth weight at term may also be associated with subcutaneous fat patterning in later life. This hypothesis was investigated in a comparative (retrospective) cohort study. The subjects, born in Cardiff between 1975 and 1977, were of mean age 15.7 years. Cases (low birth weight (< 2500 g) at term) were matched with controls (normal birth weight (3000-3800 g) at term) for sex, parity, place of birth, date of birth, and gestation. Subscapular skinfold (an index of central subcutaneous fat) and triceps skinfold (an index of peripheral subcutaneous fat) were measured using a Holtain skinfold caliper. The differences (cases minus controls) (95% confidence interval) for subscapular and triceps skinfolds were respectively -0.3 mm (-1.74 to 1.14) and -0.48 mm (-1.75 to 0.79). These findings are inconsistent with the hypothesis that low birth weight at term is associated with subcutaneous fat patterning in adolescence.
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Affiliation(s)
- J W Matthes
- Department of Child Health, Singleton Hospital, Swansea, West Glamorgan
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26
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Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ (CLINICAL RESEARCH ED.) 1995; 311:1401-5. [PMID: 8520275 PMCID: PMC2544423 DOI: 10.1136/bmj.311.7017.1401] [Citation(s) in RCA: 594] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To determine the frequency of cardiovascular risk factors in people categorised by previously defined "action levels" of waist circumference. DESIGN Prevalence study in a random population sample. SETTING Netherlands. SUBJECTS 2183 men and 2698 women aged 20-59 years selected at random from the civil registry of Amsterdam and Maastricht. MAIN OUTCOME MEASURES Waist circumference, waist to hip ratio, body mass index (weight (kg)/height (m2)), total plasma cholesterol concentration, high density lipoprotein cholesterol concentration, blood pressure, age, and lifestyle. RESULTS A waist circumference exceeding 94 cm in men and 80 cm in women correctly identified subjects with body mass index of > or = 25 and waist to hip ratios > or = 0.95 in men and > or = 0.80 in women with a sensitivity and specificity of > or = 96%. Men and women with at least one cardiovascular risk factor (total cholesterol > or = 6.5 mmol/l, high density lipoprotein cholesterol < or = 0.9 mmol/l, systolic blood pressure > or = 160 mm Hg, diastolic blood pressure > or = 95 mm Hg) were identified with sensitivities of 57% and 67% and specificities of 72% and 62% respectively. Compared with those with waist measurements below action levels, age and lifestyle adjusted odds ratios for having at least one risk factor were 2.2 (95% confidence interval 1.8 to 2.8) in men with a waist measurement of 94-102 cm and 1.6 (1.3 to 2.1) in women with a waist measurement of 80-88 cm. In men and women with larger waist measurements these age and lifestyle adjusted odds ratios were 4.6 (3.5 to 6.0) and 2.6 (2.0 to 3.2) respectively. CONCLUSIONS Larger waist circumference identifies people at increased cardiovascular risks.
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Affiliation(s)
- T S Han
- Department of Human Nutrition, University of Glasgow, Royal Infirmary
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27
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Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ (CLINICAL RESEARCH ED.) 1995; 311:158-61. [PMID: 7613427 PMCID: PMC2550221 DOI: 10.1136/bmj.311.6998.158] [Citation(s) in RCA: 1009] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To test the hypothesis that a single measurement, waist circumference, might be used to identify people at health risk both from being overweight and from having a central fat distribution. DESIGN A community derived random sample of men and women and a second, validation sample. SETTING North Glasgow. SUBJECT 904 men and 1014 women (first sample); 86 men and 202 women (validation sample). MAIN OUTCOME MEASURES Waist circumference, body mass index, waist:hip ratio. RESULTS Waist circumference > or = 94 cm for men and > or = 80 cm for women identified subjects with high body mass index (> or = 25 kg/m2) and those with lower body mass index but high waist:hip ratio (> or = 0.95 for men, > or = 0.80 women) with a sensitivity of > 96% and specificity > 97.5%. Waist circumference > or = 102 cm for men or > or = 88 cm for women identified subjects with body mass index > or = 30 and those with lower body mass index but high waist:hip ratio with a sensitivity of > 96% and specificity > 98%, with only about 2% of the sample being misclassified. CONCLUSIONS Waist circumference could be used in health promotion programmes to identify individuals who should seek and be offered weight management. Men with waist circumference > or = 94 cm and women with waist circumference > or = 80 cm should gain no further weight; men with waist circumference > or = 102 cm and women with waist circumference > or = 88 cm should reduce their weight.
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Affiliation(s)
- M E Lean
- Department of Human Nutrition, University of Glasgow, Royal Infirmary
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Matthes JW, Lewis PA, Davies DP, Bethel JA. Relation between birth weight at term and systolic blood pressure in adolescence. BMJ (CLINICAL RESEARCH ED.) 1994; 308:1074-7. [PMID: 8173427 PMCID: PMC2539928 DOI: 10.1136/bmj.308.6936.1074] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To examine whether birth weight is related to systolic blood pressure during adolescence. DESIGN Retrospective (comparative) cohort study. The observers who traced and studied the subjects were unaware of their case-control status. SUBJECTS 330 subjects were born in Cardiff in 1975-7. Cases who were low birth weight at term (< 2500 g) were matched with controls of normal birth weight (3000-3800 g) at term. MAIN OUTCOME MEASURES Systolic blood pressure measured by random zero sphygmomanometry in the subject's right arm with the subject supine, corrected for size and age. RESULTS The mean age at examination was 15.7 years. The mean systolic blood pressure of the cases was 105.8 mm Hg and of the controls 107.5 mm Hg. The corrected difference (95% confidence interval) in systolic blood pressure between the cases and controls was 1 mm Hg (-3 to +1 mm Hg; two tailed probability 0.33). CONCLUSION Systolic blood pressure in adolescents of low birth weight is not significantly different from that of adolescents of normal birth weights.
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Affiliation(s)
- J W Matthes
- University of Wales, College of Medicine, Heath Park, Cardiff
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DiPietro L, Ostfeld AM, Rosner GL. Adiposity and stroke among older adults of low socioeconomic status: the Chicago Stroke Study. Am J Public Health 1994; 84:14-9. [PMID: 8279605 PMCID: PMC1614896 DOI: 10.2105/ajph.84.1.14] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The purpose of this study was to test the hypothesis that overall and truncal adiposity increase the risk of stroke independent of their association with cardiovascular disease risk factors and other preexisting illnesses. METHODS Analyses were conducted of longitudinal data from a poor, biracial cohort of noninstitutionalized adults 65 to 74 years of age who participated in the Chicago Stroke Study from 1965 to 1970. RESULTS Ponderal index (cm/kg1/3) and chest skinfold were significantly associated with systolic and diastolic blood pressure, serum cholesterol and triglycerides, plasma glucose, and smoking. Ponderal index was also associated with diabetes and risk of stroke. After potential confounders were controlled, the following variables showed significant independent associations with risk of stroke: Black race, female gender, and age 70+; hypertensive heart disease; and diabetes. Neither adiposity variable was associated with risk of stroke in the presence of these powerful predictors. CONCLUSIONS Control of hypertension and diabetes continues to be important among older adults. Since excess adiposity seems to influence risk of stroke through its association with these disorders and other cardiovascular disease risk factors, control of weight and fat remains an important concern as well.
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Affiliation(s)
- L DiPietro
- School of Medicine, Department of Epidemiology and Public Health, Yale University, New Haven, Conn
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