Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America

Double burden of malnutrition and associated factors among mother-child pairs at household level in Bahir Dar City, Northwest Ethiopia: community based cross-sectional study design

Introduction

The double burden of malnutrition refers to the simultaneous presence of under nutrition and overweight, obesity, or diet-related non-communicable diseases which might occur at the population, household, and individual level. The simultaneous presence of overweight/obese mothers with undernourished children in the same household, as well as overweight children with underweight mothers, holds particular significance. This phenomenon primarily impacts low-income and middle-income countries. The prevalence of double-burden malnutrition at the household level has increased significantly in sub-Saharan African countries. However, there is limited knowledge regarding the extent and factors associated with the double burden of malnutrition among mother-child pairs in Ethiopia. Consequently, the objective of this study was to assess the prevalence and determinants of the double burden of malnutrition among mother-child pairs at the household level in Bahir Dar City, Ethiopia.

Method

In the year 2021, a community-based cross-sectional study design was employed among 702 mother-child pairs in Bahir Dar City from February 28 to March 23. A multistage sampling technique was used to identify study participants who were interviewed using an interviewer-administered questionnaire. The nutritional status of children was evaluated using WHO Anthro Software. To determine the strength of the association, multivariable logistic regression analysis was performed, and adjusted odds ratios with their respective 95% confidence intervals were computed.

Results

The prevalence of the double burden of malnutrition among mother-child pairs was 14.5% (95% CI: 12.8, 15.7%}. Participants who were in the richest wealth index were 2.72 {AOR = 2.72, 95% CI 2.01, 5.63} times more odds of double burden of malnutrition than the poorest. The odds of the double burden of malnutrition among children who had high dietary diversity decreased by 63% {AOR = 0.37, 95% CI 0.22, 0.61} than low dietary diversity. Food secure households were 1.96 {AOR = 1.96, 95% CI 1.13, 3.39} times more likely to have the double burden of malnutrition than food insecure households. The odds of the double burden of malnutrition among mothers who completed college and above decreased by 74% {AOR = 0.26 95% CI 0.121, 0.549} than those unable to read and write.

Conclusions and recommendation

The magnitude of the double burden of malnutrition was lower than the Ethiopian Demographic and Health Survey. Wealth index, dietary diversity, food security, and educational status were significantly associated with the double burden of malnutrition. Therefore, it is recommended to implement public health interventions that target the identified associated factors in order to reduce the burden of double malnutrition.

Association of Visfatin gene polymorphism with obesity related metabolic disorders among Pakistani population: a case control study

In recent years, the global prevalence of obesity and its associated metabolic disorders has reached alarming levels, presenting a significant challenge to public health worldwide. Visfatin, also known as pre-B cell colony-enhancing factor (PBEF) or nicotinamide phosphoribosyltransferase (NAMPT), is an adipokine that has been implicated in various physiological processes, including glucose homeostasis, lipid metabolism, and inflammation. The main objective of this proposed study is to find out the association between visfatin genetic variants and metabolic syndrome. The sample size of the study consisted of 300 blood samples (150 control and 150 cases). This study found that the genotypic frequency of visfatin SNPs, including rs2302559 (OD: 18.222; 95% CI 10.228-32.466; p-value < 0.001) and rs1215113036 (OD: 129.40; 95% CI 44.576-375.693; p-value < 0.001) were significantly associated with metabolic syndrome. Moreover, the frequency of the mutant alleles of both visfatin SNPs was found to be higher in patients with metabolic syndrome as compared to controls. Results of the current study indicate that people with any genetic variation of Visfatin, such as rs2302559 and rs1215113036, are more likely to develop metabolic syndrome. Visfatin genetic variants are linked to an increased risk of metabolic syndrome, implying it's role in disease pathophysiology.

Spatiotemporal evolution and characteristics of worldwide life expectancy

Exploring global differences in life expectancy can facilitate the development of strategies to narrow regional disparities. However, few researchers have systematically examined patterns in the evolution of worldwide life expectancy over a long time period. Spatial differences among 181 countries in 4 types of worldwide life expectancy patterns from 1990 to 2019 were investigated via geographic information system (GIS) analysis. The aggregation characteristics of the spatiotemporal evolution of life expectancy were revealed by local indicators of spatial association. The analysis employed spatiotemporal sequence-based kernel density estimation and explored the differences in life expectancy among regions with the Theil index. We found that the global life expectancy progress rate shows upward then downward patterns over the last 30 years. Female have higher rates of spatiotemporal progression in life expectancy than male, with less internal variation and a wider spatial aggregation. The global spatial and temporal autocorrelation of life expectancy shows a weakening trend. The difference in life expectancy between male and female is reflected in both intrinsic causes of biological differences and extrinsic causes such as environment and lifestyle habits. Investment in education pulls apart differences in life expectancy over long time series. These results provide scientific guidelines for obtaining the highest possible level of health in countries around the world.

Effects of Natural Alternative Sweeteners on Metabolic Diseases

The rising prevalence of obesity and diabetes is a significant health concern both in globally and is now regarded as a worldwide epidemic. Added sugars like sucrose and high-fructose corn syrup (HFCS) are a major concern due to their link with an increased incidence of diet-induced obesity and diabetes. The purpose of this review is to provide insight into the effects of natural sweeteners as alternatives to sucrose and HFCS, which are known to have negative impacts on metabolic diseases and to promote further research on sugar consumption with a focus on improving metabolic health. The collective evidences suggest that natural alternative sweeteners have positive impacts on various markers associated with obesity and diabetes, including body weight gain, hepatic fat accumulation, abnormal blood glucose or lipid homeostasis, and insulin resistance. Taken together, natural alternative sweeteners can be useful substitutes to decrease the risk of obesity and diabetes compared with sucrose and HFCS.

Non-traditional data sources in obesity research: a systematic review of their use in the study of obesogenic environments

BACKGROUND

The complex nature of obesity increasingly requires a comprehensive approach that includes the role of environmental factors. For understanding contextual determinants, the resources provided by technological advances could become a key factor in obesogenic environment research. This study aims to identify different sources of non-traditional data and their applications, considering the domains of obesogenic environments: physical, sociocultural, political and economic.

METHODS

We conducted a systematic search in PubMed, Scopus and LILACS databases by two independent groups of reviewers, from September to December 2021. We included those studies oriented to adult obesity research using non-traditional data sources, published in the last 5 years in English, Spanish or Portuguese. The overall reporting followed the PRISMA guidelines.

RESULTS

The initial search yielded 1583 articles, 94 articles were kept for full-text screening, and 53 studies met the eligibility criteria and were included. We extracted information about countries of origin, study design, observation units, obesity-related outcomes, environment variables, and non-traditional data sources used. Our results revealed that most of the studies originated from high-income countries (86.54%) and used geospatial data within a GIS (76.67%), social networks (16.67%), and digital devices (11.66%) as data sources. Geospatial data were the most utilised data source and mainly contributed to the study of the physical domains of obesogenic environments, followed by social networks providing data to the analysis of the sociocultural domain. A gap in the literature exploring the political domain of environments was also evident.

CONCLUSION

The disparities between countries are noticeable. Geospatial and social network data sources contributed to studying the physical and sociocultural environments, which could be a valuable complement to those traditionally used in obesity research. We propose the use of information available on the Internet, addressed by artificial intelligence-based tools, to increase the knowledge on political and economic dimensions of the obesogenic environment.

Thermoregulatory responses, heart rate, and the susceptibility to anxiety in obese animals subjected to stress

Obesity and stress are related to cardiovascular diseases. Rats fed a high-fat diet (HFD) show increased cardiovascular reactivity to emotional stress and altered defensive behavioral responses. Indeed, changes in thermoregulatory responses in an aversive environment are observed in these animals. However, studies aimed at clarifying the physiological mechanisms linking obesity, stress hyperreactivity and behavioral changes are needed. The aim of this study was to evaluate the changes in thermoregulatory responses, heart rate, and the susceptibility to anxiety in obese animals subjected to stress. Nine-week high-fat diet protocol was effective in inducing obesity by increasing weight gain, fat mass, adiposity index, white epididymal, retroperitoneal, inguinal and brown adipose tissue. Animals induced to obesity and subjected to stress (HFDS group) by the intruder animal method showed increases in heart rate (HR), core body temperature and tail temperature. HFDS showed an increase in the first exposure to the closed arm (anxiety-like behavior) in elevated T-Maze (ETM). The groups did not differ with respect to panic behavior assessed in the ETM and locomotor activity in the open field test. Our study shows that HFDS animals presented increased reactivity to stress with higher stress hyperthermia and anxious behavior. Thus, our results present relevant information regarding stress responsiveness and behavioral changes in obese animals.

Assessing Physical Activity Levels among Chinese College Students by BMI, HR, and Multi-Sensor Activity Monitors

We investigated the use of multi-sensor physical activity monitors, body mass index (BMI), and heart rate (HR) to measure energy expenditure (EE) of various physical activity levels among Chinese collegiate students, compared with portable indirect calorimetry.

METHODS

In a laboratory experiment, 100 college students, 18-25 years old, wore the SenseWear Pro3 Armband™ (SWA; BodyMedia, Inc., Pittsburg, PA, USA) and performed 7 different physical activities. EE was measured by indirect calorimetry, while body motion and accelerations were measured with an SWA accelerometer. Special attention was paid to the analysis of unidirectional and three-directional accelerometer output.

RESULTS

Seven physical activities were recorded and distinguished by SWA, and different physical activities demonstrated different data features. The mean values of acceleration ACz (longitudinal accel point, axis Z) and VM (vector magnitude) were significantly different (p = 0.000, p < 0.05) for different physical activities, whereas no significant difference was found in one single physical activity with varied speeds (p = 0.9486, p > 0.05). When all physical activities were included in a correlation regression analysis, a strong linear correlation between the EE and accelerometer reporting value was found. According to the correlation analysis, sex, BMI, HR, ACz, and VM were independent variables, and the EE algorithm model demonstrated a high correlation coefficient R² value of 0.7.

CONCLUSIONS

The predictive energy consumption model of physical activity based on multi-sensor physical activity monitors, BMI, and HR demonstrated high accuracy and can be applied to daily physical activity monitoring among Chinese collegiate students.

The metabolic syndrome and its components as prognostic factors in colorectal cancer: A meta-analysis and systematic review

BACKGROUND AND AIM

Metabolic syndrome (MetS) increases the risk of colorectal cancer (CRC), and the impact of MetS on CRC prognosis remains controversial after the diagnosis of CRC has been established. This study aimed to explore the impact of the individual components and synergies of MetS on the prognosis of patients with CRC.

METHODS

We searched articles published before August 3, 2022, in four databases, including PubMed, Embase, Cochrane Library, and ScienceDirect. The random-effects model inverse variance method was used to estimate the summarized effect size.

RESULTS

Patients with CRC with MetS were 1.342 times more likely to experience all-cause mortality than those without MetS, and the 95% confidence interval (CI) of hazard ratio (HR) was 1.107-1.627 (P = 0.003). CRC-specific mortality in patients with CRC with MetS was 2.122 times higher than in those without MetS, and the 95% CI of HR was 1.080-4.173 (P = 0.029). CRC-specific mortality exhibited an increasing trend of risk with increased metabolic risk factors. The HR of CRC-specific mortality for one, two, and three metabolic risk factors was 1.206 (95% CI, 1.034-1.407; P = 0.017), 1.881 (95% CI, 1.253-2.824; P = 0.002), and 2.327 (95% CI, 1.262-4.291; P = 0.007), respectively.

CONCLUSIONS

Metabolic syndrome increased all-cause and CRC-specific mortality in patients with CRC. As a single component of MetS, diabetes mellitus increased overall mortality in patients with CRC, while obesity increased CRC-specific mortality in patients with CRC, with a significant difference from non-MetS. Moreover, the risk of CRC-specific mortality increased with increasing number of metabolic risk factors.

A Comprehensive Review on Nutraceuticals: Therapy Support and Formulation Challenges

Nutraceuticals are the nourishing components (hybrid of nutrition and pharmaceuticals) that are biologically active and possess capability for maintaining optimal health and benefits. These products play a significant role in human health care and its endurance, most importantly for the future therapeutic development. Nutraceuticals have received recognition due to their nutritional benefits along with therapeutic effects and safety profile. Nutraceuticals are globally growing in the field of services such as health care promotion, disease reduction, etc. Various drug nutraceutical interactions have also been elaborated with various examples in this review. Several patents on nutraceuticals in agricultural applications and in various diseases have been stated in the last section of review, which confirms the exponential growth of nutraceuticals' market value. Nutraceuticals have been used not only for nutrition but also as a support therapy for the prevention and treatment of various diseases, such as to reduce side effects of cancer chemotherapy and radiotherapy. Diverse novel nanoformulation approaches tend to overcome challenges involved in formulation development of nutraceuticals. Prior information on various interactions with drugs may help in preventing any deleterious effects of nutraceuticals products. Nanotechnology also leads to the generation of micronized dietary products and other nutraceutical supplements with improved health benefits. In this review article, the latest key findings (clinical studies) on nutraceuticals that show the therapeutic action of nutraceutical's bioactive molecules on various diseases have also been discussed.

Investigaciones realizadas en Colombia relacionadas con actividad física y obesidad 2010-2020

Introducción: La obesidad es un problema de salud pública mundial. La actividad física es una herramienta importante de promoción y prevención de este problema. Se desconoce las investigaciones realizadas en Colombia al respecto, lo cual es necesario para implementar políticas públicas eficientes. Objetivo: analizar las investigaciones colombianas encontradas en bases de datos científicas sobre la actividad física y obesidad. Metodología: revisión sistemática de artículos de investigación realizados en Colombia del año 2010 al 2020, en las bases de datos PubMed y SciELO.  Resultados: de 87 artículos encontrados, 23 cumplieron los criterios de inclusión. El 91,3 % publicados en revistas indexadas internacionalmente. 69,5% estudios observacionales, 17,4% ensayos clínicos y 8,7% revisiones sistemáticas. Conclusiones: poca producción en Colombia. La mayoría en revistas indexadas, tuvieron diseño observacional y encontraron asociación entre poca actividad física con sobrepeso/obesidad. Alta prevalencia de sobrepeso/obesidad. Pocos autores fueron profesionales en el área del deporte y el entrenamiento. Introduction: Obesity is a global public health problem. Physical activity and exercise are important tools for promoting and preventing. The research carried out in Colombia in this regard is unknown, which is necessary to implement efficient public policies. Objective: to analyze Colombian research found in scientific databases on physical activity or exercise in overweight and obesity. Methodology: literary review of research articles carried out in Colombia from 2010 to 2020, in the PubMed and SciELO databases. Results: Of 87 articles found, 23 met the inclusion criteria. 91.3% published in internationally indexed journals. 69.5% observational studies, 17.4% clinical trials and 8.7% systematic reviews. Conclusions: little production in Colombia. Most of the indexed journals had an observational design and found an association between little physical activity and overweight/obesity. High prevalence of overweight/obesity. Few authors were professionals in the area of training.

The correlation of plasma atherogenic index and obesity in patients with familial Mediterranean fever

BACKGROUND

The plasma atherogenic index (PAI) is associated with cardiovascular diseases. This study evaluated the relationship between PAI and obesity in patients with familial Mediterranean fever (FMF) and its advantage over conventional lipid components in predicting obesity.

METHODS

The cross-sectional study included 164 FMF patients in the attack-free period and a control group of 160 healthy individuals. Serum lipid components were measured, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). PAI was calculated as log 10 (TG/HDL-C). The relationship between PAI, four conventional lipid profiles, and obesity was evaluated.

RESULTS

The mean PAI values (p = 0.003), frequency of obesity (p = 0.005), TC (p = 0.008), TG (p = 0.000), and LDL-C (p = 0.005) values were determined to be statistically significantly higher in the FMF patients than in the control group. The FMF patients with a higher PAI value had a higher risk of obesity, systolic and diastolic blood pressure, TC, and LDL-C, and lower HDL-C (p < 0.001). The Pearson coefficient for PAI (r = 0.854; p < 0.001) was calculated as an explanatory percentage on the variable of obesity of r² = 0.730. There was a stronger relationship between obesity and PAI than conventional lipid components (p < 0.001).

CONCLUSION

We have found that the PAI, BMI, TC, TG, and LDL-C values of the FMF patients were determined to be higher. The higher PAI was strongly correlated to obesity in FMF patients. The first time in FMF patients, PAI showed increased sensitivity to predict obesity, higher than conventional lipid components. It can be a promising biomarker for obesity compared to other lipid components. A low-cost and readily available index derived from routine (TG and HDL-C) tests are advantages in identifying obesity in FMF patients. Key Points • The PAI is valuable for atherosclerotic CVD risk management in patients with rheumatismal diseases. • A correlation is found between PAI level and obesity, and it is used as a biomarker for obesity in the healthy population. • The PAI revealed increased sensitivity to predict obesity, higher than conventional lipid components in FMF patients.

Brazilian Food Handlers' Years of Work in the Foodservice and Excess Weight: A Nationwide Cross-Sectional Study

This study aimed to evaluate the association between the years of work of food handlers in the foodservice and excess weight among Brazilian low-income food handlers. A total of 559 food handlers from all Brazilian regions were characterized using a questionnaire. Weight and height were measured to estimate the Body Mass Index and classify the individuals. The association between food handlers' years of work in the foodservice, anthropometric status, and other variables (gender, age group, educational level, participation in a government program and per capita income at home and energetic consumption) were performed using Pearson's chi-square test (p < 0.05). Multinomial logistic regression analyses were performed (p < 0.05) as well as sensitivity tests using the outcome continuously and transformed, excluding underweight individuals, in a multivariate linear regression model. Most of the sample was female (63.1%), aged between 21 and 40 years old (63.5%), and 53.3% had studied up to complete elementary school. Almost 41% of the food handlers had less than half the minimum wage per capita income. Of the evaluated individuals, 59.9% presented excess weight. There was an association with family per capita income (Odds Ratio - OR: 1.73; Confidence interval - CI95%: 1.09-2.75); handlers whose per capita income was ≤0.5 minimum wage had a 73% higher chance of obesity than those with higher income. Working in foodservive ≥3 years increased the chance of being overweight by 96% compared to those who work for <3 years (OR: 1.96; CI95%: 1.11-3.49). No significant association was found between the years of work of food handlers in the foodservice and obesity. Since work-related factors may contribute to the high prevalence of excess weight, including working in a food handling environment, the government and employers should consider workplace interventions. These would guide the food handlers in avoiding high rates of excess weight and their consequences on public health. Excess weight is an important driver of costs in the workplace associated with absenteeism, job change, and diseases. More studies are necessary to clarify the relationship between the factors related to work and the anthropometric status of food handlers since excess weight is multifactorial.

Vacunación contra SARS-CoV-2 y su relación con enfermedad y muerte por COVID-19 en Argentina

Objetivo.

Conocer la efectividad de la vacunación contra SARS-CoV-2 para prevenir el desarrollo de enfermedad y muerte por COVID-19 en Córdoba, Argentina, en el periodo enero-junio de 2021.

Métodos.

Se llevó a cabo un estudio de cohorte retrospectivo en 1 139 458 residentes en la provincia de Córdoba. Se construyeron modelos de regresión logística múltiple que relacionaron la vacunación con la infección por SARS-CoV-2 o la muerte por COVID-19, considerando comorbilidades y factores de riesgo de enfermedades crónicas y ajustando por sexo y edad.

Resultados.

El haber recibido una o dos dosis de vacuna en la población general redujo el riesgo de enfermar un 98,8% y 99,3%, respectivamente; y de morir un 83% y 96,5%, respectivamente. En quienes contrajeron COVID-19, la probabilidad de morir se redujo en 57% y 80%, respectivamente. En cuanto a la probabilidad de muerte, el riesgo aumentó a medida que aumentaba la edad y con la pertenencia al sexo masculino o la presencia de obesidad, hipertensión arterial o diabetes mellitus.

Conclusión.

La vacunación es efectiva y protege contra la posibilidad de contraer COVID-19, desarrollar enfermedad grave o morir. Presentar obesidad, hipertensión arterial o diabetes mellitus, en orden decreciente, aumentan el riesgo de morir.

Dihydromyricetin Ameliorates Inflammation-Induced Insulin Resistance via Phospholipase C-CaMKK-AMPK Signal Pathway

Patients with metabolic syndrome have a higher risk of type II diabetes and cardiovascular disease. The metabolic syndrome has become an urgent public health problem. Insulin resistance is the common pathophysiological basis of metabolic syndrome. The higher incidence of insulin resistance in obese groups is due to increased levels of inflammatory factors during obesity. Therefore, developing a therapeutic strategy for insulin resistance has great significance for the treatment of the metabolic syndrome. Dihydromyricetin, as a bioactive polyphenol, has been used for anti-inflammatory, antitumor, and improving insulin sensitivity. However, the target of DHM and molecular mechanism of DHM for preventing inflammation-induced insulin resistance is still unclear. In this study, we first confirmed the role of dihydromyricetin in inflammation-induced insulin resistance in vivo and in vitro. Then, we demonstrated that dihydromyricetin resisted inflammation-induced insulin resistance by activating Ca2+-CaMKK-AMPK using signal pathway blockers, Ca2+ probes, and immunofluorescence. Finally, we clarified that dihydromyricetin activated Ca2+-CaMKK-AMPK signaling pathway by interacting with the phospholipase C (PLC), its target protein, using drug affinity responsive target stability (DARTS) assay. Our results not only demonstrated that dihydromyricetin resisted inflammation-induced insulin resistance via the PLC-CaMKK-AMPK signal pathway but also discovered that the target protein of dihydromyricetin is the PLC. Our results provided experimental data for the development of dihydromyricetin as a functional food and new therapeutic strategies for treating or preventing PLC.

Does Organic Sprouted Whole Wheat Grain Flourless Bread Decreases DNA Damage in Diabetic Patients?

Diabetes is one of the main health concerns, especially in developed countries. During the last few decades, the percentage of diabetic persons is constantly increasing. Although the genetic factors have a strong influence in the development of diabetes, environmental influence (physical inactivity, inadequate nutrition leading to obesity) also have an important impact. The main objective of this investigation was to evaluate the possible influence of organic sprouted whole wheat grain flourless bread Tonus® (product of Trivit, Becej, Serbia) on DNA damage at various stages of progression through type 2 diabetes mellitus (T2DM). In addition to control (non-diabetic) subjects we analyzed obese, pre-diabetic and diabetic patients, for a total of four experimental groups. All subjects used to eat Mediterranean diet for at least two years before being included in our study. In each of four groups we had five persons practicing the Mediterranean diet but instead of bread they consumed flourless bread Tonus®. The DNA damage was evaluated on peripheral blood mononuclear cells by alkaline single cell gel electrophoresis (Comet) assay at the very beginning (before starting the Tonus® bread diet), and after exactly the three months of consumption of Tonus® bread. Statistical analysis revealed that only in patients with type 2 diabetes, Tonus® bread intake led to decreased DNA damage compared to the level of DNA damage of these patients before they started Tonus® bread diet. We assume that decrease of body weight and hyperinsulinemia caused by Tonus® bread in the diet might be one of the main causes of decreased DNA damage.

Optimization of change in epicardial fat thickness for obese patients who lost weight via the bariatric surgery method using central composite and Box-Behnken experimental designs

Background

The aim of this study was to detect the optimal values for Age, Body Mass Index (BMI) and HOMA-IR of obese patients prior to surgery that results in a maximal decrease of visceral fat mass 6 months after bariatric surgery.

Method

In this study, 3³ experimental set-ups were designed. This study was approved by Baskent University Medical and Health Sciences Research Board (Approval number: KA16/281). The study data consisted of 40 obese patients who lost weight through the bariatric surgery between February 2015 and December 2016. The values of BMI, Age and HOMA for the obese patients who lost weight through the bariatric surgery were evaluated in three categories and at three levels; the response variable was determined as the Change in Epicardial Fat Thickness (ΔEFT).

Results

As a result of CCD analysis, the optimum ΔEFT = 2.571 was determined when Age = 30.52, BMI = 45.30, and HOMA = 34.62. As a result of the BBD analysis, the optimum ΔEFT = 3.756 was determined, when Age = 38.36, BMI = 63.18, and HOMA = 14.95. The optimum ΔEFT was modeled with Contour and Response Surface plots.

Conclusion

Based on the two surface response models used in our study, the maximal decrease of visceral fat mass as assessed by measuring echography images of epicardial fat thickness can be obtained by bariatric surgery of persons who are between 31 and 38 year old, have a BMI between 45 and 63 kg/m2 and have a HOMA-IR 34 between 15 and 35. Central Composite Design and a Box-Behnken Design of suitable patient data predicted 35 optimal settings of independent variables for the maximal clinical response of an intervention.

Development and Validation of the General Dietary Behavior Inventory (GDBI) in Scope of International Nutrition Guidelines

Unhealthy eating is associated with various diseases, such as cardiovascular, neurodegenerative, or oncological. There are neither economical nor behavior-related questionnaires available in the German language to assess general dietary behavior. Therefore, the aim of this validation study was to develop an instrument considering these aspects and verifying its construct and criterion validity. The new questionnaire is based on the general nutrition recommendations of the World Health Organization and the German Nutrition Society. It consists of 16 items that contrast dietary behaviors on a semantic differential scale. Our German-speaking convenience sample consisted of 428 participants. The construct validity of the General Dietary Behavior Inventory (GDBI) could be confirmed by examining convergent and discriminant validity. Furthermore, criterion validity was confirmed (significant negative correlations with body weight, Body Mass Index, and positive correlations with physical/mental health as well as life satisfaction). A cluster analysis revealed two different dietary behavior clusters representing a rather healthy and a rather unhealthy dietary behavior cluster. The results indicate that the GDBI is a validated and economical instrument to assess general dietary behavior. In practical research, this questionnaire helps to assess dietary behavior and to derive interventions for a healthy dietary behavior in concordance with international nutrition recommendations.

Adenovirus-36 as one of the causes of obesity: the review of the pathophysiology

The dramatic increase of people affected by obesity worldwide seems to be influenced by external factors independent of eating habits, physical exercise, or genetic characteristics. There may be a number of such factors, but one hypothesis is that there is person-to-person transmission, causing an epidemic effect, as occurs with infectious diseases. In animal models, experimental infection with human adenovirus-36 (Adv36) causes obesity. Humans cannot be experimentally infected, but a number of studies found a correlation of positive serology for Adv36 with overweight/obesity in humans. In vitro studies have shown that Adv36 accelerates the differentiation and proliferation of preadipocytes into adipocytes and increases their lipid concentration. Another viral mechanism involved is the activation of a noninsulin-dependent process that increases glucose uptake, mainly in adipose tissue and muscle. The increased glucose, coupled with increased lipogenesis due to increased fatty acid synthase and the action of peroxisome proliferator-activated receptor gamma (PPAR-gamma) in stimulating adipocyte differentiation from adult stem cells enhances fat accumulation within the adipocytes. In studies conducted to date, the Adv36 E4 open reading frame 1 gene (E4orf1), which activates the glucose transporter protein isoform 4 (GLUT4) and glucose transporter protein isoform 1 (GLUT1) glucose transporters, appears to play a major role in the virus adipogenesis. The aim of this study was to review the pathophysiology of obesity and the role of Adv36.

Diet and sedentary behaviour in relation to cancer survival. A report from the national health and nutrition examination survey linked to the U.S. mortality registry

BACKGROUND & AIMS

Cancer is the second most common chronic disease and cause of death in the United States. Our aim was to evaluate the associations of sedentary behavior and nutrient intakes with total and cancer-specific mortality among US cancer survivors.

METHODS

Data from 2371 cancer survivors collected by the US National Health and Nutrition Examination Survey between 1999 and 2014 were linked to the US mortality registry. Multivariable adjusted Cox proportional hazard models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for all-cause and cancer-specific mortality associated with sedentary time and nutrient intakes. The interaction between time spent on sedentary activities and nutrient intake was evaluated on additive and multiplicative scales.

RESULTS

During a median observational period of 5.7 years, 532 total deaths occurred among cancer survivors, of which 180 were cancer-specific. A monotonic increasing linear relationship between time spent sitting and all-cause mortality was observed (HR = 1.15, 95% CI = 1.03, 1.28 per one standard deviation increment). The highest versus the lowest tertiles of intakes of dietary fiber, carotene, niacin, thiamine, riboflavin, vitamin B6, vitamin B12, and vitamin C were inversely associated with all-cause and cancer-specific mortality (HRs = 0.48 to 0.75). The inverse associations with all-cause mortality were more pronounced for combinations of low sedentary behaviour and high intakes of dietary fiber, carotenoids, vitamin B12, and vitamin C.

CONCLUSION

Our findings support recommendations for cancer survivors to reduce time spent sedentary and to follow a balanced diet with adequate intakes of dietary fiber and micronutrients.

The Inflammatory Potential of Diet is Associated with Breast Cancer Risk in Urban Argentina: A Multilevel Analysis

Dietary patterns have been associated with breast cancer (BC) in Argentina. However, little evidence exists relating the inflammatory potential of diet and BC in Latin American countries and how this may relate to rurality.The aim of the present study was to evaluate the association between the Dietary Inflammatory Index (DII^®) and BC considering urbanization contexts in Córdoba, Argentina.A frequency-matched case-control study (317 BC cases, 526 controls) was conducted from 2008 through 2016. DII scores were computed based on dietary intake assessed by a validated food frequency questionnaire. Multi-level logistic regression models were fit to evaluate the association between DII and BC, following adjustment for age, body mass index, age at menarche, number of children, smoking habits, socio-economic status and family history of BC as first-level covariates and urbanization level as the contextual variable.Increasing DII score showed significant positive associations with BC risk (OR_{tertile3vs.tertile1} 1.34; 95%CI 1.05, 1.70). The association was stronger in overweight and obese women (OR_{tertile3vs.tertile1} 1.98; 95%CI 1.86, 2.10). The DII effect on BC was higher with increased urbanization.A pro-inflammatory diet, reflected by higher DII scores, was positively associated with BC, especially in overweight women and with increased urbanization.

Intervention with kimchi microbial community ameliorates obesity by regulating gut microbiota

The objective of this study was to evaluate anti-obesity effects of kimchi microbial community (KMC) on obesity and gut microbiota using a high fat diet-induced mouse model compared to effects of a single strain. Administration of KMC decreased body weight, adipose tissue, and liver weight gains. Relative content of Muribaculaceae in the gut of the KMC-treated group was higher than that in the high-fat diet (HFD) group whereas relative contents of Akkermansiaceae, Coriobacteriaceae, and Erysipelotrichaceae were lower in KMC-treated group. Metabolic profile of blood was found to change differently according to the administration of KMC and a single strain of Lactobacillus plantarum. Serum metabolites significantly increased in the HFD group but decreased in the KMC-treated group included arachidic acid, stearic acid, fumaric acid, and glucose, suggesting that the administration of KMC could influence energy metabolism. The main genus in KMC was not detected in guts of mice in KMC-treated group. Since the use of KMC has advantages in terms of safety, it has potential to improve gut microbial community for obese people.

Prevalence of Metabolic Syndrome by different definitions, and its association with type 2 diabetes, pre-diabetes, and cardiovascular disease risk in Brazil

BACKGROUND AND AIMS

Metabolic Syndrome (MS) is increasing in developing countries. Different definitions of MS lead to discrepancies in prevalence estimates and applicability. We assessed the prevalence of MS as defined by the International Diabetes Federation (IDF), modified National Cholesterol Education Program Adult Treatment Plan III (Modified NCEP) and Joint Interim Statement (JIS); compared the diagnostic performance and association of these definitions of MS with pre-diabetes, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk.

METHODS

A total of 714 randomly selected subjects from Northeastern Brazil were investigated in a cross-sectional study. Sociodemographic, anthropometric, and clinical data were recorded. Diagnostic test performance measures assessed the ability of the different MS definitions to identify those with pre-diabetes, T2DM and increased CVD risk.

RESULTS

The adjusted prevalence of MS was 36.1% applying the JIS criteria, 35.1% the IDF and 29.5% Modified NCEP. Women were more affected by MS according to all definitions. MS was significantly associated with pre-diabetes, T2DM and CVD risk following the three definitions. However, the JIS and IDF definitions showed higher sensitivity than the Modified NCEP to identify pre-diabetes, T2DM and CVD risk. The odds ratios for those conditions were not significantly different when comparing the definitions.

CONCLUSIONS

MS is highly prevalent in Brazil, particularly among those with pre-diabetes, T2DM, and high CVD risk. The IDF and JIS criteria may be better suited in the Brazilian population to identify pre-diabetes, T2DM and CVD risk. This may also signify the importance of the assessment of MS in clinical practice.

Prevalence of stunting and obesity in Ecuador: a systematic review

OBJECTIVE

In low- and middle-income countries, undernutrition remains a major risk factor for child growth retardation. In addition, the emergence of obesity in recent years is adding another public health concern in that both stunting and obesity are associated with serious adverse health consequences. This review was designed to evaluate the prevalence of stunting and obesity in Ecuador.

DESIGN

Electronic databases were searched for articles published through February 2018 reporting the prevalence of stunting and/or obesity. Selected data were subjected to meta-analysis and pooled prevalence and their 95 percentiles (95 % CI) were calculated.

SETTING

Studies were identified in Medline, Web of Science, CINAHL, Cochrane Database and Ibero-America databases.

PARTICIPANTS

Population of Ecuador.

RESULTS

Twenty-three articles were selected according to the inclusion/exclusion criteria of the study. The estimate of pooled prevalence of stunting was 23·2 % (95 % CI 23·3, 23·5) in preschoolers (age < 5 years), but was markedly higher in indigenous and rural communities. Pooled prevalence of obesity was 8·1 % (95 % CI 6·9, 9·3), 10·7 % (95 % CI 9·6, 11·7) and 10·5 % (95 % CI 9·2, 11·8) in preschoolers, school-age children (age: 5-11 years) and adolescent (age: 12-18 years), respectively. In adults (age ≥ 19 years), the rate of obesity was remarkably high as indicated by an overall estimate equal to 44·2 % (95 % CI 43·1, 45·4).

CONCLUSIONS

This study underlines high levels of stunting among children and obesity among adults in Ecuador, both of which are not equally distributed among the population. The magnitude of this double burden emphasises the need for sustained and targeted interventions.

A cardiovascular disease risk factor in children with congenital heart disease: unmasking elevated waist circumference - a CHAMPS* study *CHAMPS: Children's Healthy-Heart Activity Monitoring Program in Saskatchewan

BACKGROUND

Children with congenital heart disease (CHD) have an elevated risk of future cardiovascular disease but the underlying mechanisms are unclear. Abdominal obesity (measured as waist circumference) is a risk factor for adult onset of cardiovascular diseases and is correlated with low physical activity levels, commonly found in children with congenital heart disease. Elevated waist circumference may be a mechanism by which cardiovascular disease risk is elevated in children with CHD. The purpose of this study was to compare waist circumference between children with and without CHD, while considering potential confounders. We hypothesized that children with CHD would have higher measures of waist circumference when controlling for differences in birthweight, lean mass, and physical activity.

METHODS

Thirty-two children with CHD (10.9 ± 2.6 years; 12 female) from the Children's Healthy-Heart Activity Monitoring Program in Saskatchewan, and 23 healthy controls (11.7 ± 2.5 years; 10 female) were studied. Waist circumference, physical activity (physical activity questionnaire), body composition (lean mass; dual x-ray absorptiometry), and birthweight were assessed. Analysis of covariance, Mann-Whitney U, and independent sample t-tests were used to assess group differences (p < 0.05).

RESULTS

Children with CHD had greater waist circumference than controls, controlling for lean mass, physical activity, birthweight, and sex (F (1, 49) = 4.488, p = 0.039). Physical activity, lean mass, and birthweight were not significantly different between groups (p > 0.05).

CONCLUSION

Our findings generate a novel hypothesis-higher waist circumferences in children with CHD compared to age-matched controls, may contribute to an elevated risk of cardiovascular disease.

Metabolic syndrome agravates cardiovascular, oxidative and inflammatory dysfunction during the acute phase of Trypanosoma cruzi infection in mice

We evaluated the influence of metabolic syndrome (MS) on acute Trypanosoma cruzi infection. Obese Swiss mice, 70 days of age, were subjected to intraperitoneal infection with 5 × 102 trypomastigotes of the Y strain. Cardiovascular, oxidative, inflammatory, and metabolic parameters were evaluated in infected and non-infected mice. We observed higher parasitaemia in the infected obese group (IOG) than in the infected control group (ICG) 13 and 15 days post-infection. All IOG animals died by 19 days post-infection (dpi), whereas 87.5% of the ICG survived to 30 days. Increased plasma nitrite levels in adipose tissue and the aorta were observed in the IOG. Higher INF-γ and MCP-1 concentrations and lower IL-10 concentrations were observed in the IOG compared to those in the ICG. Decreased insulin sensitivity was observed in obese animals, which was accentuated after infection. Higher parasitic loads were found in adipose and hepatic tissue, and increases in oxidative stress in cardiac, hepatic, and adipose tissues were characteristics of the IOG group. Thus, MS exacerbates experimental Chagas disease, resulting in greater damage and decreased survival in infected animals, and might be a warning sign that MS can influence other pathologies.

Effect of Diet on the Gut Microbiota Associated with Obesity

Obesity is abnormal or excessive fat accumulation that is associated with progression of metabolic diseases including type 2 diabetes mellitus, cardiovascular disease, nonalcoholic fatty liver disease, and cancer. Gut microbiota (GM) have received much attention as essential factors in development and progression of obesity. The diversity, composition, and metabolic activity of GM are closely associated with nutrient intake and dietary pattern. Scientific evidence supports the idea that dietary pattern directly changes the GM profile; therefore, diet is a crucial component related to interactions between GM and obesity progression. A literature review showed that dietary factors such as probiotics, prebiotics, fat, fatty acids, and fiber dramatically alter the GM profile related to obesity. Furthermore, different dietary patterns result in different GM composition and activity that can contribute to amelioration of obesity.

Metabolic Syndrome Among Primary Health Care Nursing Professionals: A Cross-Sectional Population-Based Study

This research aims at evaluating prevalence and factors associated with metabolic syndrome (MS) in primary health care (PHC) nursing professionals. A multicenter, population-based and cross-sectional study was conducted in a team-tested sample of 1125 PHC nurses in the state of Bahia, Brazil. Sociodemographic, labor, lifestyle and human biology variables were investigated by mean of anamnesis. MS was evaluated according to the criteria of the first Brazilian Guideline for Metabolic Syndrome, which fully adopts the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. MS-associated factors were tested by using robust Poisson Regression. The prevalence of MS found was 24.4%; low High Density Lipoprotein (HDL) cholesterol was the most prevalent component of the syndrome. In the multivariate analysis, physical inactivity (PR = 1.25, 95% CI = 1.02-1.53), alcohol use (PR = 1.84, 95% CI = 1.22-2.77), acanthosis nigricans (PR = 3.23, 95% CI = 2.65-3.92), burnout syndrome (PR = 1.45, 95% CI = 1.17-1.81), (PR = 1.37, 95% CI = 1.12-1.69), working as a nursing technician (PR = 1.43, 95% CI = 1.14-1.80), were associated to MS. It was found that the prevalence of MS was high, which evidences the need for interventions in the PHC environment, improvement of working conditions, monitoring of worker safety and health, diet programs and physical activity.

Using A Body Shape Index (ABSI) and Body Roundness Index (BRI) to predict risk of metabolic syndrome in Peruvian adults

Objective

We examined the ability of anthropometric measures to predict the risk of metabolic syndrome (MetS) and its components in Peruvian adults.

Methods

Participants were 1,815 Peruvian adults. Body mass index (BMI), waist circumference (WC), A Body Shape Index (ABSI), Body Roundness Index (BRI) and Visceral Adiposity Index were examined. MetS components were defined using the National Cholesterol Education Program’s Adult Treatment Panel III. Logistic regression was used to calculate odds ratios of MetS and MetS components in relation to increases in anthropometric measures. Receiver operating characteristic curves (and area under the curve) were calculated to compare each measure’s power to predict MetS and MetS components.

Results

BRI performed similar to or better than BMI and WC at predicting MetS and MetS components. ABSI underperformed other measures. In men, the odds of MetS and its components increased with unit increases in the anthropometric measures (e.g. a unit increase in BRI was associated with 2.43-fold increased odds of MetS; 95% confidence interval [CI]: 1.95–3.02). A similar association was found for women (odds ratio: 1.89; 95% CI: 1.68–2.12).

Conclusion

Our study is the first to identify BRI as a potentially useful clinical predictor of MetS in Peruvian adults.

B-vitamins and body composition: integrating observational and experimental evidence from the B-PROOF study

Purpose

Higher folate and vitamin-B12 have been linked to lower risk of overweight. However, whether this is a causal effect of these B-vitamins on obesity risk remains unclear and evidence in older individuals is scarce. This study aimed to assess the role of B-vitamin supplementation and levels on body composition in older individuals.

Methods

A double-blind, randomized controlled trial in 2919 participants aged ≥ 65 years with elevated homocysteine levels. The intervention comprised a 2-year supplementation with a combination of folic acid (400 µg) and vitamin B12 (500 µg), or with placebo. Serum folate, vitamin-B12, active vitamin-B12 (HoloTC), methylmalonic acid (MMA), and anthropometrics were measured at baseline and after 2 years of follow-up. Dietary intake of folate and vitamin-B12 was measured at baseline in a subsample (n = 603) using a validated food-frequency questionnaire. Fat mass index (FMI) and fat-free mass index (FFMI) were assessed with Dual Energy X-ray absorptiometry (DXA).

Results

Cross-sectional analyses showed that a 1 nmol/L higher serum folate was associated with a 0.021 kg/m² lower BMI (95% CI − 0.039; − 0.004). Higher HoloTC (per pmol/L log-transformed) was associated with a 0.955 kg/m² higher FMI (95% CI 0.262; 1.647), and higher MMA (per μgmol/L) was associated with a 1.108 kg/m² lower FMI (95% CI − 1.899; − 0.316). However, random allocation of B-vitamins did not have a significant effect on changes in BMI, FMI or FFMI during 2 years of intervention.

Conclusions

Although observational data suggested that folate and vitamin B12 status are associated with body composition, random allocation of a supplement with both B-vitamins combined versus placebo did not confirm an effect on BMI or body composition.

Electronic supplementary material

The online version of this article (10.1007/s00394-019-01985-8) contains supplementary material, which is available to authorized users.

Nutrition transition profiles and obesity burden in Argentina

Objective

The present study aimed to identify nutrition transition (NT) profiles in Argentina (2005–2013) and assess their association with obesity in the adult population.

Design

A large cross-sectional study was performed considering data sets of nationally representative surveys. A multiple correspondence analysis coupled with hierarchical clustering was conducted to detect geographical clusters of association among sociodemographic and NT indicators. Multilevel logistic regression models were used to assess the effect of NT profile (proxy variable of contextual order) on obesity occurrence.

Setting

First, we used geographically aggregated data about the adult and child populations in Argentina. Second, we defined the population of adults who participated in the National Survey of Chronic Disease Risk Factors (2013) as the study population.

Participants

Twenty-four geographical units that make up the territory of Argentina and 32 365 individuals over 18 years old living in towns of at least 5000 people.

Results

Three NT profiles were identified: ‘Socionutritional lag’ (characterized by undernutrition and socio-economically disadvantaged conditions; profile 1); ‘Double burden of malnutrition’ (undernutrition and overweight in highly urbanized scenarios; profile 2); and ‘Incipient socionutritional improvement’ (low prevalence of malnutrition and more favourable poverty indicator values; profile 3). Profiles 1 and 2 were significantly associated (OR; 95 % CI) with a higher risk of obesity occurrence in adults (1·17; 1·02, 1·32 and 1·44; 1·26, 1·64, respectively) compared with profile 3.

Conclusions

Argentina is facing different NT processes, where sociodemographic factors play a major role in shaping diverse NT profiles. Most of the identified profiles were linked to obesity burden in adults.

Obesity Indices in relation to Lipid Abnormalities among Medical University Students in Zahedan, South-East of Iran

Background:

There is no statement on the ability of obesity indices in prediction of lipid abnormalities among young adults. The present study was conducted to determine the ability of obesity indices as predictors of lipid abnormalities among a group of young adults.

Materials and Methods:

A total of 353 medical university students aged 18–25 years (188 males and 165 females) participated in this cross-sectional study in 2014. Weight, height, waist circumference (WC), and hip circumference were measured to calculate obesity indices including body mass index (BMI), waist-to-hip ratio, and waist-to-height ratio (WHtR). Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured by commercially available kits and were applied to calculate low-density lipoprotein cholesterol (LDL-C) and atherogenic parameters including LDL-C/ HDL-C ratio, TC/HDL-C ratio, non-HDL-C, and atherogenic index of plasma (AIP).

Results:

Subjects with BMI ≥25 kg/m² had a greater value of all lipid profiles and atherogenic parameters (P < 0.05) except for HDL-C (P > 0.05) compared to subjects with BMI <25 kg/m². In logistic regression model, BMI ≥25 kg/m² was significantly associated with the highest odds for elevated TC (odds ratio [OR] = 7.67, P = 0.003), LDL-C (OR = 3.24, P = 0.01), TC:HDL-C (OR = 4.98, P = 0.01), and non-HDL-C(OR = 4.32, P = 0.001) in males, as well as high values of TG (OR = 8.80, P = 0.002), LDL-C:HDL-C (OR = 3.64, P = 0.01), and AIP (OR = 9.65, P < 0.001) in females. In terms of central obesity indices, males with WC ≥102 cm and females with WC ≥88 cm had the highest odds of increased LDL-C:HDL-C (OR = 6.71, P = 0.01) and TC:HDL-C (OR = 3.25, P = 0.050), respectively. In addition, females with WHtR ≥0.50 had the highest odds of high TC (OR = 3.56, P = 0.02) and non-HDL-C (OR = 2.70, P = 0.02).

Conclusions:

Overall, the findings of the present study showed that BMI was a stronger index for prediction of classical lipid parameters and atherogenic parameters than central obesity indices in medical students.

Normal weight obesity and physical fitness in Chinese university students: an overlooked association

BACKGROUND

The primary aim of this study was to examine the associations of normal weight obesity (NWO) with physical fitness in Chinese university students. As a secondary aim, we assessed whether possible differences in physical fitness between students classified as NWO and normal weight non-obese (NWNO) were mediated by skeletal muscles mass.

METHODS

A total of 383 students (205 males and 178 females, aged 18-24 years) from two universities volunteered to participate in this study. Body height and weight were measured by standard procedures and body composition was assessed by bio-impedance analysis (InBody 720). NWO was defined by a BMI of 18.5-23.9 kg/m2 and a body fat percentage of > 20% or > 30% in male and female students, respectively. Physical fitness was measured using a 10-min intermittent endurance running test (Andersen test), countermovement jumps (CMJ) and a 5 × 5 m shuttle run test (5mSR). The level of leisure time physical activity (PA) was assessed by a questionnaire.

RESULTS

13.7% of male and 27.5% of female students were classified as NWO. Compared to NWNO, students classified as NWO showed a significantly poorer performance in the Andersen test (males: 1146 ± 70 m vs. 1046 ± 95 m, females: 968 ± 61 m vs. 907 ± 67 m, p < 0.001), CMJ (males: 55.0 ± 7.6 cm vs. 44.9 ± 7.5 cm, females: 39.8 ± 8.0 cm vs. 33.7 ± 5.9 cm, p < 0.001) and 5mSR (males: 18.7 ± 1.0 s vs. 20.0 ± 0.9 s, females: 21.1 ± 1.1 s vs. 22.4 ± 1.3 s, p < 0.001), respectively. The lower levels of physical fitness in NWO were partially explained by lower skeletal muscle mass (p < 0.001) both in male and female students.

CONCLUSIONS

NWO was associated with poorer physical fitness and the relationship was partially mediated by lower skeletal muscle mass. The study indicated that attention should be paid for the potential hidden health risk in university students with normal body mass index but excessive fat mass.

Evaluación antropométrica y composición corporal por medio de óxido de deuterio en escolares costarricenses

El objetivo del estudio fue determinar elestado nutricional de escolares costarricenses de seis a nueve años. Participaron 103 escolares (54 niños y 49 niñas) con un promedio de edad de 7,8 ± 0,9 años. Se evaluó peso, talla, talla sentado, circunferencia de cintura (CC), índice de masa corporal (IMC), índice córmico (IC) y relación cintura-talla (IC/T). Se utilizó el óxido de deuterio (D2O) para evaluar la composición corporal: % agua corporal total (% ACT), masa libre de grasa (MLG), masa grasa (MG) y % de grasa corporal (% GC). El sobrepeso/obesidad se determinó utilizando el IMC y el método de clasificación de McCarthy para % GC de acuerdo a sexo y edad. Los valores medios para niños y niñas fueron: peso (29,1 ± 7,2 vs 31,0 ± 6,7 kg), talla (124.7 ± 6.7 vs 127.5 ± 7.1 cm), talla sentado (64.4 ± 3.7 vs 65.6 ± 3.5 cm), IMC (18.5 ± 3.11 vs 18.9 ± 2.7 kg/m2), CC (62.1 ± 8.6 vs 63.8±7.8 cm), IC (51.6 ± 1.6 vs 51.5 ± 1.6), I.C/T (0.52 ± 0.1 vs 0.51 ± 0.1), % ACT (56.5 ± 5.7 vs 51.9 ± 4.5 %), MLG (21.0 ± 3.5 vs 20.5 ± 3.6 kg), MG (8.1 ± 4.2 vs 10.5 ± 3.6 kg), % GC (26.3 ± 7.3 vs 33.2 ± 5.7 %), respectivamente. La edad, talla, MG, % GC y % ACT fueron significativamente mayores (p<0.05) en las niñas. Los escolares presentan un crecimiento adecuado junto a una alta prevalencia de sobrepeso/obesidad.

Prevalence and Factors Associated with Metabolic Syndrome among Brazilian Adult Population: National Health Survey - 2013

Background

In Brazil, population-based researches analyzing prevalence and factors associated with metabolic syndrome (MS), a recognized predictor of cardiovascular diseases (CVD), and an important cause of disability and death in the country are scarce.

Objective

To evaluate prevalence of MS and its associated factors in Brazilian population.

Methods

Secondary analysis of the 2013 National Health Survey, a cross-sectional survey with national representativeness of Brazilian adult population (n = 59,402). MS was the outcome variable, defined from harmonization of cardiology international consensus as load ≥ 3 of the following components: self-reported diabetes and hypercholesterolemia, high blood pressure and high waist circumference. Analysis were stratified by sex and prevalence ratios, with their respective 99% confidence intervals (PR [CI 99%]) calculated by simple and multiple Poisson regression models.

Results

MS prevalence was 8.9%, being significantly higher among women compared to men; in general, this pattern was maintained in relation to exposure variables studied. Additionally, less than 25% of population did not present any MS component. In final multiple models, sociodemographic, behavioral and comorbidity variables were associated with MS, however, while low schooling (1.46 [1.23-1.74], cerebrovascular accident (1.36 [1], 00] (1.28 [1.03-1.62]) were associated among women, chronic renal failure (1.85 [2.23-2.76]) was associated exclusively among men.

Conclusion

We identified MS high prevalence in Brazilian population; on the other hand, factors associated with this condition were different depending on sex.

Impact of weight-related advice from healthcare professionals on body mass index of patients in the USA

OBJECTIVES

Healthcare professionals (HCPs) can help promote healthy eating and active living in patients. This study assessed the effects of weight-related advice from HCPs on change in body mass index (BMI) of patients in the USA.

STUDY DESIGN

A 1-year follow-up study of 20,002 adults who participated in a nationally representative survey between 2004 and 2008.

METHODS

Using the 2004-2008 Medical Expenditure Panel Survey data, 1-year BMI and weight status changes were compared between patients who did and did not report receiving advice on exercise or on restricted intake of fat and cholesterol from their HCPs.

RESULTS

Patients who received weight-related advice had a greater increase in BMI compared with those who did not receive weight-related advice. Stratified by the baseline weight status of patients (i.e. normal weight, overweight or obese), adverse direction of BMI change was only significantly associated with advice on exercise. Patients who received advice to exercise more were more likely to move to a higher weight status than remaining at the same weight status, compared with patients who did not receive advice to exercise more.

CONCLUSION

This study did not find that weight-related advice from HCPs had a positive impact on BMI loss in patients. On the contrary, patients who reported receiving weight-related advice from HCPs had worse weight outcomes 1 year later than patients who did not report receiving weight-related advice. Further research is warranted to elucidate the role of weight-related advice from HCPs on lifestyle change and obesity prevention and control.

Inhibition of dipeptidyl peptidase IV prevents high fat diet-induced liver cancer angiogenesis by downregulating chemokine ligand 2

Obesity is a major risk factor for hepatocellular carcinoma (HCC) and is typically accompanied by higher levels of serum dipeptidyl peptidase 4 (DPP4). However, the role of DPP4 in obesity-promoted HCC is unclear. Here, we found that consumption of a high-fat diet (HFD) promoted HCC cell proliferation and metastasis and led to poor survival in a carcinogen-induced model of HCC in rats. Notably, genetic ablation of DPP4 or treatment with a DPP4 inhibitor (vildagliptin) prevented HFD-induced HCC. Moreover, HFD-induced DPP4 activity facilitated angiogenesis and cancer cell metastasis in vitro and in vivo, and vildagliptin prevented tumor progression by mediating the pro-angiogenic role of chemokine ligand 2 (CCL2). Loss of DPP4 effectively reversed HFD-induced CCL2 production and angiogenesis, indicating that the DPP4/CCL2/angiogenesis cascade had key roles in HFD-associated HCC progression. Furthermore, concomitant changes in serum DPP4 and CCL2 were observed in 210 patients with HCC, and high serum DPP4 activity was associated with poor clinical prognosis. These results revealed a link between obesity-related high serum DPP4 activity and HCC progression. Inhibition of DPP4 may represent a novel therapeutic intervention for patients with HCC.

Physical exercise programs at Basic Healthcare Units decrease body fat and improve the functional capacity of women over 50 years old

This study verified the effects of a physical exercise program performed at Basic Healthcare Units on the body composition and functional capacity of women over 50 years old and to compare these variables according to age. Forty-eight women (age, 65.4±7.3 years) were assessed. The program lasted 20 weeks, and was conducted 2 times per week, 60 min/day. Body mass and height were collected and body mass index (BMI) was calculated. Bioelectrical impedance was used to estimate fat mass and fat free mass. Functional capacities: handgrip test, Timed Up and Go (TUG) test, and Guralnick test were assessment. Weight (68.7±12.5 [pre]×66.8±12.5 [post], P<0.001), BMI (28.5±4.1 kg/m² [pre]×27.6±4.0 kg/m² [post], P<0.001), and fat mass (28.4±7.8 kg [pre]×26.4±7.3 kg [post], P<0.001) were decreased. For functional capacity, handgrip (21.2±5.8 kg [pre]×22.9±6.9 kg [post], P=0.014), lower limb strength (12.0±3.0 sec [pre]×8.5±2.2 sec [post], P<0.001), TUG (8.4±1.5 sec [pre]×7.6±1.1 se [post], P<0.001) and Guralnik tests (10.6±1.6 [pre]×11.8±0.5 [post], P<0.001) were improved. 20 weeks of exercise program performed at Basic Healthcare Units decreased body fat and improvement of functional capacity of women over 50 years old and there was difference according to age only on the body composition variables.

A prospective appraisal of preoperative body mass index in D2-resected patients with non-metastatic gastric carcinoma and Siewert type II/III adenocarcinoma of esophagogastric junction: results from a large-scale cohort

Objective

To prospectively investigate associations of presurgical body mass index (BMI) with clinicopathological factors and its prognostic significance in radically D2-resected patients with non-metastasized gastric cancer (GC) and Siewert type II/III adenocarcinoma of esophagogastric junction (AEG).

Methods

A large prospective cohort consisting of radically-resected GC and AEG patients was analyzed. Follow-up was successful in 671 out of 700 patients, who were categorized into underweight (BMI<18.5), normal-weight (BMI=18.5-22.9), overweight (BMI=23-24.9), and obese (BMI≥25) groups according to Asian standards. BMI-associated factors were explored using multivariable logistic regression with adjustment. Cancer-specific survival analyses were conducted applying both univariable and multivariable Cox regression methods.

Results

Pre-operation, higher hemoglobin levels and smaller anemia proportions were observed in larger BMI groups. Higher BMI tended to be associated with higher neutrophil-lymphocyte ratios (NLRs). Patients with higher BMI had smaller tumors and more often stage I tumors, but longer surgical time and postsurgical stay. In multivariable analyses, higher hemoglobin levels, upper tumor location, poorer differentiation, and higher NLR were significantly associated with higher BMI. Overall, survival analyses revealed no significant role of BMI. However, in further stratifications after adjustment, compared to patients with normal BMI, obese patients had better survival in women, but worse in those with AEG; underweight was associated with reduced mortality risk in tumors differentiated well to moderately; overweight patients had increased death hazard when having thrombocytopenia.

Conclusion

Overall, preoperative BMI had limited prognostic significance in operated GC patients. However, under specific conditions (e.g., female, AEG, good differentiation, and thrombocytopenia), BMI might indicate postoperative survival.

A population-based national estimate of the prevalence and risk factors associated with hypertension in Rwanda: implications for prevention and control

BACKGROUND

Hypertension is a leading cause of cardiovascular diseases and a growing public health problem in many developed and developing countries. However, population-based data to inform policy development are scarce in Rwanda. This nationally representative study aimed to determine population-based estimates of the prevalence and risk factors associated with hypertension in Rwanda.

METHODS

We conducted secondary epidemiological analysis of data collected from a cross-sectional population-based study to assess the risk factors for NCDs using the WHO STEPwise approach to Surveillance of non-communicable diseases (STEPS). Adjusted odds ratios at 95% confidence interval were used to establish association between hypertension, socio-demographic characteristics and health risk behaviors.

RESULTS

Of the 7116 study participants, 62.8% were females and 38.2% were males. The mean age of study participants was 35.3 years (SD 12.5). The overall prevalence of hypertension was 15.3% (16.4% for males and 14.4% for females). Twenty two percent of hypertensive participants were previously diagnosed. A logistic regression model revealed that age (AOR: 8.02, 95% CI: 5.63-11.42, p < 0.001), living in semi-urban area (AOR: 1.30, 95% CI: 1.01-1.67, p = 0.040) alcohol consumption (AOR: 1.24, 95% CI: 1.05-1.44, p = 0.009) and, raised BMI (AOR: 3.93, 95% CI: 2.54-6.08, p < 0.001) were significantly associated with hypertension. The risk of having hypertension was 2 times higher among obese respondents (AOR: 3.93, 95% CI: 2.54-6.08, p-value < 0.001) compared to those with normal BMI (AOR: 1.74, 95% CI: 1.30-2.32, p-value < 0.001). Females (AOR: 0.75, 95% CI: 0.63-0.88, p < 0.001) and students (AOR: 0.45, 95% CI: 0.25-0.80, p = 0.007) were less likely to be hypertensive.

CONCLUSION

The findings of this study indicate that the prevalence of hypertension is high in Rwanda, suggesting the need for prevention and control interventions aimed at decreasing the incidence taking into consideration the risk factors documented in this and other similar studies.

[Metabolic syndrome in public service drivers in Armenia, Colombia]

OBJECTIVE

To characterize and compare the population of public service drivers of a transport company in Armenia, Colombia.

MATERIALS AND METHODS

Taxi and bus drivers from a transport company of Armenia, Colombia participated in an Analytical cross-sectional study. The analysis of the variables was made through Statgraphics Centurion XVI. The comparison of variables as well as multiple and logistic regression were carried out.

RESULTS

125 individuals participated, 8 were removed, and finally there were 117 male drivers as aim of research. The 28.21 % of individuals have driven small buses and the 71.79 % have driven cars. The increase in alcohol consumption was remarkable compared to tobacco. The 60.69 % of subjects did not get exercise. Besides, the BMI average and abdominal circumference was 28.03 kg/m2 and 100.09 cm respectively. The triglyceride average and serum HDL-C were 207.53 mg/dL to 33.12 mg/dL. 49.57 % of all drivers, fulfilled the Metabolic Syndrome diagnostic criteria. Statistically significant differences were found in the values of BMI, waist circumference, systolic blood pressure, diastolic blood pressure, weekly exercise, triglycerides and fasting glucose between individuals with and without Metabolic Syndrome.

CONCLUSION

Public service drivers have a profile risk for developing Metabolic Syndrome. Obesity, hypertriglyceridemia and low HDL-C were the main alarm parameters of the presence of Metabolic Syndrome.

Predictive validity of body fat percentage by bioimpedance compared with deuterium oxide dilution in Costa Rican schoolchildren

OBJECTIVE

The purpose of this study was to verify the validity of body fat percentage (BF%) by bioelectrical impedance analysis (BIA) in a sample of Costa Rican schoolchildren.

METHODS

The sample consisted of 52 male (mean age 8.1 ± 0.9 years) and 49 female (mean age 7.5 ± 1.0 years) schoolchildren. Deuterium oxide dilution was the reference method used as the "gold standard" to determine the fat mass (FM) expressed as BF%. Linear regression analyses and paired sample t-tests were used to test the association and mean differences between BIA and deuterium oxide dilution BF%. Concordance between BIA and deuterium oxide dilution BF% was determined by Lin's concordance correlation coefficient. Measurement of agreement between the two methods was analyzed using the Bland-Altman procedure.

RESULTS

Significant associations between BIA and deuterium oxide dilution BF% were found in males (R = 0.97, R²  = 0.95, P < .0001) and in females (R = 0.98, R²  = .96, P < .0001). The measurements of BF% (mean ± SD) were not significantly different between males (BIA 31.1 ± 7.6% vs. deuterium oxide dilution 31.0 ± 7.4%) and females (BIA 25.9 ± 7.9% vs. deuterium oxide dilution 26.3 ± 7.8%) by t-test. Lin's concordance correlation coefficient identified an almost perfect strength of agreement between males and females. Bland-Altman plots showed that the Bodystat measured similar BF% compared to the deuterium oxide dilution in both males and females.

CONCLUSIONS

BIA Bodystat presented high agreement with BF% measured by deuterium oxide dilution; therefore BIA Bodystat is recommended for estimating BF% in Costa Rican schoolchildren.

Elevated serum tartrate-resistant acid phosphatase isoform 5a levels in metabolic syndrome

Background

Tartrate-resistant phosphatase isoform 5a is expressed in tumor-associated macrophages and is a biomarker of chronic inflammation. Herein, we correlated serum tartrate-resistant phosphatase isoform 5a levels with metabolic syndrome status and made comparisons with traditional markers of inflammation, including c-reactive protein and interleukin-6.

Methods

One hundred healthy volunteers were randomly selected, and cut-off points for metabolic syndrome related inflammatory biomarkers were determined using receiver operating characteristic curves. Linear and logistic regression models were subsequently used to correlate inflammatory markers with the risk of metabolic syndrome.

Results

Twenty-two participants met the criteria for metabolic syndrome, and serum tartrate-resistant phosphatase isoform 5a levels of >5.8 μg/L were associated with metabolic syndrome (c-statistics, 0.730; p = 0.001; 95% confidence interval, 0.618-0.842). In addition, 1 μg/L increases in tartrate-resistant phosphatase isoform 5a levels were indicative of a 1.860 fold increase in the risk of metabolic syndrome (p = 0.012).

Conclusions

Elevated serum tartrate-resistant phosphatase isoform 5a levels are associated with the risk of metabolic syndrome, with a cut-off level of 5.8 μg/L.

Bixin ameliorates high fat diet-induced cardiac injury in mice through inflammation and oxidative stress suppression

Diabetic cardiomyopathy is known as an essential complication of diabetes, a main reason leading to mortality for diabetic patients, and novel therapeutic strategies for treatment are urgently required. Bixin (BX), isolated from the seeds of Bixa orellana, is a carotenoid, possessing anti-inflammatory, anti-tumor and anti-oxidant activities. In our study, we attempted to calculate the role of bixin in cardiac injury progression, and reveal the possible molecular mechanism. Bixin treatment ameliorated cardiac dysfunction through inhibiting fibrosis, inflammation and reactive oxygen species (ROS) generation. It reduced fibrosis levels via collagen deposition down-regulation. Inflammatory response was attenuated by reducing pro-inflammatory cytokines secretion via Toll-like receptor 4/nuclear factor kappa B (TLR4/NF-κB) signaling pathway inactivation in mice induced by high fat diet. Also, in in vitro studies, lipopolysaccharide (LPS)-treated cardiac muscle cells exhibits pro-inflammatory cytokines over-expression, which was reduced by bixin through blocking TLR4/NF-κB pathway. Additionally, oxidative stress triggered by high fat in vivo and LPS in vitro was down-regulated for bixin administration via nuclear factor-E2-related factor 2 (Nrf2) signaling pathway activation. Our study suggested that bixin might be a novel and protective agent with therapeutic activity against cardiac injury by suppressing fibrosis, inflammation and oxidative stress.

Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011

The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.

A novel dual amylin and calcitonin receptor agonist, KBP-089, induces weight loss through a reduction in fat, but not lean mass, while improving food preference

BACKGROUND AND PURPOSE

Obesity and associated co-morbidities, such as type 2 diabetes and non-alcoholic fatty liver disease, are major health challenges. Hence, there is an important need to develop weight loss therapies with the ability to reduce the co-morbidities.

EXPERIMENTAL APPROACH

The effect of the dual amylin and calcitonin receptor agonist (DACRA), KBP-089, on body weight, glucose homeostasis and fatty acid accumulation in liver and muscle tissue and on food preference was investigated. Furthermore, we elucidated weight-independent effects of KBP-089 using a weight-matched group.

KEY RESULTS

Rats fed a high-fat diet were treated, s.c., with KBP-089 0.625, 1.25, 2.5 μg·kg^-1 or vehicle. KB-089 induced in a dose-dependent and sustained weight loss (~17% by 2.5 μg·kg^-1 ). Moreover, KBP-089 reduced fat depot size and reduced lipid accumulation in muscle and liver. In Zucker Diabetic Fatty rats, KBP-089 improved glucose homeostasis through improved insulin action. To obtain a weight-matched group, significantly less food was offered (9% less than in the KBP-089 group). Weight matching led to improved glucose homeostasis by reducing plasma insulin; however, these effect were inferior compared to those of KBP-089. In the food preference test, rats fed a normal diet obtained 74% of their calories from chocolate. KBP-089 reduced total caloric intake and induced a relative increase in chow consumption while drastically reducing chocolate consumption compared with vehicle.

CONCLUSIONS AND IMPLICATIONS

The novel DACRA, KBP-089, induces a sustained weight loss, leading to improved metabolic parameters including food preference, and these are beyond those observed simply by diet-induced weight loss.

Diets link metabolic syndrome and colorectal cancer development (Review)

Diets have been believed to be an important factor in the development of metabolic syndrome and colorectal cancer (CRC). In recent years, many studies have shown an intimate relationship between mucosal immunity, metabolism and diets, which has led to a greater understanding of the pathophysiology of metabolic syndrome and CRC development. Although the precise effects of diets on oncogenesis have not been compl-etely elucidated, microbiota changes and inflammation are believed to be important factors that influence the development of CRC. Moreover, increased release of pro-inflammatory cytokines and alteration of adipokine levels have been observed in patients with colorectal adenoma and/or CRC, and these all have been considered as the important mechanisms that link diets to the development of metabolic syndrome and CRC. Importantly, a high-fat, low-fiber diet is associated with dysbiosis, and as the gut signature becomes more important in metabolic syndrome and CRC, an increased understanding of diets on bacterial activity in the pathogenesis of metabolic syndrome and CRC will lead to new preventive and therapeutic strategies.

Vitamin D administration, cognitive function, BBB permeability and neuroinflammatory factors in high-fat diet-induced obese rats

OBJECTIVES

The purpose of this research was to investigate the effects of vitamin D administration on cognitive function, nuclear factor-κB (NF-κB), brain-derived neurotrophic factor (BDNF) concentration in the hippocampus and blood-brain barrier (BBB) permeability in high-fat diet (HFD)-induced obese rats.

METHODS

Male Wistar rats were fed either a control diet or HFD for 16 weeks (n=20); then, each group was randomized into two subgroups supplemented orally with 500 IU kg^-1 vitamin D for 5 weeks. A Morris water maze (MWM) test was performed at the 21st week to examine cognitive function. BBB permeability was characterized by Evans blue dye in the hippocampus. BDNF and NF-κB concentrations in the hippocampus and serum vitamin D concentrations were also measured.

RESULTS

HFD led to a significant delay in escape latency time and reduced time of MWM probe test because of increased NF-κB and decreased BDNF concentrations in the hippocampus. Vitamin D supplementation in the HFD group significantly reduced body weight, NF-κB concentrations, BBB permeability and increased BDNF concentrations in the hippocampus.

CONCLUSIONS

Vitamin D reversed HFD-induced cognitive impairments by reduction of the NF-κB and elevation of BDNF concentrations and modulation of the BBB permeability in rats' hippocampus.

Cardiometabolic risk factors, metabolic syndrome and pre-diabetes in adolescents in the Sierra region of Ecuador

BACKGROUND

Excess weight (overweight and obesity) is the major modifiable risk factor for type 2 diabetes mellitus (T2DM) and other non-communicable diseases. However, excess weight may not be as predictive of diabetes risk as once thought. While excess weight and other obesity-related non-communicable diseases are of growing concern in low-middle income countries in Latin America, there is limited research on risk factors associated with T2DM in adolescents. This study investigated prevalence of overweight, obesity, prediabetes, diabetes and metabolic syndrome in adolescents in Ecuador.

METHODS

A cross-sectional study was conducted with 433 adolescents from two schools in a small urban center in southern Ecuador and two schools in a large urban center in Quito. Risk factors were measured, including: height, weight, BMI, waist-to-hip ratio, fasting glucose, lipid panel, and HbA1c. Multivariate analysis of variance (MANOVA) was separately applied to risk factors and demographic factors as a set of dependent variables with sex, location and their interaction included as predictors. An independent t test was run on the data at 95% confidence intervals for the mean difference. The values for the triglycerides, LDL and VLDL were positively skewed. A Mann-Whitney U test was run on these data.

RESULTS

Using IOTF standards, 9.8% were overweight and 1.9% were obese. Only 1.6% of the sample met the criteria for prediabetes by fasting glucose but 12.4% of the sample met the criteria for prediabetes by HbA1c. None of the participants met criteria for diabetes. There were 2.3% of the participants that met the IDF criteria for metabolic syndrome. Adolescents from the larger urban center had higher rates of prediabetes, higher mean HbA1c, blood pressure, lipid values, and lower HDL levels.

CONCLUSIONS

Use of HbA1c identified more adolescents with prediabetes than FBG. The HbA1c measure is an attractive screening tool for prediabetes in developing countries. Although rates of obesity in Ecuadorian adolescents are low there is significant evidence to suggest that prediabetes is permeating the smaller urban centers. Traditional screening tools may underestimate this risk.

From obesity to cancer: a review on proposed mechanisms

Nowadays, obesity is considered as a serious and growing global health problem. It is documented that the overweight and obesity are major risk factors for a series of noncommunicable diseases, and in recent years, the obesity-cancer link has received much attention. Numerous epidemiological studies have shown that obesity is associated with increased risk of several cancer types, including colon, breast, endometrium, liver, kidney, esophagus, gastric, pancreatic, gallbladder, and leukemia, and can also lead to poorer treatment. We review here the epidemiological and experimental evidences for the association between obesity and cancer. Specifically, we discuss potential mechanisms focusing how dysfunctional angiogenesis, chronic inflammation, interaction of proinflammatory cytokines, endocrine hormones, and adipokines including leptin, adiponectin insulin, growth factors, estrogen, and progesterone and strikingly, cell metabolism alteration in obesity participate in tumor development and progression, resistance to chemotherapy, and targeted therapies such as antiangiogenic and immune therapies.