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Sherf-Dagan S, Refaeli R, Buch A. Phenotyping of Obesity Treatment Candidates: A Narrative Review. Curr Obes Rep 2024; 13:564-573. [PMID: 38874701 DOI: 10.1007/s13679-024-00576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE OF REVIEW This review explores characterizing candidates for obesity treatments including pharmacotherapy, endoscopic bariatric therapies, and metabolic bariatric surgery (MBS), focusing on established clinical parameters for diagnosing obesity beyond body mass index alone. RECENT FINDINGS Existing literature primarily provides rates for fat mass percentage (i.e., a marker for adiposity quantity), waist circumference (i.e., a marker for adiposity distribution), and C-reactive protein levels (i.e., a marker for adiposity functionality) among obesity treatment candidates. Limited data on abnormal values and sex-based differentiation exist. The literature indicates high central-tendency measures for fat mass percentage and waist circumference, while C-reactive protein levels vary. Data on the Edmonton Obesity Staging System (i.e., a marker for adiposity-related disease severity) is predominantly available for MBS candidates. Future studies in obesity interventions should improve screening and diagnosis of obesity by incorporating sex-specific considerations and providing abnormal value rates for measurements to enhance understanding of patients' characteristics.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat H'mada 3, Ariel, Israel.
- Department of Nutrition, Assuta Medical Center, Tel Aviv, Israel.
| | - Rotem Refaeli
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat H'mada 3, Ariel, Israel
- Department of Nutrition, Rabin Medical Center, Beilinson hospital, Petah Tikva, Israel
| | - Assaf Buch
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Kiryat H'mada 3, Ariel, Israel
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Rafiee P, Rasaei N, Amini MR, Rabiee R, Kalantar Z, Sheikhhossein F, Gholizadeh M, Hekmatdoost A. The effects of ursolic acid on cardiometabolic risk factors: a systematic review and meta-analysis. Future Cardiol 2024; 20:151-161. [PMID: 38923885 PMCID: PMC11216268 DOI: 10.1080/14796678.2024.2349476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/26/2024] [Indexed: 06/28/2024] Open
Abstract
Aim: Ursolic acid (UA) has an important biological role in the fight against fat accumulation, insulin resistance, obesity and inflammation. Therefore, in the current review and meta-analysis work, we investigate the effects of UA (dosage range is 50.94 to 450 mg/day) on cardiometabolic risk factors. Materials & methods: After searching the studies up to February 2023, six articles were included in the study. Results: The pooled effect size showed that UA supplementation didn't significantly change body weight, body mass index, waist circumference, body fat percentage, lean body mass, systolic blood pressure, diastolic blood pressure, fasting blood glucose, insulin, triglyceride and high-density lipoprotein compared with control groups. Conclusion: UA supplementation had no significant effect on the cardiometabolic risk factors in adults.
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Affiliation(s)
- Pegah Rafiee
- Student Research Committee, Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences & Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, 1981619573, Iran
| | - Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, 14155-6117, Iran
- Network of Interdisciplinarity in Neonates & Infants (NINI), Universal Scientific Education & Research Network (USERN), Tehran, 14155-6117, Iran
| | - Mohammad Reza Amini
- Student Research Committee, Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences & Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, 1981619573, Iran
- Nutrition & Food Security Research Center & Department of Community Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, 1981619573, Iran
| | - Reyhaneh Rabiee
- Student Research Committee, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, 8915173160, Iran
| | - Zahra Kalantar
- Department of Clinical Nutrition, School of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Fatemeh Sheikhhossein
- Department of Clinical Nutrition, School of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, 14155-6117, Iran
| | - Mohammad Gholizadeh
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences & Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, 1981619573, Tehran,Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition Sciences & Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, 1981619573, Tehran,Iran
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Meshram II, Nagalla B, Rao Kodavanti M, Avula L, Ginnela Narsimhachary Veera B. Overweight/obesity, pre-diabetes, diabetes and its association with hypertension and other factors among rural adults (≥18 years) in India. Indian Heart J 2024; 76:182-191. [PMID: 38908547 PMCID: PMC11329029 DOI: 10.1016/j.ihj.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 03/26/2024] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Non-communicable diseases are important causes of morbidity and mortality throughout the world. METHODS A community-based cross-sectional study conducted in 10 Indian states using multi-stage random sampling procedures. Information was collected on socio-economic and demographic particulars, anthropometric measurements such as height, weight and waist circumference, fasting blood glucose and blood pressure was measured. One day 24-h dietary recall was done for foods and nutrient intakes. Bivariate and multivariate step-wise logistic regression analyses was done. RESULTS The prevalence of overweight/obesity among rural adults was 23.4 % (95 % CI: 22.9-23.9), while age adjusted prevalence of pre-diabetes was 8.4 % (95 % CI: 8.1-8.7) and diabetes was 6.8, (95 % CI 6.7-7.1), respectively. The prevalence of diabetes was lowest in Uttar Pradesh, West Bengal and Odisha (3-4%) and higher in Kerala and Tamil Nadu (12-15 %). The odds of diabetes was 5.5 times more among elderly, 1.3 times higher among Christians and among high income groups, and 2 times among overweight (CI: 1.50-2.50), obese (CI: 1.61-2.76) and abdominal obesity (OR; 1.57; CI: 1.29-1.91) and 1.6 times more among hypertensives. The odds of diabetes were high among those consuming the lower tertiles of carbohydrates, pulses, milk and milk products and folic acid. CONCLUSION the age-adjusted prevalence of diabetes and pre-diabetes was 6.8 % and 8.4 % respectively and the odds of diabetes was high among elderly, among high socio-economic groups, overweight/obese subjects and among hypertensives. Also, knowledge about symptoms of diabetes was low. There is a need to improve awareness for early diagnosis and treatment for control of diabetes and hypertension.
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Affiliation(s)
- Indrapal I Meshram
- Division of Public Health Nutrition, ICMR-National Institute of Nutrition, Hyderabad-500007, India.
| | - Balakrishna Nagalla
- Division of Public Health Nutrition, ICMR-National Institute of Nutrition, Hyderabad-500007, India.
| | | | - Laxmaiah Avula
- Division of Public Health Nutrition, ICMR-National Institute of Nutrition, Hyderabad-500007, India.
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Wang B, Yang X, Wei B, Ren T, Huang N, Escobar C, Pang PYK, Liu X, Zhou H. Associations between waist circumference, central obesity, and the presence of non-valvular atrial fibrillation patients with heart failure. J Thorac Dis 2024; 16:2049-2059. [PMID: 38617752 PMCID: PMC11009574 DOI: 10.21037/jtd-24-170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/18/2024] [Indexed: 04/16/2024]
Abstract
Background Reportedly, there is a clear correlation between waist circumference (WC) and atrial fibrillation (AF). However, there is no specific discussion about the relationship between WC and non-valvular AF (NVAF) patients with heart failure. Our main purpose was to study the relationship between WC, central obesity (CO), and NVAF patients with heart failure. Methods This is a retrospective cohort study. A total of 3,435 patients with NVAF in the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2017 were enrolled. The targeted independent variable and the dependent variable were WC and CO and the presence of NVAF with heart failure, respectively. Univariate, multiple regression, and subgroup analyses were used to analyze their relationship. We used the receiver operating characteristic (ROC) curve to choose the better predictor of NVAF with heart failure between WC and CO and calculated the proposed cut-off value of WC in males and female separately. Results The identified risk factors of NVAF with heart failure were sex, height, WC, CO, body mass index (BMI), fasting blood glucose (FBG), homocysteine (HCY), triglyceride (TG), low-density lipoprotein cholesterol (LDLC), hypertension, diabetes mellitus (DM), stroke, vascular disease, and plaque. Then, a binary logistic regression model indicated that the occurrence of NVAF patients with heart failure increased 10% with WC increasing 1 cm and had a 2.8-fold increased risk with CO compared to those without. The predictive value [area under the ROC curve (AUC)], specificity, sensitivity, and accuracy of WC for the disease risk of NVAF with heart failure were higher than those of CO. The proposed cut-off value of WC was 91.85 cm for males and 93.15 cm for females. The diagnostic value of WC for NVAF with heart failure was higher for females than it was for males. Conclusions Our research found that WC is related to the presence of heart failure in the patients with NYAF and can predict the presence of NVAF with heart failure. Our findings may help to improve the treatment and care strategies of NVAF individuals with abdominal obesity.
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Affiliation(s)
- Bing Wang
- Department of Cardiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Internal Medicine, School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Xinglin Yang
- Department of Laboratory, Guiyang Public Health Clinical Center, Guiyang, China
| | - Bo Wei
- Department of Cardiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Tingting Ren
- Department of Laboratory, Guiyang Public Health Clinical Center, Guiyang, China
| | - Niwen Huang
- Department of Cardiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Carlos Escobar
- Cardiology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Philip Y. K. Pang
- Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore, Singapore
| | - Xingde Liu
- Department of Internal Medicine, School of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Haiyan Zhou
- Department of Cardiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Physiology and Biophysics, University of Washington, Seattle, WA, USA
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Çelik C, Türker PF, Çalışkan H. The Relationship of Food Literacy and Sustainable Consumption Behaviors with Anthropometric Measurements during the Covid-19 Pandemic Period: A Sample from Turkey. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:279-285. [PMID: 37905948 DOI: 10.1080/27697061.2023.2272257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023]
Abstract
AIM This study aimed to evaluate the impact of food literacy and sustainable consumption behaviors on nutritional status during the pandemic in Turkey. METHODS The study was conducted between May and July 2021 with a questionnaire delivered in a digital environment (social media, Twitter/Facebook/Instagram) to 200 volunteer adults aged 20-65. With this questionnaire form, sociodemographic characteristics, general information, and consumer behaviors of the individuals were obtained. Anthropometric measurements (height, body weight, body mass index (BMI), waist circumference, hip circumference, waist/hip ratio, and waist/height ratio) of the individuals were recorded online as self-report. The Self Perceived Food Literacy (SPFL) Scale was administered to measure nutritional literacy levels. To measure the sustainable consumption behaviors of the individuals, the Sustainable Consumption Behavior (SCB) Scale was administered. RESULTS We found that 87.2% of women and 40% of men had heard of sustainable nutrition before (p < 0.001). The mean total score of SCB was statistically significantly higher in women than in men (3.1 ± 0.48 in women, 2.9 ± 0.69 in men, p < 0.05). The mean score of SPFL was 3.31 ± 0.275 in women, while it was 3.05 ± 0.395 in men. There was a statistically significant relationship between SPFL mean scores and gender (p < 0.05). CONCLUSION There was a statistically significant negative relationship between SPFL score and BMI, body weight, and waist/hip ratio. There was a statistically significant negative relationship between the SCB and waist/hip ratio. Food literacy and sustainable consumption behaviors are associated with anthropometric measurements. Sustainable nutrition, sustainable consumption behaviors, and food literacy should be considered as a whole. Trainings should be increased to raise awareness of individuals about food literacy.
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Affiliation(s)
- Cansu Çelik
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
| | - Perim Fatma Türker
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
| | - Hilal Çalışkan
- Department of Nutrition and Dietetics, Baskent University, Ankara, Turkey
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Palamarchuk OS, Leshko MM, Klushyn VO, Feketa VP. A differentiated approach to the diagnosis of overweight and obesity in children based on bioimpedance analysis of body composition. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:402-408. [PMID: 38691779 DOI: 10.36740/wlek202403105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Aim: The current study introduces a novel diagnostic algorithm employing bioimpedance analysis to comprehensively evaluate body composition in children, assessing fat content, skeletal muscle content, and fat distribution. PATIENTS AND METHODS Materials and Methods: Bioelectrical impedance measurements were obtained using the TANITA MC-780 MA analyzer. Indicators such as body weight, BMI, total fat content, absolute limb muscle mass, skeletal muscle strength, and waist-to-hip ratio (WHR) were assessed. A sample of 101 children aged 9 to 14 were studied using the proposed algorithm, refining BMI-based classifications. RESULTS Results: The algorithm comprises three steps, categorizing children based on fat content, presence of sarcopenia, and central fat distribution. It identified diverse somatotypes within the groups classified by BMI. Notably, it revealed prognostically unfavorable somatotypes, such as sarcopenic obesity with central fat distribution, highlighting potential health risks. Current BMI-centric diagnoses may misclassify cardiometabolic risks, making early detection challenging. The algorithm enables a detailed evaluation, unmasking metabolically unfavorable conditions like sarcopenic obesity. The incorporation of functional tests, such as a standardized hand-grip test, enhances diagnostic accuracy. The proposed WHR indicator for characterizing fat distribution provides a practical method for determining somatotypes in children. CONCLUSION Conclusions: This comprehensive algorithm offers an alternative to BMI-based classifications, enabling early detection of obesity and associated risks. Further validation through large-scale epidemiological studies is essential to establish correlations between somatotypes and cardiometabolic risks, fostering a more nuanced and individualized approach to pediatric obesity management.
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Lopez-Lopez JP, Gonzalez AM, Lanza P, Martinez-Bello D, Gomez-Arbelaez D, Otero J, Cohen DD, Perez-Mayorga M, Garcia-Peña AA, Rangarajan S, Yusuf S, Lopez-Jaramillo P. Waist circumference cut-off points to identify major cardiovascular events and incident diabetes in Latin America: findings from the prospective Urban rural epidemiology study Colombia. Front Cardiovasc Med 2023; 10:1204885. [PMID: 38028452 PMCID: PMC10643140 DOI: 10.3389/fcvm.2023.1204885] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Abdominal obesity (AO) indirectly represents visceral adiposity and can be assessed by waist circumference (WC) measurement. In Latin America, cut-off points for the diagnosis of AO are based on Asian population data. We aim to establish the WC cut-off points to predict major cardiovascular events (MACE) and incident diabetes. Methods We analyzed data from the cohort PURE study in Colombia. WC cut-off points were defined according to the maximum Youden index. Multivariate logistic regression was used to obtain associations between WC and MACE, diabetes, and cumulative incidence of outcomes visualized using Kaplan-Meier curves. Results After a mean follow-up of 12 years, 6,580 individuals with a mean age of 50.7 ± 9.7 years were included; 64.2% were women, and 53.5% were from rural areas. The mean WC was 85.2 ± 11.6 cm and 88.3 ± 11.1 cm in women and men, respectively. There were 635 cases of the MACE composite plus incident diabetes (5.25 events per 1,000 person-years). Using a cut-off value of 88.85 cm in men (sensitivity = 0.565) and 85.65 cm in women (sensitivity = 0.558) resulted in the highest value for the prediction of the main outcome. These values were associated with a 1.76 and 1.41-fold increased risk of presenting the composite outcome in men and women, respectively. Conclusions We defined WC cut-off points of 89 cm in men and 86 cm in women to identify the elevated risk of MACE and incident diabetes. Therefore, we suggest using these values in cardiovascular risk assessment in Latin America.
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Affiliation(s)
- Jose P. Lopez-Lopez
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
- Cardiology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ana María Gonzalez
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Paola Lanza
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
| | | | - Diego Gomez-Arbelaez
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Johanna Otero
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Daniel D. Cohen
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Maritza Perez-Mayorga
- MASIRA Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
- Medicine School, Universidad Militar Nueva Granada, Clínica Marly, Bogotá, Colombia
| | - Angel A. Garcia-Peña
- Cardiology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Sumathy Rangarajan
- Department of Health Research Methods, Evidence, and Impact, McMaster University and Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
| | - Salim Yusuf
- Department of Health Research Methods, Evidence, and Impact, McMaster University and Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
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Castle AC, Hoeppner SS, Manne-Goehler JM, Olivier S, Magodoro IM, Singh U, Edwards JA, Tanser F, Bassett IV, Wong EB, Siedner MJ. Identifying sex-specific anthropometric measures and thresholds for dysglycemia screening in an HIV-endemic rural South African population. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001698. [PMID: 37889883 PMCID: PMC10610455 DOI: 10.1371/journal.pgph.0001698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Valid screening and diagnostic algorithms are needed to achieve 2030 targets proposed by the WHO's Global Diabetes Compact. We explored anthropometric thresholds to optimally screen and refer individuals for diabetes testing in rural South Africa. We evaluated screening thresholds for waist circumference (WC), body mass index (BMI), and waist-hip ratio (WHR) to detect dysglycemia based on a glycated hemoglobin (HbA1C) ≥6.5% among adults in a population-based study in South Africa using weighted, non-parametric ROC regression analyses. We then assessed the diagnostic validity of traditional obesity thresholds, explored optimal thresholds for this population, and fit models stratified by sex, age, and HIV status. The prevalence of dysglycemia in the total study population (n = 17,846) was 7.7%. WC had greater discriminatory capacity than WHR to detect dysglycemia in men (p-value<0.001) and women (p<0.001). WC had greater discriminatory capacity than BMI to detect dysglycemia in women (p<0.001). However, BMI and WC performed similarly for men (p = 0.589). Whereas traditional WC thresholds for women (>81cm) performed well (sensitivity 91%, positive predictive value [PPV] 14.9%), substantially lower thresholds were needed to achieve acceptable sensitivity and PPV among men (traditional >94cm, derived >79.5cm). WC outperforms BMI as an anthropometric screening measure for dysglycemia in rural South Africa. Whereas WC guideline thresholds are appropriate for women, male-derived WC cutoffs performed better at lower thresholds. In this rural South African population, thresholds that maximize specificity and PPV for efficient resource allocation may be preferred.
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Affiliation(s)
- Alison C. Castle
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Jennifer M. Manne-Goehler
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Stephen Olivier
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Itai M. Magodoro
- Emory Global Diabetes Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Urisha Singh
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
| | - Johnathan A. Edwards
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, United States of America
- School of Health and Social Care, University of Lincoln, Lincoln, United Kingdom
| | - Frank Tanser
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Health and Social Care, University of Lincoln, Lincoln, United Kingdom
- Lincoln Institute for Health, University of Lincoln, Lincoln, United Kingdom
| | - Ingrid V. Bassett
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Emily B. Wong
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, University of Alabama Birmingham, Birmingham, Alabama, United States of America
| | - Mark J. Siedner
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa
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Carvalho VCHDS, Moreira LB, Luft VC, Fuchs SC. Waist-to-Height Ratio: A Sensitive Tool for Assessing the Need for Nutritional Risk Management in Elderly Populations from Brazil. Healthcare (Basel) 2023; 11:2406. [PMID: 37685440 PMCID: PMC10486933 DOI: 10.3390/healthcare11172406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/13/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Nutritional status assessment commonly relies on body mass index (BMI), which overlooks lean mass and adipose tissue distribution. However, waist circumference (WC) and waist-to-height ratio (WHtR) provide additional insights into fat accumulation. By combining these indices, it may be possible to identify older adults needing weight management interventions. OBJECTIVES To assess the WC and WHtR as strategies for identifying individuals requiring weight management. METHODS A cross-sectional study was conducted with 509 elderly individuals in Northeast Brazil. Weight, height, hip circumference, and waist circumference were measured, and combined with indices such as BMI WC, WHR, and WHtR to identify those who require weight management. The DeLong test compared areas under the curves using receiver operating characteristic curves and statistical significance. Sensitivity, specificity, and positive and negative predictive values were calculated to verify usefulness for clinical application. A validation sample of 599 elderly individuals from the country's Southern region was used to confirm the results. RESULTS Both WC and WHtR showed adequate diagnostic accuracy with no statistically significant difference in AUCs. WHtR ≥ 0.50 had 92% sensitivity in identifying men and women requiring nutritional management. WC presented lower sensitivity but 93% specificity, useful for excluding elderly individuals from the nutritional risk category. These results were consistent in the validation sample. CONCLUSION WHtR is a valuable index for screening nutritional risk management in the elderly population, applicable to men and women. Conversely, WC performs better in excluding individuals who do not need nutritional risk management.
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Affiliation(s)
- Vivian C. Honorato dos Santos Carvalho
- Post-Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º Andar, Santa Cecilia, Porto Alegre 90035-003, RS, Brazil; (V.C.H.d.S.C.); (V.C.L.)
- Department of Nutrition, Multidisciplinary Health Institute, Universidade Federal da Bahia, Vitória da Conquista 40170-110, BA, Brazil
| | - Leila B. Moreira
- Post-Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º Andar, Santa Cecilia, Porto Alegre 90035-003, RS, Brazil;
| | - Vivian C. Luft
- Post-Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º Andar, Santa Cecilia, Porto Alegre 90035-003, RS, Brazil; (V.C.H.d.S.C.); (V.C.L.)
| | - Sandra C. Fuchs
- Post-Graduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º Andar, Santa Cecilia, Porto Alegre 90035-003, RS, Brazil; (V.C.H.d.S.C.); (V.C.L.)
- Post-Graduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º Andar, Santa Cecilia, Porto Alegre 90035-003, RS, Brazil;
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Gholami F, Samadi M, Rasaei N, Yekaninejad MS, Keshavarz SA, Javdan G, Shiraseb F, Bahrampour N, Mirzaei K. Interactions Between Genetic Risk Score and Healthy Plant Diet Index on Cardiometabolic Risk Factors Among Obese and Overweight Women. Clin Nutr Res 2023; 12:199-217. [PMID: 37593209 PMCID: PMC10432161 DOI: 10.7762/cnr.2023.12.3.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/30/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023] Open
Abstract
People with higher genetic predisposition to obesity are more susceptible to cardiovascular diseases (CVDs) and healthy plant-based foods may be associated with reduced risks of obesity and other metabolic markers. We investigated whether healthy plant-foods-rich dietary patterns might have inverse associations with cardiometabolic risk factors in participants at genetically elevated risk of obesity. For this cross-sectional study, 377 obese and overweight women were chosen from health centers in Tehran, Iran. We calculated a healthy plant-based diet index (h-PDI) in which healthy plant foods received positive scores, and unhealthy plant and animal foods received reversed scores. A genetic risk score (GRS) was developed based on 3 polymorphisms. The interaction between GRS and h-PDI on cardiometabolic traits was analyzed using a generalized linear model (GLM). We found significant interactions between GRS and h-PDI on body mass index (BMI) (p = 0.02), body fat mass (p = 0.04), and waist circumference (p = 0.056). There were significant gene-diet interactions for healthful plant-derived diets and BMI-GRS on high-sensitivity C-reactive protein (p = 0.03), aspartate aminotransferase (p = 0.04), alanine transaminase (p = 0.05), insulin (p = 0.04), and plasminogen activator inhibitor 1 (p = 0.002). Adherence to h-PDI was more strongly related to decreased levels of the aforementioned markers among participants in the second or top tertile of GRS than those with low GRS. These results highlight that following a plant-based dietary pattern considering genetics appears to be a protective factor against the risks of cardiometabolic abnormalities.
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Affiliation(s)
- Fatemeh Gholami
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Mahsa Samadi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Mir Saeid Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Seyed Ali Keshavarz
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Gholamali Javdan
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar ‘Abbas 79166-13885, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
| | - Niki Bahrampour
- Department of Nutrition, Science and Research Branch, Islamic Azad University (SRBIAU), Tehran 14778-93855, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14155-6117, Iran
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11
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Pita-Rodríguez GM, Basabe-Tuero B, Díaz-Sánchez ME, Alfonso-Sagué K, Álvarez AMG, Montero-Díaz M, Valdés-Perdomo S, Chávez-Chong C, Rodríguez-Martinez E, Díaz-Fuentes Y, Llera-Abreu E, Calzadilla-Cámbara A, Ríos-Castillo I. Prevalence of Anemia and Iron Deficiency in Women of Reproductive Age in Cuba and Associated Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5110. [PMID: 36982031 PMCID: PMC10049065 DOI: 10.3390/ijerph20065110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
This study aims to evaluate the prevalence of anemia and iron deficiency in women of reproductive age and the association with inflammation, global overweight, adiposity, and menorrhagia. A sample design of women of reproductive age from the Eastern, Central, and Havana Regions was carried out. Biochemical determinations of hemoglobin, serum ferritin, soluble transferrin receptors, leukocytes, C-reactive protein, alpha-1 acid glycoprotein, and homocysteine were performed. Serum ferritin was also adjusted by inflammation. Nutritional status was assessed, and menstrual characteristics were collected by survey. A total of 742 women were studied. The prevalence of anemia was 21.4%, iron storage deficiency at 16.0%, and erythropoietic dysfunction at 5.4%, with inflammation at 47.0% and elevated homocysteine at 18.6%. Global overweight was 46.2% and increased adiposity at 58.4%. Anemia is associated with iron deposition deficiency (OR = 3.023 (1.816-5.033)) and with erythropoietic deficiency (OR = 5.62 (3.03-10.39)), but not with inflammation, global overweight, and adiposity. Global overweight was found to be associated with inflammation (OR = 2.23 (1.41-3.53)). Anemia was associated with heavy menstrual bleeding (OR = 1.92 (1.34-2.76)). Homocysteine was associated with inflammation (OR = 2.05 (1.08-3.90)), but not with anemia. In conclusion, anemia in Cuba is classified as a moderate public health problem, but not iron deficiency. A high prevalence of overweight and obesity was found, associated with inflammation, but not with anemia or iron deficiency. Heavy menstrual bleeding is a factor associated with anemia.
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Affiliation(s)
| | - Beatriz Basabe-Tuero
- National Institute of Hygiene, Epidemiology and Microbiology (INHEM), Havana 10300, Cuba
| | | | - Karen Alfonso-Sagué
- National Institute of Hygiene, Epidemiology and Microbiology (INHEM), Havana 10300, Cuba
| | | | | | - Sonia Valdés-Perdomo
- National Institute of Hygiene, Epidemiology and Microbiology (INHEM), Havana 10300, Cuba
| | | | | | - Yoandry Díaz-Fuentes
- National Institute of Hygiene, Epidemiology and Microbiology (INHEM), Havana 10300, Cuba
| | - Elisa Llera-Abreu
- National Institute of Hygiene, Epidemiology and Microbiology (INHEM), Havana 10300, Cuba
| | | | - Israel Ríos-Castillo
- Food and Agricultural Organization (FAO), Sub Regional Office in Mesoamerica, Panama City 0843-00006, Panama
- Nutrition and Dietetic School, University of Panama, Panama City 3366, Panama
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12
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Won KB, Shin ES, Kang J, Yang HM, Park KW, Han KR, Moon KW, Oh SK, Kim U, Rhee MY, Kim DI, Kim SY, Lee SY, Han JK, Koo BK, Kim HS. Body Mass Index and Major Adverse Events During Chronic Antiplatelet Monotherapy After Percutaneous Coronary Intervention With Drug-Eluting Stents - Results From the HOST-EXAM Trial. Circ J 2023; 87:268-276. [PMID: 36123011 DOI: 10.1253/circj.cj-22-0344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND This study evaluated the association of body mass index (BMI) with adverse clinical outcomes during chronic maintenance antiplatelet monotherapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Methods and Results: Overall, 5,112 patients were stratified (in kg/m2) into underweight (BMI ≤18.4), normal weight (18.5-22.9), overweight (23.0-24.9), obesity (25.0-29.9) and severe obesity (≥30.0) categories with randomized antiplatelet monotherapy of aspirin 100 mg or clopidogrel 75 mg once daily for 24 months. The primary endpoint was the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome and major bleeding of Bleeding Academic Research Consortium type ≥3. Compared with normal weight, the risk of primary composite outcomes was higher in the underweight (hazard ratio [HR] 2.183 [1.199-3.974]), but lower in the obesity (HR 0.730 [0.558-0.954]) and severe obesity (HR 0.518 [0.278-0.966]) categories, which is partly driven by the difference in all-cause death. The risk of major bleeding was significantly higher in the underweight (HR 4.140 [1.704-10.059]) than in the normal weight category. A decrease in categorical BMI was independently associated with the increased risk of primary composite outcomes. CONCLUSIONS Lower BMI is associated with a higher risk of primary composite outcomes, which is primarily related to the events of all-cause death or major bleeding during chronic maintenance antiplatelet monotherapy after PCI with DES.
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Affiliation(s)
- Ki-Bum Won
- Division of Cardiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine
| | - Eun-Seok Shin
- Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine
| | - Jeehoon Kang
- Division of Cardiology, Seoul National University Hospital
| | - Han-Mo Yang
- Division of Cardiology, Seoul National University Hospital
| | - Kyung Woo Park
- Division of Cardiology, Seoul National University Hospital
| | - Kyoo-Rok Han
- Division of Cardiology, Kangdong Sacred Heart Hospital, Hallym University
| | - Keon-Woong Moon
- Division of Cardiology, St. Vincent's Hospital, The Catholic University of Korea
| | - Seok Kyu Oh
- Division of Cardiology, Wonkwang University Hospital
| | - Ung Kim
- Division of Cardiology, Yeungnam University Hospital
| | - Moo-Yong Rhee
- Division of Cardiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine
| | - Doo-Il Kim
- Division of Cardiology, Haeundae Paik Hospital, Inje University
| | - Song-Yi Kim
- Division of Cardiology, College of Medicine, Jeju National University
| | - Sung-Yun Lee
- Division of Cardiology, Ilsan Paik Hospital, Inje University
| | - Jung-Kyu Han
- Division of Cardiology, Seoul National University Hospital
| | - Bon-Kwon Koo
- Division of Cardiology, Seoul National University Hospital
| | - Hyo-Soo Kim
- Division of Cardiology, Seoul National University Hospital
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13
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Gholami F, Rasaei N, Samadi M, Yekaninejad MS, Keshavarz SA, Javdan G, Karimi Z, Mirzaei K. The relationship of genetic risk score with cardiometabolic risk factors: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:459. [PMID: 36324080 PMCID: PMC9632045 DOI: 10.1186/s12872-022-02888-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background & aims For more than eight decades, cardiovascular disease (CVD) has remained the leading cause of death in the world. CVD risk factors are multifaceted, with genetics and lifestyle both playing a role. The aim of this study was to investigate the association between a genetic profile risk score for obesity GRS and cardio-metabolic risk factors in overweight and obese women. Methods The current cross-sectional study was conducted on 391 overweight and obese women. The genetic risk score was created by combining three single nucleotide polymorphisms [MC4R (rs17782313), CAV-1 (rs3807992), and Cry-1 (rs2287161)]. Anthropometric measurements, blood pressure, and some blood parameters were measured by standard protocols. Results A significant association between the GRS and some of cardiometabolic risk factors variables such as body mass index (β = 0. 49, 95%CI = 0.22 to 0.76, p < 0.001), waist circumference (β = 0. 86, 95%CI = 0.18 to 1.54, p = 0.01), body fat mass (β = 0. 82, 95%CI = 0.25 to 1.39, p = 0.005), %body fat (β = 0. 44, 95%CI = 0.06 to 0.82, p = 0.02), and hs-CRP (β = 0.46, 95% CI = 0.14 to 0.78, p = 0.005) was observed in crude model. After adjustment for confounding factors (age, BMI, and physical activity), a significant positive association was observed between BMI (p = 0.004), WC (p = 0.02), body fat mass (p = 0.01), %BF (p = 0.01), hs-CRP (p = 0.009), and GRS. In addition, we discovered a significant negative association between the GRS and BMC (= -0.02, 95%CI = -0.05 to -0.001, p = 0.04). But other variables did not show any significant association with GRS among obese and overweight women. Conclusion We found a significant positive association between GRS, including MC4R (rs17782313), CAV-1 (rs3807992), and Cry-1 (rs2287161) and cardiometabolic risk factors among overweight and obese Iranian women.
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Affiliation(s)
- Fatemeh Gholami
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran
| | - Niloufar Rasaei
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran
| | - Mahsa Samadi
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran
| | - Mir Saeid Yekaninejad
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Seyed Ali Keshavarz
- grid.411705.60000 0001 0166 0922Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamali Javdan
- grid.412237.10000 0004 0385 452XFood Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Karimi
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Khadijeh Mirzaei
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P. O Box 6446, 14155 Tehran, Iran ,grid.411705.60000 0001 0166 0922 Food Microbiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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14
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Wang L, Yi Z. Association of the Composite dietary antioxidant index with all-cause and cardiovascular mortality: A prospective cohort study. Front Cardiovasc Med 2022; 9:993930. [PMID: 36267633 PMCID: PMC9577254 DOI: 10.3389/fcvm.2022.993930] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/16/2022] [Indexed: 12/05/2022] Open
Abstract
Background According to epidemiological and experimental data, high individual dietary antioxidant intake is correlated with reduced cancer risk. The correlations between combined dietary antioxidants and the risk of all-cause and cardiovascular mortality remain unclear. Consequently, this study focused on evaluating the correlation between the food-derived Composite Dietary Antioxidant Index (CDAI) and all-cause and cardiovascular mortality. Materials and methods Two years of data collected from participants aged ≥20 years were included in this prospective cohort study, which was obtained from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The US NHANES adopted a complicated, multistage probability sampling method to collect health data representing the US population. Data collection was done through in-person interviews, virtual physical examinations, and laboratory tests. Mortality-related follow-up statistics from the start of the survey to 31 December 2019 were available. The shape of the correlation between CDAI and all-cause and cardiovascular mortality was inspected using a restricted cubic spline model. For CDAI and all-cause and cardiovascular mortality, the univariate- and multivariate-adjusted Cox proportional hazard models were estimated and presented as regression coefficients and 95% confidence intervals. Results In total, 44,031 NHANES participants represented 339.4 million non-institutionalized residents of the US (age, 47.2 ± 16.9 years; 52.5% women, 70.2% non-Hispanic whites, 10.8% non-Hispanic black people, and 7.5% Mexican Americans). In the 118-month follow-up, 9,249 deaths were reported, including 2,406 deaths resulting from heart disease and 519 deaths due to cerebrovascular disease. In the restricted cubic spline regression models, a linear relationship between CDAI and all-cause mortality was present. The weighted multivariate hazard ratios for all-cause mortality were computed to be 0.97 (0.87–1.07) for Q2, 0.88 (0.81–0.96) for Q3, and 0.90 (0.80–1.00) for Q4 (P for trend = 0.009) upon comparison with the lowest quartile of CDAI, and an identical trend was observed for cardiovascular mortality. Conclusion A high CDAI was linked to decreased all-cause and cardiovascular mortality risk. The intake of an antioxidant-rich diet significantly prevents cardiovascular mortality. To shed more light on these outcomes, more itemized investigations such as randomized control trials are required.
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Affiliation(s)
- Lei Wang
- Department of Cardiology, Aerospace Center Hospital, Beijing, China
| | - Zhong Yi
- Department of Geriatric Medicine, Aerospace Center Hospital, Beijing, China,*Correspondence: Zhong Yi,
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15
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Kogan SM, Reck AJ, Curtis MG, Zuercher H, Collins C, Kwon E, Augustine DA. Planful Self-Control, Metabolic Risk, and Psychosocial Outcomes Among Young, Black Men: A Test of Skin-Deep Resilience Theory. Front Psychol 2022; 13:806955. [PMID: 35756200 PMCID: PMC9218602 DOI: 10.3389/fpsyg.2022.806955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/09/2022] [Indexed: 11/19/2022] Open
Abstract
Research on skin-deep resilience suggests that for youth and young adults from disadvantaged backgrounds, high levels of planful self-control may promote positive psychosocial outcomes while simultaneously conferring vulnerabilities to chronic diseases related to aging. In this study, we investigated the divergent effects of planful self-control on young Black American men's psychosocial well-being and their metabolic risk. We expected that high levels of planful self-control in emerging adulthood would predict positive outcomes in young adulthood (educational attainment, low depressive symptoms, job satisfaction); however, the combination of high levels of planful self-control and the experience of contextual adversity either in emerging adulthood or in childhood would forecast poor metabolic health. Hypotheses were tested with prospective data from 504 Black American men followed from age 20 to age 26. Planful self-control in emerging adulthood directly forecasted low levels of depressive symptoms, one's likelihood of obtaining a bachelor's degree, increased job satisfaction, and increases in metabolic risk. Exposure to childhood deprivation moderated the influence of planful self-control on metabolic risk. Men with high levels of deprivation and high levels of planful self-control exhibited the worst metabolic profiles in the sample. In contrast, men with high levels of childhood deprivation and low levels of planful self-control exhibited the best metabolic profiles. Documenting the health consequences associated with planful self-control provides a foundation from which to identify modifiable psychosocial factors that affect the course of psychosocial problems and health.
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Affiliation(s)
- Steven M. Kogan
- Center for Family Research, Owens Institute for Behavioral Research, University of Georgia, Athens, GA, United States
- Department of Human Development and Family Science, University of Georgia, Athens, GA, United States
| | - Ava J. Reck
- Department of Human Development and Family Science, University of Georgia, Athens, GA, United States
| | - Michael G. Curtis
- Department of Human Development and Family Science, University of Georgia, Athens, GA, United States
| | - Heather Zuercher
- Center for Family Research, Owens Institute for Behavioral Research, University of Georgia, Athens, GA, United States
| | - Christopher Collins
- Department of Human Development and Family Science, University of Georgia, Athens, GA, United States
| | - Elizabeth Kwon
- Center for Family Research, Owens Institute for Behavioral Research, University of Georgia, Athens, GA, United States
| | - Danielle A. Augustine
- Carl Vinson Institute of Government, University of Georgia, Athens, GA, United States
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16
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Clark SGF, Guilherme RC, Motter FR, Vasconcelos FND, Lira PICD, Canuto R. Cardiovascular risk behavior among industrial workers in the Northeast of Brazil: a cluster analysis. CIENCIA & SAUDE COLETIVA 2022; 27:1403-1412. [PMID: 35475821 DOI: 10.1590/1413-81232022274.07122021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/01/2021] [Indexed: 11/21/2022] Open
Abstract
This research aimed to investigate the occurrence of clusters of cardiovascular risk behaviors and their association with social demographic and occupational characteristics in a population of industrial workers in the metropolitan area of Recife, Brazil. It was a transversal study with 727 workers of both genders. We identified cluster distribution from the variables: smoking, alcohol consumption, physical activity and waist circumference, by a combination of hierarchical and non-hierarchical analysis. We later tested the association with the social demographic and occupational variables with a multi-varied analysis. We have identified a protection cluster (sufficient physical activity, moderate alcohol consumption) and a risk cluster (high waist circumference, sedentarism, smoking, excessive alcohol consumption). The protection cluster was positively associated with night shift or variable shift work (RP: 1.66, IC95%: 1.26-2.17), and the risk cluster was associated with women (RP: 1.15, IC95%: 1.01-1.31). Cluster analysis allowed to identify that, for day shift workers and women, the shortest daytime outside the work environment can influence the adoption of cardiovascular risk behaviors.
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Affiliation(s)
- Sabrina Gomes Ferreira Clark
- Programa de Pós-Graduação em Nutrição, Universidade Federal de Pernambuco (UFPE). Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
| | | | - Fabiane Raquel Motter
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade de Sorocaba. Sorocaba SP Brasil
| | - Fábio Nogueira de Vasconcelos
- Programa de Pós-Graduação em Nutrição, Universidade Federal de Pernambuco (UFPE). Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Pedro Israel Cabral de Lira
- Programa de Pós-Graduação em Nutrição, Universidade Federal de Pernambuco (UFPE). Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
| | - Raquel Canuto
- Programa de Pós-Graduação em Nutrição, Universidade Federal de Pernambuco (UFPE). Av. Prof. Moraes Rego 1235, Cidade Universitária. 50670-901 Recife PE Brasil.
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17
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Santa-Paavola R, Lehtinen-Jacks S, Jääskeläinen T, Männistö S, Lundqvist A. The association of high-sensitivity C-reactive protein with future weight gain in adults. Int J Obes (Lond) 2022; 46:1234-1240. [PMID: 35260816 PMCID: PMC9151385 DOI: 10.1038/s41366-022-01101-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
Background Obesity is associated with low-grade systemic inflammation, and it has been suggested that increased inflammation markers could predict future weight gain. Our aim was to investigate the associations of high-sensitivity C-reactive protein (hs-CRP) concentration with changes in weight and waist circumference in adults during 11 years of follow-up. Methods We used data from the Health 2000 and Health 2011 surveys consisting of a population-based sample of Finnish adults. We included those 3143 participants, aged 30–75 years at baseline, whose baseline hs-CRP was measured, and who had information on measured weight and height at both time points. Associations between baseline hs-CRP and changes in weight and waist circumference were analyzed using multinomial logistic regression, adjusted for sociodemographic factors (age, sex, marital status, and educational status), lifestyle factors (smoking, alcohol consumption, leisure-time physical activity, sitting time, sleeping time, and psychological distress), and baseline values of BMI and waist circumference. Results Hs-CRP was not associated with weight gain (≥5%) when adjusted for potential confounders (OR 0.99, 95% CI 0.96–1.01), compared to stable weight (change <±5%). Higher baseline hs-CRP was associated with decrease in weight (≤−5%) in the unadjusted (OR 1.03, 1.01–1.05), but not in the adjusted (OR 1.01, 0.99–1.03) model. No association was observed between hs-CRP and waist circumference. Conclusions Hs-CRP was not associated with future changes in weight or waist circumference in adults. These findings suggest that hs-CRP concentration does not predict future weight gain.
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Affiliation(s)
- Riina Santa-Paavola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
| | - Susanna Lehtinen-Jacks
- School of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland.,Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | | | - Satu Männistö
- Finnish Institute for Health and Welfare, Helsinki, Finland
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18
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Pétursdóttir Maack H, Sundström Poromaa I, Segeblad B, Lindström L, Jonsson M, Junus K, Wikström AK. Waist Circumference Measurement for Prediction of Preeclampsia: A Population-Based Cohort Study. Am J Hypertens 2022; 35:200-206. [PMID: 34570167 PMCID: PMC8807166 DOI: 10.1093/ajh/hpab156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/04/2021] [Accepted: 09/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Identifying women at high risk for preeclampsia is essential for the decision to start treatment with prophylactic aspirin. Prediction models have been developed for this purpose, and these typically incorporate body mass index (BMI). As waist circumference (WC) is a better predictor for metabolic and cardiovascular outcomes than BMI in nonpregnant populations, we aimed to investigate if WC is a BMI-independent predictor for preeclampsia and if the addition of WC to a prediction model for preeclampsia improves its performance. METHODS We used a population-based cohort of 4,696 women with WC measurements taken in the first trimester. The influence of WC on the risk of developing preeclampsia was evaluated by multivariable logistic regression. We generated receiver operating characteristic curves and calculated the area under the curve (AUC) to evaluate the usefulness of WC measurements for prediction of preeclampsia. RESULTS Women who developed preeclampsia had greater early pregnancy WC than women who did not (85.8 ± 12.6 vs. 82.3 ± 11.3 cm, P < 0.001). The risk of preeclampsia increased with larger WC in a multivariate model, adjusted odds ratio 1.02 (95% confidence interval 1.01-1.03). However, when adding BMI into the model, WC was not independently associated with preeclampsia. The AUC value for preeclampsia prediction with BMI and the above variables was 0.738 and remained unchanged with the addition of WC to the model. CONCLUSIONS Large WC is associated with a higher risk of preeclampsia, but adding WC to a prediction model for preeclampsia that already includes BMI does not improve the model's performance.
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Affiliation(s)
| | | | - Birgitta Segeblad
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Linda Lindström
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Maria Jonsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Katja Junus
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anna-Karin Wikström
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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19
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Meshram I, Boiroju NK, Longvah T. Prevalence of overweight/obesity, hypertension and its associated factors among women from Northeast India. Indian Heart J 2022; 74:56-62. [PMID: 34954135 PMCID: PMC8891027 DOI: 10.1016/j.ihj.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/07/2021] [Accepted: 12/21/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess prevalence of overweight/obesity, hypertension and its risk factors among women from North-eastern States of India. METHODS A community based cross-sectional study was carried out in two north-eastern States. Information was collected on household's socio-economic & demographic particulars. Height (cm), weight (kg), waist and hip circumferences and blood pressure were measured on all the selected women. Association between overweight/obesity, hypertension with socio-demographic variables was tested using Chi-square and logistic regression was done. Total 1047 women were covered from both the states. RESULTS The prevalence of chronic energy deficiency was 19% & 10%, overweight/obesity (BMI≥23) was 17.5% & 26% and hypertension was 15% & 17% (age adjusted 19.6% & 17%) respectively among women from Meghalaya & Nagaland. The prevalence of pre-hypertension was observed more among women from Nagaland (36.5%) as compared to Meghalaya (18.3%). Only 31% women were aware of hypertension and 6% had history of hypertension and 82% of them were on treatment. The prevalence of hypertension was observed high among 36-49 years and among overweight/obese women. On logistic regression, only age, BMI and use of additional salt was observed to be significantly associated with hypertension, while living in pucca house was associated with overweight/obesity. CONCLUSIONS The prevalence of hypertension was similar in both the states (15-17%) and pre-hypertension was high among women from Nagaland. This is warning sign for women in Nagaland. There is an urgent need to undertake more health & nutrition education sessions along with regular check-up for early diagnosis and treatment of hypertension.
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Affiliation(s)
- Indrapal Meshram
- Division of Public Health Nutrition, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500007, India.
| | - Naveen Kumar Boiroju
- Division of Biostatistics, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500007, India.
| | - Thingnganing Longvah
- Division of Food Chemistry, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500007, India.
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Prevalence of Underweight, Overweight and Obesity among Adults in Urban Bissau, Western Africa. Nutrients 2021; 13:nu13124199. [PMID: 34959751 PMCID: PMC8707413 DOI: 10.3390/nu13124199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Overweight and obesity affect a large proportion of the population and are important causes of death in both developed and low- and middle-income countries. In Guinea-Bissau, there are no previous population-based studies assessing this phenomenon. Therefore, we aimed to quantify the prevalence of underweight, overweight, and obesity among adults in Bissau. A stratified and cluster sample of 935 adults was assembled in 2021 and was evaluated using standardized questionnaires and anthropometric measurements, following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance. Underweight, obesity, and overweight were defined by body mass index based on the World Health Organization definitions. The prevalence of overweight and obesity was 48.7% among women and 25.0% among men. The proportion of women with abdominal obesity was 14 times higher than it was in men (35.3% vs. 2.5%). The prevalence of overweight and obesity increased with age and income. Underweight was more prevalent in the age group of 18 to 24 years (18.4% in women and 28.9% in men) and was less frequent among individuals with higher socioeconomic status. In conclusion, the prevalence of overweight and obesity is similar to the trends that are observed in many other urbanized populations in Africa and is already a major public health issue in urban Guinea-Bissau.
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Lean MEJ. Banting Memorial Lecture 2021-Banting, banting, banter and bravado: Convictions meet evidence in the scientific process: Diabetes UK Professional Conference, 27 April 2021. Diabet Med 2021; 38:e14643. [PMID: 34288105 DOI: 10.1111/dme.14643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
This personal account presents some glimpses into the clinical research processes which have made radical changes to our understanding of disease and treatment, and some characteristics of researchers, drawn from history and personal experiences around obesity and type 2 diabetes. Some summary messages emerge: The history of clinical diabetes research has shown how, perhaps through skilful leadership, combining very different personalities, skills and motivation can solve great challenges: Type 2 diabetes is a primary nutritional disease, secondary to the disease-process of obesity, not a primary endocrine disease. Type 2 diabetes is a manifestation of the disease-process of obesity, revealed by weight gain in people with underlying metabolic syndrome genetics/diathesis, mediated in large part at least by reversible ectopic fat accumulation impairing function of organs (liver, pancreas, brown adipose tissue). Treat overweight/obesity more seriously (defined as a disease-process with multiple organ-specific complications-not as a disease-state or BMI cut-off). Discuss the complications and risks of T2D openly: remission is as important as for cancers. Offer and support an optimal dietary weight management program as soon as possible from diagnosis, specifically aiming for remission: (a) Warn against non-evidence-based programs that look similar or claim to have similar potential: we have fully evidence-based programs; (b) Target sustained loss of >15 kg for Europeans (possibly less, e.g. >10 kg for Asians?). Increase future research support to enhance long-term weight loss maintenance. Several approaches need consideration: (a) Personalise diet compositions (recognising there is no intrinsic advantage from different carbohydrate/fat content). (b) Novel diet strategies (e.g. 5:2, time-restricted, flexible diet compositions). (c) New pharmaceutical agents as adjuncts to diet if necessary. (d) Novel food supplements to increase endogenous GLP-1 secretion.
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Affiliation(s)
- Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland
- Edgar Diabetes and Obesity Research, School of Medicine, University of Otago, Dunedin, New Zealand
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22
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Kakazu VA, Pinto RZ, Dokkedal-Silva V, Fernandes GL, Gobbi C, Andersen ML, Tufik S, Pires GN, Morelhão PK. Sleep Quality, Body Mass Index and Waist-to-Hip Ratio in Older Adults. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2021.1994098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Viviane Akemi Kakazu
- Departamento de Fisioterapia, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Presidente Prudente, Brazil
| | - Rafael Zambelli Pinto
- Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Vinicius Dokkedal-Silva
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Cynthia Gobbi
- Departamento de Fisioterapia, Universidade Cesumar, Maringá, Brazil
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Priscila Kalil Morelhão
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Pimenta IT, Coelho GMDO, Soares EDA. Is body image perception and (dis)satisfaction associated with anthropometric profile of older women attending a senior community center? J Women Aging 2021; 34:473-486. [PMID: 34280076 DOI: 10.1080/08952841.2021.1917241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The study aimed to assess the association between body image perception and (dis)satisfaction and the anthropometric profile of older women. Data from 60 women attending a senior community center were analyzed. Body image perception and (dis)satisfaction were considered dependent variables and were assessed using a silhouette scale constructed for the Brazilian population. The independent variables were body mass (BM), body mass index (BMI), waist circumference (WC), and calf circumference (CC). The associations were performed by logistic and linear regression models. Half of the participants overestimated their body size and 61.7% were dissatisfied due to excess weight. Overweight older women had 3.6 times higher odds to overestimate body size and 14.4 higher odds to be dissatisfied due to excess weight compared to normal-weight women. The increase in BM, BMI, WC, and CC raised mean difference between perceived and desired BMI and the odds of dissatisfaction due to excess weight. The anthropometric profile was more important to explain (dis)satisfaction than body size perception. The stimulus to changes that provide the adequacy of the anthropometric profile may reduce dissatisfaction due to excess weight among older women.
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Affiliation(s)
- Isiyara Taverna Pimenta
- Department of Basic and Experimental Nutrition, Graduate Program of Food, Nutrition and Health, Rio De Janeiro State University, Rio De Janeiro, Brazil
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Mirzababaei A, Shiraseb F, Abaj F, Khosroshahi RA, Tavakoli A, Koohdani F, Clark CCT, Mirzaei K. The effect of dietary total antioxidant capacity (DTAC) and Caveolin-1 gene variant interaction on cardiovascular risk factors among overweight and obese women: A cross-sectional investigation. Clin Nutr 2021; 40:4893-4903. [PMID: 34358834 DOI: 10.1016/j.clnu.2021.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/26/2021] [Accepted: 07/06/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Previous studies have shown that the Caveolin-1 (CAV-1) gene variant may be associated with Cardiovascular disease (CVD) risk. Moreover, dietary total antioxidant capacity (DTAC) has been shown to potentially elicit favorable effects on CVD risk. Therefore, this study sought to investigate the effect of DTAC and CAV-1 interaction on CVD risk factors. METHODS This cross-sectional study consisted of 352 women, with overweight and/or obesity, aged 18-48years from Iran. A food frequency questionnaire (FFQ), with 147 items, was used to assess dietary intake. The CAV-1 rs 3807992 and anthropometric data were measured by the PCR-RFLP method and bioelectrical impedance analysis (BIA), respectively. Serum profiles were measured by standard protocols. Participants were also divided into two groups based on DTAC score and rs3807992 genotype. RESULTS The mean age of the participants was 37.34 ± 9.11 and 36.01 ± 9.12 years for homozygous (GG) and minor allele carriers (AG + AA) respectively.The mean ± SD of insulin, total cholesterol (TC),high-density lipoprotein (HDL), low-density lipoprotein (LDL) and TG of participants were 1.21 ± 0.23, 185.3 ± 35.77, 46.58 ± 10.86, 95.3 ± 24.12 and 118.1 ± 58.88, respectively. There was a significant difference between genotypes for physical activity (P = 0.05), HDL (P < 0.001), insulin (P = 0.04), CRI-I (TC/HDL-C) (P = 0.01), and CRI-II (LDL-C/HDL-C) (P = 0.04). Our findings also showed, after controlling for confounding factors, significant interactions between DTAC score and the A allele carrier group on TC (Pinteraction = 0.001), LDL (Pinteraction = 0.001), insulin (Pinteraction = 0.08), HOMA-IR (Pinteraction = 0.03), AC ((TC - HDL - C)/HDL - C) (Pinteraction = 0.001), and CHOLINDEX (LDL-C-HDL-C) (Pinteraction = 0.02). CONCLUSION The results of the present study indicate that high DTAC intake may modify the odds of risk factors for CVD in AA and AG genotypes of rs 3807992. These results highlight that diet, gene variants, and their interaction, should be considered in CVD risk assessment.
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Affiliation(s)
- Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reza Amiri Khosroshahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atefeh Tavakoli
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fariba Koohdani
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Bramhankar M, Pandey M, Rana GS, Rai B, Mishra NL, Shukla A. An assessment of anthropometric indices and its association with NCDs among the older adults of India: evidence from LASI Wave-1. BMC Public Health 2021; 21:1357. [PMID: 34238276 PMCID: PMC8268209 DOI: 10.1186/s12889-021-11421-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to assess the status of physical body indices such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) among the older adults aged 45 and above in India. Further, to explore the association of anthropometric indices with various non-communicable morbidities. METHODS The study uses secondary data of the Longitudinal Ageing Survey's first wave in India (2017-18). The national representative sample for older adults 45 and above (65,662) considered for the analysis. The prevalence of the non-communicable diseases (NCDs) included in the study is based on the self-reporting of the participants. Diseases included are among the top ten causes of death, such as cancer, hypertension, stroke, chronic heart diseases, diabetes, chronic respiratory diseases, and multi-morbidity. Multi-morbidity is a case of having more than one of the morbidities mentioned above. BMI-obese indicates an individual having a BMI ≥30, and the critical threshold value for high-risk WC for men is ≥102 cm while for women is ≥88 cm. The critical limit for the high-risk WHR for men and women is ≥0.90 and ≥ 0.85, respectively. Descriptive statistics and multiple logistic regressions are used to assess the association BMI, WC, and WHR with non-communicable morbidities. RESULTS Based on the multivariate-adjusted model, odds shows that an Indian older adult aged 45 and above is 2.3 times more likely (AOR: 2.33; 95% CI (2.2, 2.5)) by obesity, 61% more likely (AOR: 1.61; 95% CI (1.629, 1.631)) by high-risk WHR and 98% more likely (AOR: 1.98; 95% CI (1.9, 2.1)) by high-risk WC to develop CVDs than their normal counterparts. Similarly, significant positive associations of obesity, high-risk WC, and high-risk WHR were observed with other NCDs and multi-morbidity. CONCLUSION Our study shows that obesity, high-risk WC, and high-risk WHR are significant risks for developing NCDs and multi-morbidity among the older adults in India. There is a need for a multi-sectoral approach to reduce the share of the elderly population in high-risk groups of BMIs, WHR, and WC.
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Affiliation(s)
| | - Mohit Pandey
- International Institute For Population Sciences, Mumbai, 400088 India
| | | | - Balram Rai
- International Institute For Population Sciences, Mumbai, 400088 India
| | - Nand Lal Mishra
- International Institute For Population Sciences, Mumbai, 400088 India
| | - Anandi Shukla
- International Institute For Population Sciences, Mumbai, 400088 India
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Piqueras P, Ballester A, Durá-Gil JV, Martinez-Hervas S, Redón J, Real JT. Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Front Psychol 2021; 12:631179. [PMID: 34305707 PMCID: PMC8299753 DOI: 10.3389/fpsyg.2021.631179] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/07/2021] [Indexed: 12/18/2022] Open
Abstract
Obesity is characterized by the accumulation of an excessive amount of fat mass (FM) in the adipose tissue, subcutaneous, or inside certain organs. The risk does not lie so much in the amount of fat accumulated as in its distribution. Abdominal obesity (central or visceral) is an important risk factor for cardiovascular diseases, diabetes, and cancer, having an important role in the so-called metabolic syndrome. Therefore, it is necessary to prevent, detect, and appropriately treat obesity. The diagnosis is based on anthropometric indices that have been associated with adiposity and its distribution. Indices themselves, or a combination of some of them, conform to a big picture with different values to establish risk. Anthropometric indices can be used for risk identification, intervention, or impact evaluation on nutritional status or health; therefore, they will be called anthropometric health indicators (AHIs). We have found 17 AHIs that can be obtained or estimated from 3D human shapes, being a noninvasive alternative compared to X-ray-based systems, and more accessible than high-cost equipment. A literature review has been conducted to analyze the following information for each indicator: definition; main calculation or obtaining methods used; health aspects associated with the indicator (among others, obesity, metabolic syndrome, or diabetes); criteria to classify the population by means of percentiles or cutoff points, and based on variables such as sex, age, ethnicity, or geographic area, and limitations.
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Affiliation(s)
- Paola Piqueras
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Alfredo Ballester
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Juan V. Durá-Gil
- Instituto de Biomecánica de Valencia, Universitat Politècnica de Valencia, Valencia, Spain
| | - Sergio Martinez-Hervas
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Josep Redón
- Department of Internal Medicine, Hospital Clínico de Valencia, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular and Renal Risk Research Group, Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), University of Valencia, Valencia, Spain
| | - José T. Real
- Service of Endocrinology and Nutrition, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Institute of Health Research of the Hospital Clinico Universitario de Valencia (INCLIVA), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Grytten E, Laupsa-Borge J, Bohov P, Bjørndal B, Strand E, Skorve J, Nordrehaug JE, Berge RK, Rostrup E, Mellgren G, Dankel SN, Nygård OK. Changes in lipoprotein particle subclasses, standard lipids, and apolipoproteins after supplementation with n-3 or n-6 PUFAs in abdominal obesity: A randomized double-blind crossover study. Clin Nutr 2021; 40:2556-2575. [PMID: 33933722 DOI: 10.1016/j.clnu.2021.03.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS Marine-derived omega-3 (n-3) polyunsaturated fatty acids (PUFAs), mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower circulating levels of triacylglycerols (TAGs), and the plant-derived omega-6 (n-6) PUFA linoleic acid (LA) may reduce cholesterol levels. Clinical studies on effects of these dietary or supplemental PUFAs on other blood fat fractions are few and have shown conflicting results. This study aimed to determine effects of high-dose supplemental n-3 (EPA + DHA) and n-6 (LA) PUFAs from high-quality oils on circulating lipoprotein subfractions and standard lipids (primary outcomes), as well as apolipoproteins, fatty acids, and glycemic control (secondary outcomes), in females and males with abdominal obesity. METHODS This was a randomized double-blind crossover study with two 7-wk intervention periods separated by a 9-wk washout phase. Females (n = 16) were supplemented with 3 g/d of EPA + DHA (TAG fish oil) or 15 g/d of LA (safflower oil), while males (n = 23) received a dose of 4 g/d of EPA + DHA or 20 g/d of LA. In fasting blood samples, we investigated lipoprotein particle subclasses by nuclear magnetic resonance spectroscopy, as well as standard lipids, apolipoproteins, fatty acid profiles, and glucose and insulin. Data were analyzed by linear mixed-effects modeling with 'subjects' as the random factor. RESULTS The difference between interventions in relative change scores was among the lipoprotein subfractions significant for total very-low-density lipoproteins (VLDLs) (n-3 vs. n-6: -38%∗ vs. +16%, p < 0.001; ∗: significant within-treatment change score), large VLDLs (-58%∗ vs. -0.91%, p < 0.001), small VLDLs (-57%∗ vs. +41%∗, p < 0.001), total low-density lipoproteins (LDLs) (+5.8%∗ vs. -4.3%∗, p = 0.002), large LDLs (+23%∗ vs. -2.1%, p = 0.004), total high-density lipoproteins (HDLs) (-6.0%∗ vs. +3.7%, p < 0.001), large HDLs (+11%∗ vs. -5.3%, p = 0.001), medium HDLs (-24%∗ vs. +6.2%, p = 0.030), and small HDLs (-9.9%∗ vs. +9.6%∗, p = 0.002), and among standard lipids for TAGs (-16%∗ vs. -2.6%, p = 0.014), non-esterified fatty acids (-19%∗ vs. +5.5%, p = 0.033), and total cholesterol (-0.28% vs. -4.4%∗, p = 0.042). A differential response in relative change scores was also found for apolipoprotein (apo)B (+0.40% vs. -6.0%∗, p = 0.008), apoA-II (-6.0%∗ vs. +1.5%, p = 0.001), apoC-II (-11%∗ vs. -1.7%, p = 0.025), and apoE (+3.3% vs. -3.8%, p = 0.028). CONCLUSIONS High-dose supplementation of high-quality oils with n-3 (EPA + DHA) or n-6 (LA) PUFAs was followed by reductions in primarily TAG- or cholesterol-related markers, respectively. The responses after both interventions point to changes in the lipoprotein-lipid-apolipoprotein profile that have been associated with reduced cardiometabolic risk, also among people with TAG or LDL-C levels within the normal range. REGISTRATION Registered under ClinicalTrials.gov Identifier: NCT02647333. CLINICAL TRIAL REGISTRATION Registered at https://clinicaltrials.gov/ct2/show/NCT02647333.
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Affiliation(s)
- Elise Grytten
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Johnny Laupsa-Borge
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Pavol Bohov
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Bodil Bjørndal
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Elin Strand
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Jon Skorve
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Jan Erik Nordrehaug
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Rolf K Berge
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Espen Rostrup
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway.
| | - Gunnar Mellgren
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Simon N Dankel
- Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, 5021 Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
| | - Ottar K Nygård
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway.
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Waduud MA, Sucharitkul PP, Giannoudi M, Bailey MA, Scott DJ. The abdominal waist circumference and 4-year outcomes following peripheral bypass grafting. INT ANGIOL 2021; 40:213-221. [PMID: 33739076 DOI: 10.23736/s0392-9590.21.04642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Current literature evaluating the relationship between obesity, utilizing measures other than the Body Mass Index (BMI), and postoperative outcomes following vascular surgery are sparse. This study aimed to investigate any association between abdominal waist circumference (AWC) and waist-hip ratio (WHR) in relation to postoperative morbidity and mortality following peripheral artery bypass graft (PABG) surgery. METHODS AWC and hip circumference (HC) were measured from pre-intervention magnetic resonance (MR) and computed tomography (CT) scans of patients undergoing elective and nonelective PABG. The AWC and WHR were assessed in relation to: the need for higher level care (i.e. level 2/3), the duration of higher level care, postoperative limb ischemia, postoperative hospital stay, graft patency on discharge and 30 day readmission, using logistic and linear regression analysis. Mortality was assessed using cox-regression analysis with calculation of hazard ratios at 30 days and 4 years. RESULTS In total, 177 patient images performed between January 2014 to January 2017 were analyzed. There were no significant intra-observer and interobserver differences in measurements of AWC and HC. Pre-intervention AWC was predictive of the need for higher level care following non-elective PABG (adjusted OR 1.1 [95% CI: 1.0-1.1, P=0.026]). An inverse relationship between AWC and mortality at 4 years was also observed (adjusted HR=0.9, 95% CI: 0.9-1.0, P=0.028). However, pre-intervention WHR failed to predict mortality and morbidity. CONCLUSIONS AWC may potentially be a suitable risk stratification tool in patients undergoing non-elective PABG. The association of AWC with long-term mortality outcomes require further investigation so that suitable cut-off values may be determined.
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Affiliation(s)
- Mohammed A Waduud
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK -
| | - Penelope P Sucharitkul
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Marilena Giannoudi
- Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Marc A Bailey
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - David J Scott
- Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Zhang Y, Li B, Liu N, Wang P, He J. Evaluation of Different Anthropometric Indicators for Screening for Nonalcoholic Fatty Liver Disease in Elderly Individuals. Int J Endocrinol 2021; 2021:6678755. [PMID: 33574841 PMCID: PMC7861948 DOI: 10.1155/2021/6678755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/20/2020] [Accepted: 01/11/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To explore the anthropometric indicators suitable for screening for nonalcoholic fatty liver disease (NAFLD) in the elderly population. METHODS This cross-sectional study screened subjects over 65 years, who had undergone a physical examination in 2019. Their height, weight, waist circumference, and fasting blood glucose and triglyceride levels were measured. Body mass index (BMI), waist circumstance (WC), waist-to-height ratio (WHtR), relative fat mass (RFM), ponderal index (PI), conicity index (CI), lipid accumulation product (LAP), and body shape index (ABSI) were calculated. Statistical analyses were performed using the Chi-square test, logistic regression, and receiver operating characteristic (ROC) curve. SUBJECTS Of a total of 4985 subjects, 1173 diagnosed with NAFLD and 3812 without NAFLD were included. RESULTS The NAFLD group had increased BMI, WC, WHtR, RFM, PI, CI, and LAP. ABSI was only significantly different in males between the groups. Logistic regression analysis showed that RFM was an effective prognostic factor for males with NAFLD, and LAP, BMI, and WC were effective prognostic factors for females. ROC curve analysis showed that LAP played a significant role in the prediction of NAFLD. CONCLUSION LAP is closely related to the occurrence of NAFLD and could be an efficient screening and treatment tool for NAFLD in the elderly people. Lay Summary. We conducted a screening and study of nonalcoholic fatty liver disease in the elderly population by determining the association between obesity indexes and nonalcoholic fatty liver disease. We found that LAP is practical, easy-to-measure tool for screening and studying NAFLD in the high-risk community elderly population, making it a valuable indicator in research.
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Affiliation(s)
- Yan Zhang
- Zhujiang Hospital, Southern Medical University, 253 Gongye Road, Guangzhou, Guangdong 510280, China
- Institute of Chronic Disease Risks Assessment, Henan University, Jinming Campus, Kaifeng, Henan 457004, China
| | - Bo Li
- Institute of Chronic Disease Risks Assessment, Henan University, Jinming Campus, Kaifeng, Henan 457004, China
| | - Nan Liu
- Institute of Chronic Disease Risks Assessment, Henan University, Jinming Campus, Kaifeng, Henan 457004, China
| | - Peixi Wang
- Institute of Chronic Disease Risks Assessment, Henan University, Jinming Campus, Kaifeng, Henan 457004, China
| | - Jinghua He
- Pingshan District People's Hospital of Shenzhen, Pingshan General Hospital of Southern Medical University, Shenzhen, Guangdong 518118, China
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Silva SRDA, Marques APDO, Leal MCC, Santos LGCD, Araújo JGCD, Araújo KMSTD. Nutritional risk and associated factors in older people with HIV / AIDS and use of antiretroviral therapy in reference centers. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.210209.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective To identify the nutritional risk of older people with HIV / AIDS and the associated factors. Method It is a cross-sectional and analytical study. 241 older people from the Reference Services in Recife/PE, Brazil participated. The dependent variable was Nutritional risk, assessed by the Mini Nutritional Assessment and the independent ones, the sociodemographic, lifestyle and health conditions. Results 44% of participants with nutritional risk were identified. There was an association between nutritional risk and female gender, education between 1-4 years of study and symptoms of depression. Conclusion It is suggested to include screening measures for early intervention of nutritional status, such as Mini Nutritional Assessment in the care routine, with a view to enabling greater comprehensiveness in care in Gerontology and reducing the risk of morbidity and mortality associated with the disease, and promoting longevity of better quality for those living with HIV.
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Silva SRDA, Marques APDO, Leal MCC, Santos LGCD, Araújo JGCD, Araújo KMSTD. Risco nutricional e fatores associados em idosos com HIV/aids em uso de terapia antirretroviral nas unidades de referência. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.210209.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo identificar o risco nutricional de pessoas idosas com HIV/aids em uso de terapia antirretroviral (TARV) e fatores associados. Método estudo de natureza transversal e analítico. Participaram 241 idosos cadastrados nos Serviços de Referência para tratamento de HIV/aids do Município de Recife/PE, Brasil. A variável dependente correspondeu ao risco nutricional, avaliado por meio da Mini Avaliação Nutricional e as independentes incluíram: dados sociodemográficos, estilo de vida e condições de saúde. ResuItados foram identificados 44% dos participantes com risco nutricional e verificada associação entre risco nutricional e sexo feminino, escolaridade entre 1-4 anos de estudo e sintomatologia depressiva. Conclusão Sugere-se a inclusão de medidas de rastreio para intervenção precoce do estado nutricional como a Mini Avaliação Nutricional na rotina do cuidado, com vistas a possibilitar maior integralidade na assistência e redução de riscos de morbimortalidade associada ao HIV.
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Lucas RWDC, Nassif PAN, Tabushi FI, Nassif DSB, Ariede BL, Brites-Neto J, Malafaia O. CAN STATURE, ABDOMINAL PERIMETER AND BMI INDEX PREDICT POSSIBLE CARDIOMETABOLIC RISKS IN FUTURE OBESITY? ACTA ACUST UNITED AC 2020; 33:e1529. [PMID: 33237167 PMCID: PMC7682149 DOI: 10.1590/0102-672020200002e1529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/29/2020] [Indexed: 01/26/2023]
Abstract
Background:
Obesity changes the anatomy of the patient. In addition to the aesthetic
change, the high percentage of fat determines evident functional changes.
Anthropometric normality in measuring abdominal circumference and height can
serve as a basis for measuring cardiometabolic risks of obesity.
Aim:
To verify if it is possible to determine parameters of normality between
waist and height in people with normal BMI and fat percentages, to serve as
a basis for assessing risks for obesity comorbidities.
Methods:
A sample of 454 individuals with BMI and percentages of fat considered within
the normal range was extracted. It was divided into age groups for both men
and women between 18 and 25; 26 to 35; 36 to 45; 46 to 55; 56 to 65. A total
of 249 men and 205 women were included.
Results:
Regarding the percentage of height as a measure of the abdominal perimeter,
the total female sample had an average of 44.2±1.1% and the male 45.3%+1.5.
For women, this percentage determined the equation of the waist-height ratio
represented by X=(age+217) / 5.875, and for men X=(age+190.89) / 5.2222. “X”
represents the percentage of the height measurement so that the individual
falls into the category of adequate percentage of fat and BMI.
Conclusion:
Between the stature of adult men and women with normal fat percentage and
BMI, there is a common numerical relationship, with is on average 44% for
women and 45% for men.
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Affiliation(s)
- Ricardo Wallace das Chagas Lucas
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil
| | - Paulo Afonso Nunes Nassif
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Paulo Nassif Institute, Curitiba, PR, Brazil.,Bariatric and Metabolic Surgery Service, University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil
| | | | - Denise Serpa Bopp Nassif
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Paulo Nassif Institute, Curitiba, PR, Brazil
| | | | | | - Osvaldo Malafaia
- Postgraduate Program in Principles of Surgery, Mackenzie Evangelical Faculty of Paraná/Medical Research Institute, Curitiba, PR, Brazil.,Bariatric and Metabolic Surgery Service, University Evangelical Mackenzie Hospital, Curitiba, PR, Brazil
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Torbahn G, Schoene D, Schwingshackl L, Rücker G, Knüttel H, Kemmler W, Sieber CC, Batsis JA, Villareal DT, Stroebele-Benschop N, Volkert D, Kiesswetter E. Effective SLOPE: EffectS of Lifestyle interventions in Older PEople with obesity: a systematic review and network meta-analysis protocol. BMJ Open 2020; 10:e038330. [PMID: 33033022 PMCID: PMC7542917 DOI: 10.1136/bmjopen-2020-038330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Obesity is highly prevalent in older adults aged 65 years or older. Different lifestyle interventions (diet, exercise, self-management) are available but benefits and harms have not been fully quantified comparing all available health promotion interventions. Special consideration must be given to functional outcomes and possible adverse effects (loss of muscle and bone mass, hypoglycaemia) of weight loss interventions in this age group. The objective of this study is to synthesise the evidence regarding the effects of different types and modalities of lifestyle interventions, or their combinations, on physical function and obesity-related outcomes such as body composition in older adults with obesity. METHODS AND ANALYSES Six databases (Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Psychinfo and Web of Science) and two trial registries (Clinicaltrials.gov and the WHO International Clinical Trials Registry Platform) will be searched for randomised controlled trials of lifestyle interventions in older adults with obesity. Screening (title/abstract and full-text) and data extraction of references as well as assessment of risk of bias and rating of the certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation for network meta-analyses) will be performed by two reviewers independently. Frequentist random-effects network meta-analyses will be conducted to determine the pooled effects from each intervention. ETHICS AND DISSEMINATION We will submit our findings to peer-reviewed journals and present at national and international conferences as well as in scientific medical societies. Patient-targeted dissemination will involve local and national advocate groups. PROSPERO REGISTRATION NUMBER CRD42019147286.
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Affiliation(s)
- Gabriel Torbahn
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
| | - Daniel Schoene
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Gerta Rücker
- Institute of Medical Biometry and Medical Informatics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, Regensburg, Germany
| | - Wolfgang Kemmler
- Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Cornel C Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
- Department of Medicine, Kantonsspital Winterthur, Winterthur, Zurich, Switzerland
| | - John A Batsis
- Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston, Texas, USA
| | - Nanette Stroebele-Benschop
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Bayern, Germany
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Amstutz D, Gonçalves D, Hudelson P, Stringhini S, Durieux-Paillard S, Rolet S. Nutritional Status and Obstacles to Healthy Eating Among Refugees in Geneva. J Immigr Minor Health 2020; 22:1126-1134. [PMID: 32940816 PMCID: PMC7683482 DOI: 10.1007/s10903-020-01085-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2020] [Indexed: 12/02/2022]
Abstract
Refugees face various nutritional challenges during and after migration. This cross-sectional, mixed-methods study seeks to investigate the prevalence of undernutrition and obesity among refugees in Geneva, and to identify barriers to healthy eating. Anthropometric measurements of 354 adult refugees were collected between 2017 and 2019 by trained nurses and dietitians. Seven focus group discussions totaling 51 participants, refugees and social workers, investigated conceptions and needs regarding diet. The mean Body Mass Index is 24.6 ± 4.8 kg/m2. Women are disproportionately affected by obesity compared to men (p < 0.001). Weight gain post-migration is correlated positively with length of stay in Geneva (p < 0.001). Major obstacles to healthy eating are economic and linguistic. For participants, cooking workshops and free physical activities are highly needed interventions. Post-migration lifestyle interventions should be implemented to prevent weight gain in this population. Such interventions must be multi-level, to overcome structural, social and behavioral barriers to healthy eating.
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Affiliation(s)
- Delphine Amstutz
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Daniela Gonçalves
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Patricia Hudelson
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sophie Durieux-Paillard
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sylvie Rolet
- Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland.,Care Directorate, Geneva University Hospitals, Geneva, Switzerland
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Stanley A, Schuna J, Yang S, Kennedy S, Heo M, Wong M, Shepherd J, Heymsfield SB. Distinct phenotypic characteristics of normal-weight adults at risk of developing cardiovascular and metabolic diseases. Am J Clin Nutr 2020; 112:967-978. [PMID: 32687153 PMCID: PMC7762762 DOI: 10.1093/ajcn/nqaa194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The normal-weight BMI range (18.5-24.9 kg/m2) includes adults with body shape and cardiometabolic disease risk features of excess adiposity, although a distinct phenotype developed on a large and diverse sample is lacking. OBJECTIVE To identify demographic, behavioral, body composition, and health-risk biomarker characteristics of people in the normal-weight BMI range who are at increased risk of developing cardiovascular and metabolic diseases based on body shape. METHODS Six nationally representative waist circumference index (WCI, weight/height0.5) prediction formulas, with BMI and age as covariates, were developed using data from 17,359 non-Hispanic (NH) white, NH black, and Mexican-American NHANES 1999-2006 participants. These equations were then used to predict WCI in 5594 NHANES participants whose BMI was within the normal weight range. Men and women in each race/Hispanic-origin group were then separated into high, medium, and low tertiles based on the difference (residual) between measured and predicted WCI. Characteristics were compared across tertiles; P values for significance were adjusted for multiple comparisons. RESULTS Men and women in the high WCI residual tertile, relative to their BMI and age-equivalent counterparts in the low tertile, had significantly lower activity levels; higher percent trunk and total body fat (e.g. NH white men, X ± SE, 25.3 ± 0.2% compared with 20.4 ± 0.2%); lower percent appendicular lean mass (skeletal muscle) and bone mineral content; and higher plasma insulin and triglycerides, higher homeostatic model assessment of insulin resistance (e.g. NH white men, 1.45 ± 0.07 compared with 1.08 ± 0.06), and lower plasma HDL cholesterol. Percent leg fat was also significantly higher in men but lower in women. Similar patterns of variable statistical significance were present within sex and race/ethnic groups. CONCLUSIONS Cardiometabolic disease risk related to body shape in people who are normal weight according to BMI is characterized by a distinct phenotype that includes potentially modifiable behavioral health risk factors.
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Affiliation(s)
- Abishek Stanley
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - John Schuna
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, South Carolina, SC, USA
| | - Michael Wong
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
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Cowan AE, Higgins KA, Fisher JO, Tripicchio GL, Mattes RD, Zou P, Bailey RL. Examination of different definitions of snacking frequency and associations with weight status among U.S. adults. PLoS One 2020; 15:e0234355. [PMID: 32555712 PMCID: PMC7299329 DOI: 10.1371/journal.pone.0234355] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/22/2020] [Indexed: 01/03/2023] Open
Abstract
Snacks, while widely consumed in the United States (U.S.), do not have a standard definition, complicating research to understand associations, if any, with weight status. Therefore, the purpose of this study was to examine the association between snacking frequency and weight status using various snacking definitions that exist in the scientific literature among U.S. adults (NHANES 2013–2016; ≥20y n = 9,711). Four event-based snacking definitions were operationalized including participant-defined snacks, eating events outside of meals, and operationally defined snacks based on absolute thresholds of energy consumed (>50 kcal). Weight status was examined using body mass index (BMI), waist circumference, and sagittal abdominal diameter risk. Logistic regression models examined snacking frequency and associations with weight status. Outcomes varied by the definition of a snack employed, but the majority of findings were null. Mean energy from snacks was significantly higher among women with obesity compared to women with normal weight when a snack was defined as any event outside of a typical mealtime (i.e. other than breakfast, lunch, dinner, super, brunch), regardless of whether or not it contributed ≥50 kcal. Further investigation into ingestive behaviors that may influence the relationship between snacking frequency and weight status is needed.
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Affiliation(s)
- Alexandra E. Cowan
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Kelly A. Higgins
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
- Center for Chemical Regulation and Food Safety, Exponent, Inc., Washington, DC, United States of America
- * E-mail:
| | - Jennifer O. Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Gina L. Tripicchio
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Richard D. Mattes
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Peishan Zou
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Regan L. Bailey
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
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Cham B, Scholes S, Ng Fat L, Badjie O, Groce NE, Mindell JS. The silent epidemic of obesity in The Gambia: evidence from a nationwide, population-based, cross-sectional health examination survey. BMJ Open 2020; 10:e033882. [PMID: 32487572 PMCID: PMC7265034 DOI: 10.1136/bmjopen-2019-033882] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Non-communicable diseases account for 70% of global deaths; 80% occur in low-income and middle-income countries. The rapid increase of obesity in sub-Saharan Africa is a concern. We assessed generalised and abdominal obesity and their associated risk factors among adults in The Gambia. DESIGN Nationwide cross-sectional health examination survey using the WHO STEPwise survey methods. SETTING The Gambia. PARTICIPANTS This study uses secondary analysis of a 2010 nationally representative random sample of adults aged 25-64 years (78% response rate). The target sample size was 5280, and 4111 responded. Analysis was restricted to non-pregnant participants with valid weight and height measurements (n=3533). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome variable was generalised obesity, using WHO body mass index (BMI) thresholds. Analyses used non-response weighting and adjusted for the complex survey design. We conducted multinomial logistic regression analysis to identify factors associated with BMI categories. The secondary outcome variable was abdominal obesity, defined as high waist circumference (using the International Diabetes Federation thresholds for Europeans). RESULTS Two-fifths of adults were overweight/obese, with a higher obesity prevalence in women (17%, 95% CI 14.7 to 19.7; men 8%, 95% CI 6.0 to 11.0). 10% of men and 8% of women were underweight. Urban residence (adjusted relative risk ratio 5.8, 95% CI 2.4 to 14.5), higher education (2.3, 1.2 to 4.5), older age, ethnicity, and low fruit and vegetable intake (2.8, 1.1 to 6.8) were strongly associated with obesity among men. Urban residence (4.7, 2.7 to 8.2), higher education (2.6, 1.1 to 6.4), older age and ethnicity were associated with obesity in women. CONCLUSION There is a high burden of overweight/obesity in The Gambia. While obesity rates in rural areas were lower than in urban areas, obesity prevalence was higher among rural residents in this study compared with previous findings. Preventive strategies should be directed at raising awareness, discouraging harmful beliefs on weight, and promoting healthy diets and physical activity.
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Affiliation(s)
- Bai Cham
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- Department of Public Health, University of The Gambia, Brikama, The Gambia
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Shaun Scholes
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Linda Ng Fat
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Omar Badjie
- Non-communicable Diseases Control Unit, Ministry of Health, Banjul, The Gambia
| | - Nora Ellen Groce
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, University College London, London, UK
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Delluc A, Lacut K, Rodger MA. Arterial and venous thrombosis: What's the link? A narrative review. Thromb Res 2020; 191:97-102. [PMID: 32416310 DOI: 10.1016/j.thromres.2020.04.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 01/10/2023]
Abstract
Arterial thrombosis and venous thromboembolism (VTE) are traditionally considered two different entities. However, patients with unprovoked VTE are at higher risk of developing subclinical and overt atherosclerosis compared to healthy controls challenging these distinctions. Obesity may explain the association between arterial and venous disease: overweight/obese patients are prone to stasis in lower limbs veins, chronic inflammation, dyslipidemia, hypertension, and diabetes mellitus; all of which result in a hypercoagulability, VTE, and atherosclerosis. Novel therapeutic approaches combining and re-purposing traditional arterial therapies (antiplatelets and statins) and venous thrombosis therapies (anticoagulants) are emerging for the management of patients with vascular disease.
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Affiliation(s)
- Aurélien Delluc
- Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Karine Lacut
- Department of Internal Medicine and Chest Diseases, EA3878 (G.E.T.B.O.), CIC INSERM 0502, University Hospital of Brest, European University of Occidental Brittany, Brest, France
| | - Marc A Rodger
- Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Prevalence and awareness of cardiovascular risk factors in patients with schizophrenia: A cross-sectional study in a low cardiovascular disease risk geographical area. Eur Psychiatry 2020; 24:431-41. [DOI: 10.1016/j.eurpsy.2009.07.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 06/03/2009] [Accepted: 07/21/2009] [Indexed: 11/24/2022] Open
Abstract
AbstractObjectivePrevalence of cardiovascular disease is high in schizophrenia. Our aim is to estimate the prevalence of cardiovascular risk factors (CVRF) among schizophrenia patients.MethodNational cross-sectional study in patients diagnosed with schizophrenia under treatment with second generation antipsychotics and admitted to short-stay hospitalisation units.ResultsA sample of 733 consecutively admitted patients was enrolled; the most prevalent CVRFs were smoking 71% (95% CI: 67–74%) and hypercholesterolemia 66% (61–70%) followed by hypertriglyceridemia 26% (26–32%), hypertension 18% (15–21%) and diabetes 5% (4–7%). Metabolic syndrome showed 19% (95% CI: 16–23%) prevalence or, according to updated definitions (Clin Cornerstone 7 [2005] 36–45), 24% (95% CI: 20–28%). The rate of patients within the high-risk range of a 10-year fatal cardiovascular event was 6.5%. CVRFs under routine management were diabetes (60%), hypertension (28%) and, to a lesser extent, dyslipemia (14%). Treatment for CVRFs was associated to gender, men for hypertension OR = 25.34, p < 0.03 and women for diabetes OR = 0.02, p < 0.03.ConclusionWe found that CVRFs in schizophrenia were prevalent and under-diagnosed, and thus with insufficient therapeutic management.
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Zweers H, Smit D, Leij S, Wanten G, Janssen MC. Individual dietary intervention in adult patients with mitochondrial disease due to the m.3243 A>G mutation. Nutrition 2020; 69:110544. [DOI: 10.1016/j.nut.2019.06.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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41
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Liao CC, Sheu WHH, Lin SY, Lee WJ, Lee IT. The Relationship Between Abdominal Body Composition and Metabolic Syndrome After a Weight Reduction Program in Adult Men with Obesity. Diabetes Metab Syndr Obes 2020; 13:1-8. [PMID: 32021346 PMCID: PMC6954077 DOI: 10.2147/dmso.s228954] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 12/06/2019] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To assess the relationship between changes in abdominal adipose tissue and metabolic syndrome (MetS) in men with obesity after a weight reduction program (WRP). PATIENTS AND METHODS Adult men with obesity and MetS were recruited for this prospective single-arm intervention study. Participants consumed an energy-restricted diet of 1200 kcal/day and performed 50-mins aerobic exercise daily for 12 weeks. Changes in the components of MetS were recorded. Changes in subcutaneous abdominal fat area (SAFA) and intra-abdominal fat area (IAFA) at the umbilicus level were determined using magnetic resonance imaging. RESULTS A total of 30 men (mean age, 42.3 ± 10.0 years; body mass index, 33.7 ± 4.1 kg/m2) were included in this study. A moderate (8.0%) weight reduction occurred. Reversion of MetS was observed in 15 (50%) participants after the WRP. There was significant reduction in SAFA (68.3 ± 20.2 vs. 51.5 ± 18.6 cm2; P < 0.001) and IAFA (96.3 ± 15.6 vs. 86.0 ± 16.5 cm2; P < 0.001); the magnitude of reduction was greater for SAFA than for IAFA (-16.8 ± 7.7 vs. -10.3 ± 8.3 cm2; P < 0.001). Multivariate logistic regression analysis showed a reduction in IAFA to be an independent factor to decrease the risk of persistent MetS after WRP by adjustment for age, baseline IAFA, and change in SAFA (odds ratio = 0.25, 95% confidence interval: 0.07-0.95, P = 0.041). Reduction in SAFA was not significantly associated with the reversion of MetS (P = 0.411). CONCLUSION Reduction in IAFA via a 12-week WRP may help reverse MetS in men with obesity and MetS.
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Affiliation(s)
- Chun-Cheng Liao
- Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wayne Huey-Herng Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Rong Hsing Research Center for Translational Medicine, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Shih-Yi Lin
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Jane Lee
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- College of Science, Tunghai University, Taichung City, Taiwan
- Correspondence: I-Te Lee Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard, Sect. 4, Taichung40705, TaiwanTel +886-4-23741300Fax +886-4-23593662 Email
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Smith NA, Batterham M, Peoples GE, Shulman MA. The clinical, functional and disability characteristics of patients with severe obesity presenting for non-bariatric surgery. Anaesth Intensive Care 2019; 47:522-531. [PMID: 31779477 DOI: 10.1177/0310057x19887976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The clinical and functional characteristics of patients with severe obesity who present for non-bariatric surgery have rarely been described. For this study, 293 such patients (mean body mass index 42 kg/m2) were investigated using their medical records, a 6-minute walk test, N-terminal pro B-type natriuretic peptide measurement, and the World Health Organization Disability Assessment Schedule 2.0 measure of disability. Cardiorespiratory disease and diabetes were common, with blood tests revealing a high probability of additional unexpected and undiagnosed renal and cardiac disease in a significant proportion of patients. One-third of patients had natriuretic peptide values that identify early left ventricular dysfunction in the community, with 16% above a value described as useful in predicting adverse outcomes for elective surgical patients. Only 10% of patients walked a distance within 10% of that predicted in six minutes, and 22% did not complete the test. Over one-third of patients (34%) had a clinically significant level of disability, with those unable to walk for six minutes describing higher levels of disability. Functional capacity as measured by the 6-minute walk test was significantly lower than would be expected from age, gender, and weight alone, and was related to age and degree of disability but not body mass index. We describe a severely obese population presenting for non-bariatric surgery who had significant levels of comorbid disease, functional impairment, and disability that were not apparent on routine preoperative assessment.
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Affiliation(s)
- Natalie A Smith
- School of Medicine, University of Wollongong, Wollongong, Australia
| | - Marijka Batterham
- Statistical Consulting Centre, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, Australia
| | | | - Mark A Shulman
- Department of Anaesthesiology and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Australia
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Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, Whittaker V, Sharp T, Lean M, Hankey C, Ells L. Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2019; 16:507-547. [PMID: 29419624 DOI: 10.11124/jbisrir-2016-003248] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To examine the effectiveness of intermittent energy restriction in the treatment for overweight and obesity in adults, when compared to usual care treatment or no treatment. INTRODUCTION Intermittent energy restriction encompasses dietary approaches including intermittent fasting, alternate day fasting, and fasting for two days per week. Despite the recent popularity of intermittent energy restriction and associated weight loss claims, the supporting evidence base is limited. INCLUSION CRITERIA This review included overweight or obese (BMI ≥25 kg/m) adults (≥18 years). Intermittent energy restriction was defined as consumption of ≤800 kcal on at least one day, but no more than six days per week. Intermittent energy restriction interventions were compared to no treatment (ad libitum diet) or usual care (continuous energy restriction ∼25% of recommended energy intake). Included interventions had a minimum duration of 12 weeks from baseline to post outcome measurements. The types of studies included were randomized and pseudo-randomized controlled trials. The primary outcome of this review was change in body weight. Secondary outcomes included: i) anthropometric outcomes (change in BMI, waist circumference, fat mass, fat free mass); ii) cardio-metabolic outcomes (change in blood glucose and insulin, lipoprotein profiles and blood pressure); and iii) lifestyle outcomes: diet, physical activity, quality of life and adverse events. METHODS A systematic search was conducted from database inception to November 2015. The following electronic databases were searched: MEDLINE, Embase, CINAHL, Cochrane Library, ClinicalTrials.gov, ISRCTN registry, and anzctr.org.au for English language published studies, protocols and trials. Two independent reviewers evaluated the methodological quality of included studies using the standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted from papers included in the review by two independent reviewers using the standardized data extraction tool from the Joanna Briggs Institute. Effect sizes were expressed as weighted mean differences and their 95% confidence intervals were calculated for meta-analyses. RESULTS Six studies were included in this review. The intermittent energy restriction regimens varied across studies and included alternate day fasting, fasting for two days, and up to four days per week. The duration of studies ranged from three to 12 months. Four studies included continuous energy restriction as a comparator intervention and two studies included a no treatment control intervention. Meta-analyses showed that intermittent energy restriction was more effective than no treatment for weight loss (-4.14 kg; 95% CI -6.30 kg to -1.99 kg; p ≤ 0.001). Although both treatment interventions achieved similar changes in body weight (approximately 7 kg), the pooled estimate for studies that investigated the effect of intermittent energy restriction in comparison to continuous energy restriction revealed no significant difference in weight loss (-1.03 kg; 95% CI -2.46 kg to 0.40 kg; p = 0.156). CONCLUSIONS Intermittent energy restriction may be an effective strategy for the treatment of overweight and obesity. Intermittent energy restriction was comparable to continuous energy restriction for short term weight loss in overweight and obese adults. Intermittent energy restriction was shown to be more effective than no treatment, however, this should be interpreted cautiously due to the small number of studies and future research is warranted to confirm the findings of this review.
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Affiliation(s)
- Leanne Harris
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sharon Hamilton
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Liane B Azevedo
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Joan Olajide
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Caroline De Brún
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Gillian Waller
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Vicki Whittaker
- Health and Social Care Institute, Teesside University, Middlesbrough, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
| | - Tracey Sharp
- Independent Public Health Consultant, United Kingdom
| | - Mike Lean
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Catherine Hankey
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Louisa Ells
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.,Teesside Centre for Evidence Informed Practice: a Joanna Briggs Institute Centre of Excellence, United Kingdom
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Mozaffari H, Namazi N, Larijani B, Bellissimo N, Azadbakht L. Association of dietary acid load with cardiovascular risk factors and the prevalence of metabolic syndrome in Iranian women: A cross-sectional study. Nutrition 2019; 67-68:110570. [DOI: 10.1016/j.nut.2019.110570] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 08/11/2019] [Accepted: 08/13/2019] [Indexed: 12/25/2022]
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Nyberg CK, Fjell AM, Walhovd KB. Level of body fat relates to memory decline and interacts with age in its association with hippocampal and subcortical atrophy. Neurobiol Aging 2019; 91:112-124. [PMID: 32224068 DOI: 10.1016/j.neurobiolaging.2019.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/28/2019] [Accepted: 10/08/2019] [Indexed: 12/28/2022]
Abstract
Higher levels of body fat have shown adverse effects on multiple aspects of health, including cognitive and neuroanatomical changes. We tested the relationships of body fat levels and cholesterol to longitudinal age trajectories of subcortical gray matter volume (SCV), hippocampal volume (HCV), and episodic memory. Body fat was indexed by a concerted factor of BMI, visceral adipose tissue, percentage body fat, and total fat mass and was included in the analyses as a cross-sectional measure. We hypothesized that higher level of body fat would be related to steeper age trajectories of SCV, HCV, and memory. The sample consisted of 581 participants (20-83 years) with 942 magnetic resonance imaging and 945 memory examinations. Using generalized additive mixed models, a negative effect of body fat was found on SCV, HCV, and memory. Age and body fat interacted in their association with brain volume change. The results suggest that among cognitively healthy adults, there is a negative effect of higher body fat on SCV, HCV, and memory decline, an effect that increased with age for the neuroanatomical volumes.
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Affiliation(s)
- Claudia Kim Nyberg
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway; Research Department, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.
| | - Anders M Fjell
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway; Department of radiology and nuclear medicine, Oslo University Hospital, Oslo, Norway
| | - Kristine B Walhovd
- Department of Psychology, Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway; Department of radiology and nuclear medicine, Oslo University Hospital, Oslo, Norway
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Pajuelo-Ramírez J, Torres-Aparcana H, Agüero-Zamora R, Quispe AM. Altitude and its inverse association with abdominal obesity in an Andean country: a cross-sectional study. F1000Res 2019; 8:1738. [PMID: 31824671 PMCID: PMC6896245 DOI: 10.12688/f1000research.20707.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2019] [Indexed: 11/28/2022] Open
Abstract
Background: Abdominal obesity represents an accurate predictor of overall morbidity and mortality, which is worrisome because it is also continuously increasing across Andean countries. However, its relationship with altitude remains unclear. The objective of this study was to assess the association between altitude and abdominal obesity in Peru, and how sociodemographic variables impact this association. Methods: We estimated the prevalence of abdominal obesity in Peru and analyzed its association with altitude using the data from the 2012-2013 National Household Survey (ENAHO). During this survey, a representative sample of Peruvians was screened for abdominal obesity, using waist circumference as a proxy, and the Adult Treatment Panel III guidelines cutoffs. Results: Data were analyzed from a sample of 20,489 Peruvians (51% male). The prevalence of abdominal obesity was estimated at 33.6% (95% CI: 32.5 to 34.6%). In Peru, altitude was significantly and inversely associated with abdominal obesity, decreasing with higher altitudes: 1500-2999 meters above mean sea level (MAMSL) vs <1500 MAMSL, adjusted prevalence rate [aPR]= 0.86 (95% CI: 0.75 to 0.97); ≥3000 MAMSL vs <1500 MAMSL, aPR= 0.98 (95% CI: 0.87 to 1.11), when adjusting by age, gender and residence area (rural/urban). However, this association was significantly modified by age and gender ( p< 0.001). Conclusion: Abdominal obesity is highly prevalent in Peru and decreases significantly with altitude, but age and gender modify this association. Thus, abdominal obesity appears to affect older women from low altitudes more than younger men from high altitudes.
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Abstract
OBJECTIVE The ongoing demographic, nutritional and epidemiological transitions in sub-Saharan Africa highlight the importance of monitoring overweight and obesity. We aimed to assess the prevalence of overweight and obesity in Mozambique in 2014/2015 and compare the estimates with those obtained in 2005. DESIGN Cross-sectional study conducted in 2014/2015, following the WHO Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). Prevalence estimates with 95 % CI were computed for different categories of BMI and abdominal obesity, along with age-, education- and income-adjusted OR. The age-standardized prevalence in the age group 25-64 years was compared with results from a STEPS survey conducted in 2005. SETTING Mozambique. PARTICIPANTS Representative sample of the population aged 18-64 years (n 2595). RESULTS Between 2005 and 2014/2015, the prevalence of overweight and obesity increased from 18·3 to 30·5 % (P < 0·001) in women and from 11·7 to 18·2 % (P < 0·001) in men. Abdominal obesity increased among women (from 9·4 to 20·4 %, P < 0·001), but there was no significant difference among men (1·5 v. 2·1 %, P = 0·395). In 2014/2015, the prevalence of overweight and obesity was more than twofold higher in urban areas and in women; in the age group 18-24 years, it was highest in urban women and lowest in rural men. CONCLUSIONS In Mozambique, there was a steep increase in the prevalence of overweight and obesity among adults between 2005 and 2014/2015. Overweight and obesity are more prevalent in urban areas and among women, already affecting one in five urban women aged 18-24 years.
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Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2016.01.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Wafaa Yousif Abdel Wahed
- Department of Public Health and Community Medicine, Faculty of Medicine, Fayoum University, Egypt
| | - Safaa Khamis Hassan
- Department of Public Health and Community Medicine, Faculty of Medicine, Fayoum University, Egypt
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Naguib A, Elsawy N, Aboul-enein F, Hossam N. The relation between serum visfatin levels and cardiovascular involvement in rheumatoid arthritis. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2011.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Abir Naguib
- Department of Physical, Medicine Rheumatology and Rehabilitation Faculty of Medicine Alexandria UniversityEgypt
| | - Noha Elsawy
- Department of Physical, Medicine Rheumatology and Rehabilitation Faculty of Medicine Alexandria UniversityEgypt
| | - Fatma Aboul-enein
- Department of Cardiology and Angiology Faculty of Medicine Alexandria University Egypt
| | - Nermin Hossam
- Department of Clinical Pathology Faculty of Medicine Alexandria University Egypt
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Tal S, Litovchik I, Klar MM, Maresky HS, Grysman N, Wiser I, Vitkon-Barkay I, Marcus G, Tzuman O, Pereg D, Rum V, Ziv-Baran T, Fuchs S, Minha S. The association between neck adiposity and long-term outcome. PLoS One 2019; 14:e0215538. [PMID: 31013323 PMCID: PMC6478301 DOI: 10.1371/journal.pone.0215538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/03/2019] [Indexed: 01/06/2023] Open
Abstract
Anthropometric indices of obesity (e.g. body mass index, waist circumference and neck circumference) are associated with poor long-term cardiovascular outcome. Prior studies have associated neck circumference and central body adiposity. We explored the association between neck fat volume (NFV) and long-term cardiovascular outcome. The study provides a retrospective analysis of all patients undergoing computerized tomography angiography for suspected cerebrovascular accident between January and December 2013. NFV was assessed by three dimensional reconstructions and was adjusted to height to account for differences in body sizes, thus yielding the NFV/height ratio (NHR). Univariate and multivariate analysis were utilized to explore the association between various indices including NHR and all-cause mortality. The analysis included 302 patients. The average age was 61.9±14.3 years, 60.6% of male gender. Diabetes mellitus, hypertension and cardiovascular disease were frequent in 31.5%, 69.9%, and 72.2% of patients, respectively. The median NHR was 492.53cm2 [IQR 393.93–607.82]. Median follow up time was 41.2 months, during which 40 patients (13.2%) died. Multivariate analysis adjusting for age, sex, and diabetes mellitus indicated an independent association between the upper quartile of NHR and all-cause mortality (hazard ratio = 2.279; 95% CI = 1.209–4.299; p = .011). NHR is a readily available anthropometric index which significantly correlated with poor long-term outcome. Following validation in larger scale studies, this index may serve a risk stratifying tool for cardiovascular disease and future outcome.
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Affiliation(s)
- Sigal Tal
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Ilya Litovchik
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Miriam M. Klar
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Hillel S. Maresky
- Department of Radiology, Assaf Harofeh Medical Center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Medical Imaging, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Noam Grysman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, MO, United States of America
| | - Itay Wiser
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Plastic and Reconstructive Surgery, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Itzhak Vitkon-Barkay
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Gil Marcus
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Oran Tzuman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assuta Medical Center, Ashdod, Israel
| | - David Pereg
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
| | - Victoria Rum
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventative Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shmuel Fuchs
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
| | - Sa’ar Minha
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel
- * E-mail:
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