Combined early and adult life risk factor associations for mid-life obesity in a prospective birth cohort: assessing potential public health impact

Association between alcohol intake and overweight and obesity: a systematic review and dose-response meta-analysis of 127 observational studies

Several studies have assessed the relationship between alcohol intake and overweight/obesity; however, the reported results are inconsistent. Therefore, the present systematic review and dose-response meta-analysis of observational studies was designed to investigate the association between alcohol intake and general and abdominal obesity among the adults. Literature search was conducted in the PubMed/Medline and Web of Science databases up to August 2020. Odds ratio (OR), risk ratio (RR), or hazard ratio (HR) with 95% confidence interval (95% CI) were used to pool effect size. To conduct dose-response meta-analysis, amount of alcohol intake was classified into three categories including light (<14 g/d), moderate (14-28 g/d), and heavy (>28 g/d). In the present study, 127 eligible studies were included. In cohort studies, there was no significant association between alcohol drinking and risk of overweight (OR: 0.93, 95% CI: 0.46 to 1.89), obesity (OR: 0.84, 95% CI: 0.52 to 1.37), overweight/obesity (OR: 1.15, 95% CI: 0.84 to 1.58), and abdominal obesity (OR: 1.13, 95% CI: 0.90 to 1.41). In cross-sectional studies, alcohol intake was associated with the increased odds of overweight (OR: 1.11, 95% CI: 1.05 to 1.18), overweight/obesity (OR: 1.23, 95% CI: 1.11 to 1.37), and abdominal obesity (OR: 1.19, 95% CI: 1.09 to 1.29); but not obesity (OR: 1.03, 95% CI: 0.95 to 1.12). Results of dose-response analysis indicated that heavy alcohol drinking was positively associated with odds of overweight (OR: 1.12, 95% CI: 1.01 to 1.24), overweight/obesity (OR: 1.32, 95% CI: 1.16 to 1.51), and abdominal obesity (OR: 1.25, 95% CI: 1.12 to 1.38) compared to non- or light alcohol drinking. There was no publication bias among studied on outcomes of interest. In conclusion, our results revealed alcohol drinkers, especially heavy alcohol drinkers, had increased odds of overweight, overweight/obesity, and abdominal obesity than non-alcohol drinker or light alcohol drinkers among cross-sectional studies but not cohort studies.

Relationship between BMI and alcohol consumption levels in decision making

BACKGROUND

Decision-making deficits in obesity and alcohol use disorder (AUD) may contribute to the choice of immediate rewards despite their long-term deleterious consequences.

METHODS

Gambling task functional MRI in Human connectome project (HCP) dataset was used to investigate neural activation differences associated with reward or punishment (a key component of decision-making behavior) in 418 individuals with obesity (high BMI) and without obesity (lean BMI) and either at high (HR) or low (LR) risk of AUD based on their alcohol drinking levels.

RESULTS

Interaction between BMI and alcohol drinking was seen in regions of the default mode network (DMN) and those implicated in self-related processing, memory, and salience attribution. ObesityHR relative to obesityLR also recruited DMN along with primary motor and regions implicated in inattention, negative perception, and uncertain choices, which might facilitate impulsive choices in obesityHR. Furthermore, obesityHR compared to leanHR/leanLR also demonstrated heightened activation in DMN and regions implicated in uncertain decisions.

CONCLUSIONS

These results suggest that BMI is an independent variable from that of alcohol drinking levels in neural processing of gambling tasks. Moreover, leanLR relative to leanHR, showed increased activation in motor regions [precentral and superior frontal gyrus] suggestive of worse executive function from excessive alcohol use. Delayed discounting measures failed to distinguish between obesity and high alcohol drinking levels, which as for gambling task results suggests independent negative effects of obesity and chronic alcohol drinking on decision-making. These findings highlight distinct associations of obesity and high-risk alcohol drinking with two key constituents of decision-making behavior.

Exploring the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults (aged 18-25): A qualitative research study

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This is the first qualitative study to explore the links between unhealthy eating behaviour and heavy alcohol use in the social, emotional and cultural lives of young adults. We conducted 45 in-depth interviews with 18-25-year-olds in North-East England to inform development of a dual-focused intervention to reduce health risk due to excess weight gain and alcohol use. Data were analysed thematically, following the principles of constant comparison, resulting in three intersecting themes: (1) how food and alcohol consumption currently link together for this population group; (2) influences upon linked eating and drinking behaviours and (3) young adults' feelings and concerns about linked eating and drinking behaviours. Socio-cultural, physical and emotional links between food and alcohol consumption were an unquestioned norm among young adults. Eating patterns linked to alcohol use were not tied only to hunger, but also to sociability, traditions and identity. Young adults conceptualised and calculated risks to weight, appearance and social status, rather than to long-term health. This study is the first to evidence the deeply interconnected nature of food and alcohol consumption for many young adults. Findings have important implications for intervention development, UK public health policy and practice, and point to a need for similar research in other countries.

Socio-Ecological Influences on Adolescent (Aged 10-17) Alcohol Use and Unhealthy Eating Behaviours: A Systematic Review and Synthesis of Qualitative Studies

Excess body weight and risky alcohol consumption are two of the greatest contributors to global disease. Alcohol use contributes directly and indirectly to weight gain. Health behaviours cluster in adolescence and track to adulthood. This review identified and synthesised qualitative research to provide insight into common underlying factors influencing alcohol use and unhealthy eating behaviours amongst young people aged 10–17. Sixty two studies met inclusion criteria. Twenty eight studies focused on alcohol; 34 focused on eating behaviours. Informed by principles of thematic analysis and meta-ethnography, analysis yielded five themes: (1) use of alcohol and unhealthy food to overcome personal problems; (2) unhealthy eating and alcohol use as fun experiences; (3) food, but not alcohol, choices are based on taste; (4) control and restraint; and (5) demonstrating identity through alcohol and food choices. Young people faced pressure, reinforced by industry, to eat and drink in very specific ways, with clear social consequences if their attitudes or behaviour were deemed unacceptable. No qualitative studies were identified with an explicit and concurrent focus on adolescent eating behaviours and alcohol consumption. Further exploratory work is needed to examine the links between food and alcohol in young people’s emotional, social and cultural lives.

Reducing growth and developmental problems in children: Development of an innovative postnatal risk assessment

Introduction

Globally, awareness of the relevance of both medical and non-medical risk factors influencing growth and development of children has been increasing. The aim of our study was to develop an innovative postnatal risk assessment to be used by the Preventive Child Healthcare (PCHC) to identify at an early stage children at risk for growth (catch-up growth, overweight and obesity) and developmental problems (such as motor, cognitive, psychosocial and language/ speech problems).

Methods

We used the first four steps of the Intervention Mapping process. Step 1: Review of the literature and focus group discussions. Step 2: Identification of program objectives on how to develop and implement a risk assessment in PCHC daily practice. Step 3: Application of the ASE model to initiate behavioral change in the target group. Step 4: Development of the postnatal R4U and a program plan for the implementation in PCHC organizations.

Results

Subsequently in 2015, the 41 item postnatal R4U (the postnatal Rotterdam Reproduction Risk Reduction checklist) was developed according to steps one until four of the Intervention Mapping process and was implemented in four PCHC organizations.

Conclusions

It was feasible to design and implement a postnatal risk assessment identifying both medical and non-medical risks for growth and developmental problems, using the Intervention Mapping process.

Non-Pharmacological Interventions to Reduce Unhealthy Eating and Risky Drinking in Young Adults Aged 18⁻25 Years: A Systematic Review and Meta-Analysis

Alcohol use peaks in early adulthood and can contribute both directly and indirectly to unhealthy weight gain. This review aimed to systematically evaluate the effectiveness of preventative targeted interventions focused on reducing unhealthy eating behavior and linked alcohol use in 18⁻25-year-olds. Twelve electronic databases were searched from inception to June 2018 for trials or experimental studies, of any duration or follow-up. Eight studies (seven with student populations) met the inclusion criteria. Pooled estimates demonstrated inconclusive evidence that receiving an intervention resulted in changes to self-reported fruit and vegetable consumption (mean change/daily servings: 0.33; 95% CI -0.22 to 0.87) and alcohol consumption (mean reduction of 0.6 units/week; CI -1.35 to 0.19). There was also little difference in the number of binge drinking episodes per week between intervention and control groups (-0.01 sessions; CI -0.07 to 0.04). This review identified only a small number of relevant studies. Importantly, included studies did not assess whether (and how) unhealthy eating behaviors and alcohol use link together. Further exploratory work is needed to inform the development of appropriate interventions, with outcome measures that have the capacity to link food and alcohol consumption, in order to establish behavior change in this population group.

Socio-ecological influences on adolescent (aged 10-17) alcohol use and linked unhealthy eating behaviours: protocol for a systematic review and synthesis of qualitative studies

BACKGROUND

Excess body weight and risky alcohol consumption are two of the greatest contributors to global disease. Health behaviours cluster in adolescence and track to adulthood. Very little is known about similar and contrasting influences on young people's eating behaviours and alcohol use. Whilst there are bodies of literature which explore the influences on young people's eating behaviour and alcohol consumption respectively, no qualitative studies have been identified with an explicit and concurrent focus on adolescent eating behaviours and alcohol consumption. This review will identify and synthesise qualitative research evidence to provide insight into common underlying factors which influence alcohol use and unhealthy eating behaviours amongst young people aged 10-17. This will involve bringing together two separate bodies of literature to enable analysis and comparison across two associated fields of study.

METHODS

We will conduct searches in MEDLINE, Scopus, PsycINFO, Sociological Abstracts (via ProQuest social science premium collection), CINAHL, ERIC, IBSS (via ProQuest social science premium collection), ASSIA (via ProQuest social science premium collection), and Web of Science Core Collection. Studies reporting primary data of any qualitative design, for example, ethnographic studies, studies that used a phenomenological or grounded theory approach, or participatory action research will be included in the review. Database searches will be supplemented with searches of Google Scholar, hand searches of key journals, and backward and forward citation searches of reference lists of identified papers. Search records will be independently screened by two researchers, with full text copies of potentially relevant papers retrieved for in-depth review against the inclusion criteria. Reporting of identified studies will be assessed using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist. GRADE-CERQual will also be used to assess confidence in the findings arising from our review. Qualitative synthesis will involve three core phases: line-by-line coding of findings; development of descriptive themes; and development of analytical themes. Findings from papers will be examined for overlaps, similarities and differences.

DISCUSSION

This synthesis will interpret individual studies by identification of second-order constructs (interpretations offered by the original researchers) and third-order constructs (development of new interpretations beyond those offered in individual studies) by way of the development of a 'model structure' of shared influences upon both unhealthy eating behaviours and alcohol use. It is anticipated that this 'model structure' will aid subsequent co-design and piloting of a future intervention to help reduce health risk and social inequalities due to excess weight gain and alcohol consumption.

SYSTEMATIC REVIEW REGISTRATION

CRD42017060624 .

Non-pharmacological interventions designed to reduce health risks due to unhealthy eating behaviour and linked risky or excessive drinking in adults aged 18-25 years: a systematic review protocol

BACKGROUND

Excess body weight and heavy alcohol consumption are two of the greatest contributors to global disease. Alcohol use peaks in early adulthood. Alcohol consumption can also exacerbate weight gain. A high body mass index and heavy drinking are independently associated with liver disease but, in combination, they produce an intensified risk of damage, with individuals from lower socio-economic status groups disproportionately affected.

METHODS

We will conduct searches in MEDLINE, Embase, PubMed, PsycINFO, ERIC, ASSIA, Web of Knowledge (WoK), Scopus, CINAHL via EBSCO, LILACS, CENTRAL and ProQuest Dissertations and Theses for studies that assess targeted preventative interventions of any length of time or duration of follow-up that are focused on reducing unhealthy eating behaviour and linked risky alcohol use in 18-25-year-olds. Primary outcomes will be reported changes in: (1) dietary, nutritional or energy intake and (2) alcohol consumption. We will include all randomised controlled trials (RCTs) including cluster RCTs; randomised trials; non-randomised controlled trials; interrupted time series; quasi-experimental; cohort involving concurrent or historical controls and controlled before and after studies. Database searches will be supplemented with searches of Google Scholar, hand searches of key journals and backward and forward citation searches of reference lists of identified papers. Search records will be independently screened by two researchers, with full-text copies of potentially relevant papers retrieved for in-depth review against the inclusion criteria. Methodological quality of RCTs will be evaluated using the Cochrane risk of bias tool. Other study designs will be evaluated using the Cochrane Public Health Review Group's recommended Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Studies will be pooled by meta-analysis and/or narrative synthesis as appropriate for the nature of the data retrieved.

DISCUSSION

It is anticipated that exploration of intervention effectiveness and characteristics (including theory base, behaviour change technique; modality, delivery agent(s) and training of intervention deliverers, including their professional status; and frequency/duration of exposure) will aid subsequent co-design and piloting of a future intervention to help reduce health risk and social inequalities due to excess weight gain and alcohol consumption.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42016040128 .

Obesity and Knee Arthroscopy – a Review

Obesity is currently a global epidemic, often referred to as “globesity”, impacting the life of millions worldwide. A risk factor for many diseases, obesity can also be linked to developing intra-articular lesions of the knee, affecting the menisci, ligaments and cartilage. Furthermore, obesity has been shown to influence the outcome of surgical interventions, including those of the musculoskeletal system. Although many studies addressed the relationship of obesity and joint replacement, articles relating to arthroscopy and obesity, and knee arthroscopy in particular, are a bit scarcer. The majority of data suggest that an increase in BMI leads to a similar increase in the rates of intra- and postoperative complications, and most authors agree that a higher body mass index can influence both the procedure itself and its outcomes, including the subjective results reported by the patients. Still, some studies show different results, especially in patients that are overweight or with low-grade obesity, where the outcomes are comparable to those of the non-obese population. Thus, it can be concluded that obesity is an important patient characteristic that needs to be taken into consideration when planning, performing, and assessing the results of knee arthroscopy.