Excess weight and abdominal obesity in postmenopausal Brazilian women: a population-based study

Contribution of systemic factors on macular vessel density: a sex-specific population-based study

PURPOSE

To evaluate the influence of systemic factors on macular vessel density in quantitative Optical Coherence Tomography Angiography (OCTA) by sex.

STUDY DESIGN

A cross-sectional study.

METHODS

A total of 2018 adults were recruited in this study. Participants were excluded (n=964) due to missing data, eye-related problems, or low OCTA scan quality. Macular vessel densities were measured with OCTA using split-spectrum amplitude decorrelation angiography algorithm. Only the data from the right eyes were selected for analysis. Multivariable linear regression analysis was performed to determine the associations between macular vessel density and obesity-related systemic factors in each gender group.

RESULTS

The right eyes of 1054 participants (59.6% women) were enrolled. Men had significantly higher obesity parameters and associated risk factors. In multivariable linear regression analysis in men, older age and type 2 diabetes mellitus were independently associated with lower superficial retinal vessel density (β = -0.37, p = 0.002; β = -1.22, p = 0.03) and deep retinal vessel density, respectively (β = -0.66, p < 0.001; β = -1.76, p = 0.02); positive association was also observed between body mass index (BMI) and superficial retinal vessel density (β = 0.56, p = 0.02). In women, only higher systolic blood pressure was independently associated with a lower deep retinal vessel density (β = -0.50, p = 0.003).

CONCLUSIONS

This large cross-sectional study shows that older age and type 2 diabetes mellitus are associated with lower superficial and deep retinal capillary vessel density in men. This may help clinicians better understand how systemic factors influence retinal vessel density in different genders and future studies can ascertain more potential sex differences.

A comprehensive evaluation of predictors of obesity in women during the perimenopausal period: A systematic review and narrative synthesis

INTRODUCTION

Obesity during perimenopausal transition can be attributed to various factors. Identifying these factors is crucial in preventing obesity and developing effective strategies to manage weight during this phase. This review aimed to systematically understand predictors of obesity during menopausal transition.

METHODS

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched databases like PubMed, Wiley Online Library, and Cochrane Reviews. Cohort and cross-sectional studies in English language assessing obesity among menopausal women were included. The methodological quality was assessed using Joanna Briggs Checklist for critical appraisal. Risk of Bias (RoB) was generated using Review Manager 5.4.1 (RevMan). Identified predictors were assessed for overall quality of evidence using adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS

This review encompassed 42 studies, (21 cross-sectional and 21 cohort) with sample ranging from 164 to 107,243 across studies. Higher parity( ≥ 3 children) emerged as a strong predictor of obesity across seven studies, with good-quality evidence. Lower physical activity was another predictor, supported by eight studies with good-quality evidence. Sociodemographic factors like lower education(<8 years or < than college degree), socioeconomic background, menopausal transition, and older age at menarche showed associations with weight gain, with moderate-quality evidence. Lifestyle factors (high-fat consumption, sedentariness, active smoking status, and psychological difficulties) also showed moderate-quality evidence.

CONCLUSION

This review underscores the multifaceted factors associated with obesity during the perimenopausal transition. Identifying these factors will be helpful in prevention and management of obesity among these women.

Factors associated with the combination of general and abdominal obesity in middle-aged and older Korean women: a cross-sectional study

BACKGROUND

To identify factors associated with general and abdominal obesity in middle-aged and older Korean women based on the biopsychosocial model.

METHODS

Data from 4,076 women aged ≥45 years who participated in the Korea National Health and Nutrition Examination Survey from 2015 to 2020 were analyzed. Complex sampling analysis was performed using IBM SPSS ver. 26.0.

RESULTS

The combination of general and abdominal obesity was positively associated with age ≥65 years, postmenopausal status, and without breastfeeding experience among biomedical factors; depressive symptoms and prolonged (≥8 hours a day) sedentary behavior among psychosocial factors; and an educational level lower than middle or high school graduation and the first and second income quantiles among biosocial factors.

CONCLUSION

Healthcare providers in communities and public societies should screen for risk factors for the combination of general and abdominal obesity while considering non-modifiable biomedical (e.g., age) and biosocial factors (e.g., educational level). In addition, intervention strategies should be developed by considering modifiable psychosocial factors such as sedentary behavior.

Prevalence of excess weight and associated socio-demographic factors among postmenopausal women: A population-based study in Ghana

BACKGROUND

Excess weight (obesity and overweight) is a pervasive condition that is considered a global epidemic and a threat to public health. Furthermore, numerous changes in fat deposits occur with the advent of menopause, leading to a change in the distribution of body fat. Knowledge of sociodemographic factors and prevalence can inform the effective management of these women.

AIM

This study aimed to investigate the prevalence of excess weight among postmenopausal women in Ghana's Bono East (Techiman) region.

SETTING

This study was conducted in Bono East regional capital, Techiman, Ghana.

METHODS

This is a cross-sectional study conducted over 5 months at Bono East regional capital, Techiman in Ghana. Anthropometric parameters such as body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were obtained using physical measurements while socio-demographic data were gathered using questionnaires. Data analysis was performed using IBM SPSS 25.

RESULTS

The mean age of the 378 women who participated in the study was 60.09 ± 6.24 years. Body mass index, WHtR and WHR indicated excess weight of 73.2%, 91.8% and 91.0%, respectively. Education and ethnicity were predictors of excess weight (WHR). Women of the Ga tribe with high school education have 4.7- and 8.6-times increased odds of having excess weight.

CONCLUSIONS

There are higher prevalence rates of excess weight (obesity and overweight) among postmenopausal women using BMI, WHtR and WHR. Education and ethnicity are predictors of excess weight.Contribution: The study's findings can be used to develop interventions that focus on addressing excess weight in postmenopausal women within the Ghanaian context.

An exploratory study on excess weight gain: Experiences of Postmenopausal Women in Ghana

INTRODUCTION

Excess weight gain is a problem with a significant impact on health and quality of life as well as the consequent economic burden on human populations. While society advocates preference for excess weight gain, limited evidence exists concerning postmenopausal women's experiences in Ghana.

AIM

The current study explored the experiences regarding excess weight (overweight and obesity) gain among Ghanaian postmenopausal women in Bono East (Techiman) region.

METHODS

This is a qualitative exploratory descriptive study where anthropometric measurements [body mass index (BMI), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR)] were determined and participants who were identified with excess weight (obesity and overweight) were recruited to participate in a focus group discussion (FGD). Four focus group discussions were held and 24 postmenopausal women (>45 years) in Techiman took part. Discussions were audio-recorded and transcribed for thematic analysis.

RESULTS

From the qualitative analysis of the FGD, three major themes emerged from the study namely, (i) perception of body weight, (ii) measures to reduce body weight, and (iii) support to adhere to the weight management program. Sub-themes revealed that weight gained was viewed as the presence of diseases and admired by society as a culturally accepted body image. Diet-related changes, a combination of diet modification and physical activity, and weight management supplements emerged as measures to reduce excess weight. Support to adhere to the weight program included health education, access, affordable exercise facilities, and social support.

CONCLUSIONS

Sociocultural norms influence the image perception and acceptance of weight gain among postmenopausal women in Ghana, but there is an acknowledgment of the perceived negative health implications of such excess weight. Measures for weight reduction and support to adhere to the weight reduction programme require attention in Ghana.

The association of the age, period, and birth cohort with 15-year changes in body mass index and waist circumference in adults: Tehran lipid and glucose study (TLGS)

Objective

To examine the association of age, period, and birth cohort with body mass index (BMI) and waist circumference (WC) changes among the participants of the Tehran Lipid and Glucose Study from 1999 to 2015.

Methods

This prospective cohort study included 4895 participants aged ≥20 years (41.3% men), who were divided into twelve gender stratified groups, having a ten-year age difference between them. Analyses were conducted to explicitly assess the association of age vs. period on BMI and WC changes. In addition, we evaluated BMI and WC changes among different birth cohorts.

Results

Upon 15 years of follow-up, the mean BMI of men and women increased from 26.0 ± 3.9 to 27.5 ± 4.3 kg/m² and from 27.5 ± 4.8 to 29.9 ± 5.4 kg/m² (P trend < 0.001), and this trend was accompanied by an increase in WC from 88.8 ± 10.9 to 97.8 ± 10.4 cm and from 87.3 ± 12.4 to 95.8 ± 12.1 cm, respectively (P trend < 0.001). Men and women in all age cohorts tended to have a rise in their BMI and WC with aging throughout the follow-up period. For men, this trend was more prominent in younger birth cohorts at phase III for BMI and at phases III and V for WC (indicating a significant negative association with birth cohort). For women, this trend was more prominent in older birth cohorts at both phases III and V for BMI and WC (indicating a significant positive association with the birth cohort).

Conclusion

The rise in BMI and WC was strongly associated with age in both sexes. The men born in the recent birth cohorts and the women born in earlier birth cohorts had the most alarming BMI and WC trends. More efforts must be spent on obesity prevention policies, especially for younger men.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12810-z.

Central obesity and its predictors among adults in Nekemte town, West Ethiopia

BACKGROUND

Abdominal obesity is emerging as a major contributor to the worsening of non-communicable diseases. There is a dearth of data on central obesity among adults in Ethiopia in general and in the study area in particular. The aim of this research was to determine the prevalence of central obesity and its predictors among adults in Nekemte, Ethiopia.

METHODS

Community-based cross-sectional study was conducted in Nekemte town from March to April 2020. Multistage sampling technique was used to select 466 study participants. Interviewer-administered structured questionnaire was used for data collection. The data were entered into Epi Data 3.1 and analyzed by SPSS Version 25. Bivariate logistic regression analysis was used to identify candidate variables at p < 0.25. Finally, multivariable logistic regression analysis was used to identify the independent predictors of central obesity at p < 0.05 with 95% confidence intervals.

RESULTS

Prevalence of central obesity in this study was found to be 28.4% (95% CI 24.5-32.6). Where, the prevalence was higher among females (37%) than males (18%). Being a female (AOR = 5.59, 95% CI 2.95-10.57), age range of 40-49 years (AOR = 4.91, 95% CI 2.17-11.13), ⩾ 50 years (AOR = 8.16, 95% CI 3.21-20.72), being in marriage (AOR = 9.306, 95% CI 4.23-20.44), highest wealth status (AOR = 7.94, 95% CI 3.76-16.76), consumption of fast foods (AOR = 3.022, 95% CI 1.375-6.64), and lack of knowledge about obesity (AOR = 3.39, 95% CI 1.93-5.95) were factors associated with central obesity.

CONCLUSION

The study revealed a moderate prevalence of central obesity in the study area. Being a female, older age, being in marriage, richest household wealth status, consumption of fast foods, and lack of knowledge on obesity were identified as factors associated with central obesity. Comprehensive health education and promotion on healthy diet should be encouraged focusing on females, married individuals, and older ages.

Social position and anthropometric status among adults in the ELSA-Brasil study: a latent class analysis

The objective of the present study was to evaluate the association between social position and anthropometric status in women and men Brazilian adult. This was a cross-sectional study that used baseline data collected from 2008 to 2010 for the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil, in Portuguese), in the six major Brazilian state capital cities. A total of 15,105 active and retired civil servants aged from 35 to 74 years. Two latent variables were defined by latent class analysis, social position and anthropometric status. Both constructs and the analyses were separately evaluated by sex. Associations were assessed using multivariate logistic regression analysis with adjustment for age, self-reported skin color/race, and marital status. Around 44% of the women and 26% of the men were classified as overweight or obese. Social position tended to be lower in women (43.2%) and higher among men (40.4%). Heavier women were more likely to be black and brown-skinned, whereas slimmer women were more likely to be white. After adjustment, women's weight increased as social position decreased (OR = 1.52; 95%CI: 1.36-1.70), whereas in men weight decreased as social position decreased (OR = 0.87; 95%CI: 0.76-0.99). Social position affected the anthropometric status of women and men differently, with body patterns also being affected by ethnicity/skin color, showing the potentiality of taking the intersectional perspective when investigating the possible social determinants of the phenomenon.

Gender-specific temporal trends in overweight prevalence among Chinese adults: a hierarchical age-period-cohort analysis from 2008 to 2015

Background

As a key health risk, the prevalence of overweight has been strikingly increasing worldwide. This study aimed to disentangle the net age, period, and cohort effects on overweight among Chinese adults by gender.

Methods

Data came from the Chinese General Social Survey from 2008 to 2015, which was a repeated cross-sectional survey (n = 55,726, aged 18 and older). χ² or t tests were used to estimate the gender disparities in overweight and socioeconomic status (SES). A series of hierarchical age-period-cohort cross-classified random-effects models were performed using SAS version 9.4 to estimate the overall and gender-specific temporal trends of overweight, as well as the association between SES and overweight. Further, a series of line charts were used to present the age and cohort variations in overweight.

Results

After controlling for covariates, significant age and cohort effects were observed among adults in China (b = 0.0205, p < 0.001; b = 0.0122, p < 0.05; respectively). Specifically, inverted U-shaped age effects were identified for both genders, with a high probability of overweight occurring in middle age (b = -0.0012, p < 0.001). Overweight was more prevalent among men than women before 60 years old, and this trend reversed thereafter (b = -0.0253, p < 0.001). Moreover, men born during the war (before 1950) and reform cohorts (after the 1975s) demonstrated a substantial decline in overweight, while men born in 1950-1975 showed an increasing trend in overweight prevalence (b = 0.0378, p < 0.05). However, the cohort effect on women was not statistically significant. Additionally, a higher SES was related to an elevated probability of overweight.

Conclusion

Gender-specific age and cohort effects on the prevalence of overweight were observed among Chinese adults. Both China and other developing countries need to pay attention to the coming obesity challenge and related health inequality. Full life-cycle overweight prevention interventions should focus on middle-aged adults, men born in the war and reform eras, and adults with a higher SES.

Abdominal obesity and association with sociodemographic, behavioral and clinical data in climacteric women assisted in primary care

This study aims to investigate the prevalence and factors associated with abdominal obesity in climacteric women assisted at Family Health Strategy units of the city of Montes Claros, State of Minas Gerais, Brazil. It is a cross-sectional analytical study. The women were selected by probabilistic sampling from August 2014 to August 2015. A questionnaire containing information referring to sociodemographic and economic characteristics, behavioral characteristics and clinical data was used. To estimate abdominal obesity, the measure of circumference ≥ 88 cm was considered. To analyze the association between abdominal obesity and the independent variables, a bivariate analysis was performed by means of Pearson’s chi-square test (p≤0.25). Subsequently, a multiple Poisson regression analysis with robust variance was performed, through which prevalence ratios with level of significance of 5% (p<0.05) were obtained. A total of 805 women were evaluated, aged 40 to 65 years, and the prevalence of women with abdominal obesity was 62.4%. The mean and median of abdominal circumference were 93.0 cm. The associated variables were being sedentary (PR = 1.44) or irregularly active (PR = 1.39), presenting altered total cholesterol (PR = 1.21), and being hypertensive (PR = 1.31). The abdominal obesity in climacteric women was associated with physical inactivity, total cholesterol and arterial hypertension. The measurement of abdominal circumference must be valued and adopted in the routine of professionals who work in Primary Care.

Association of Menopausal Symptoms with Overweight and Obesity among Rural Middle Aged Women in North India: A Population Based Study

Background:

Overweight and obesity are important determinant of increasing morbidity among all age groups, including menopausal women. The symptoms of menopause have a negative impact on the quality of life.

Objectives:

The aim of this study is to assess the prevalence of overweight and obesity in menopausal women and also to find its association with menopausal symptoms and sociodemographic variables.

Materials and Methods:

The study was conducted among middle-aged women (40–60 years) from April 2018 to March 2019. The Menopausal Rating Scale was used to assess the severity of menopausal symptoms in 400 women, and data were collected for sociodemographic factors, menstrual history in the past month, and personal history.

Results:

About 35.5% of menopausal women were overweight/obese (26% overweight and 9.5% obese) with average body mass index of 23.9 ± 4.84 and mean age of 53.65 ± 5.11 years Joint and muscular discomfort (P = 0.001), hypertension (P = 0.014), literacy level (P = 0.009), and socioeconomic status (P = 0.01) were significantly associated with overweight/obesity. With reference to women with no/little somatic and urogenital complaints, the odds of developing obesity was more (adjusted odds) in patients with mild (odds ratio [OR] - 2.8), moderate (OR - 2.1), and severe (2.19) somatic complaints and also higher risk in patients with mild (OR-3.2), moderate (OR - 1.1), and severe (OR - 1.74) urogenital symptoms. The age of menopause was significantly more among overweight than normal-weight women (P = 0.033).

Conclusion:

Overweight and obesity associated with menopause require increased attention and a multidisciplinary approach to women's health to prevent morbidity in this population group.

Does menopausal status have an effect on body mass index and blood pressure?

Aim of the study was to understand the relationship of menopausal status with BMI and blood pressure. The study area was selected through multistage sampling technique covering six districts of West Bengal, a state located at the eastern part of India. 1400 participants were selected for the study. The participants were divided into four groups on the basis of menopausal status: early and late perimenopausal; early and late postmenopausal. Results shows that menopausal status was significantly associated with Body Mass Index (BMI) and Mean Arterial Pressure (MAP), after controlling the effect of covariates such as participants' age, reproductive behavior, diet and addiction to tobacco use.

Associations of Pregnancy History with BMI and Weight Gain in 45-54-Year-Old Women

BACKGROUND

Midlife women have a higher risk of cardiometabolic disease than younger women, but the lifelong biological/lifestyle factors responsible for this increase are unclear.

OBJECTIVES

We investigated whether pregnancy history is a risk factor for midlife overweight/obesity and evaluated potential hormonal mechanisms.

METHODS

The Baltimore Midlife Women's Health Study, a prospective cohort, recruited 772 women aged 45-54 y. Women reported pregnancy characteristics via questionnaires, trained staff measured weight/height to calculate midlife BMI, and serum hormones were assessed by ELISA. Logistic regression models assessed associations of pregnancy history with risk of midlife overweight/obesity and BMI gain since age 18. We additionally explored whether associations differed by menopausal status, and whether midlife hormones mediated relationships of pregnancy history and midlife BMI.

RESULTS

These premenopausal or perimenopausal women were 66% Caucasian/White and 30% African American/Black, with a median of 2 live births (range: 0-11) and median age at first birth of 27 y (range: 12-46 y). Women with 0 and ≥2 live births had lower odds of overweight/obesity than those with 1 birth (OR = 0.47; 95% CI: 0.23, 0.96; P = 0.04, and OR = 0.58; 95% CI: 0.35, 0.95; P = 0.03, respectively). Women with ≥2 live births also had lower odds of BMI gain than those with 1 birth (OR = 0.66; 95% CI: 0.41, 1.06; P = 0.08). Furthermore, women who were older at their first birth had lower odds of overweight/obesity (OR = 0.96; 95% CI: 0.92, 1.00; P = 0.03) and BMI gain (OR = 0.97; 95% CI: 0.93, 1.00; P = 0.06). Number of pregnancies and age at last pregnancy were not associated with midlife overweight/obesity or BMI gain. Associations did not differ by menopausal status and were not explained by midlife hormones.

CONCLUSIONS

Earlier childbirth and having 1 child increased women's risk of midlife overweight/obesity and BMI gain since age 18. Additional studies should focus on women's childbearing years as a critical determinant of midlife metabolic health.

Longitudinal assessment of the impact of higher body mass index on cancer-related fatigue in patients with breast cancer receiving chemotherapy

PURPOSE

To assess the impact of obesity on cancer-related fatigue (CRF) in patients with breast cancer, through a secondary analysis of a large, longitudinal, nationwide study of breast cancer patients beginning chemotherapy.

METHODS

All patients (N = 565; aged 53 ± 10.6) with breast cancer completed the multidimensional fatigue symptom inventory and the symptom inventory to measure CRF symptoms at baseline, post-chemotherapy, and 6 months post-chemotherapy. Height and weight at baseline were used to categorize subjects based on body mass index (BMI): obese (≥ 30.0 kg/m²; n = 294), overweight (25.0-29.9 kg/m²; n = 146), and normal weight (18.5-24.9 kg/m²; n = 125). Multivariate regression models evaluated the relationship of obesity level to CRF over time, controlling for age, menopausal status, race, Karnofsky Performance Status, cancer stage, radiation, and exercise status.

RESULTS

At baseline, the obese had significantly higher CRF symptoms than the normal weight subjects for both the Multidimensional fatigue symptom inventory (MFSI) total (obese = 11.2 vs normal weight = 6.3; p = 0.03) and Symptom Inventory (SI) (obese = 3.5 vs normal weight = 2.9; p = 0.03). Significantly higher SI fatigue scores persisted at post-chemotherapy for the obese (obese = 5.0 vs normal weight = 4.4; p = 0.02). At 6 months post-chemotherapy, the obese patients still had significantly higher SI fatigue scores (obese = 3.5 vs normal weight = 3.0; p = 0.05).

CONCLUSION

Obese patients suffered greater CRF from pre-chemotherapy through 6 months post-chemotherapy. Recommendations for weight loss or weight maintenance may impact CRF levels in obese breast cancer patients before and after chemotherapy.

Prevalence and Predictors of Obesity and Overweight among Adults Visiting Primary Care Settings in the Southwestern Region, Saudi Arabia

Introduction

Obesity is becoming the most common health problem of the 21st century, as it will contribute significantly to the high prevalence of cardiovascular disease in developing countries. The main objective of our study was to estimate the prevalence of obesity and overweight among adults attending primary health care settings, southwestern region of the Kingdom of Saudi Arabia.

Methods

The studied population was composed of adults visiting primary health care centres in the southwestern region of Saudi Arabia. A cross-sectional study was carried out on a representative sample of 1681 adult patients. Obesity and overweight were defined according to the WHO standards. Statistical analysis was conducted using the statistical package SPSS 17.0. Logistic regression analysis was used to identify independent predictors of obesity and overweight in the studied population.

Results

Data on body mass index (BMI) measurement was recorded for 1649 out of 1681 participants (98.1%). The overall mean weight was 74.1 ± 15.81 kg; and that for men was 77.69 ± 16.14 kg vs. 69.37 ± 14.02 kg for women with significant statistical difference of p < 0.001. The overall prevalence of overweight and obesity was, respectively, 38.3% and 27.6%. Smoking was not significantly associated with obesity, whereas hypertension was significantly associated with obesity. The risk of overweight or obesity significantly increased from the highest to the lowest monthly income; it passed from 1.67 CI 95% = [1.24-2.25] within the category 5000-7000 SAR to 2.23 CI 95% = [1.71-2.90] within the category less than 5000 SAR.

Conclusion

Our study showed high prevalence of overweight and obesity which should be considered as a public health concern to be followed by specific interventions at the community level with multidisciplinary activities starting from childhood as a primordial prevention program.

Effects of aerobic and resistance exercises on circulating apelin-12 and apelin-36 concentrations in obese middle-aged women: a randomized controlled trial

BACKGROUND

The risk for obesity-related diseases increases with the prevalence of obesity. In obesity, adipokines secreted from adipose tissue induce inflammation, causing adverse effects. Recently, adipokines such as apelin, visfatin, and chemerin have been studied. Long-term resistance training improves health in middle-aged women by improving metabolic risk factors, body composition, and muscle strength. However, there is still a lack of evidence on the association of apelin concentration with different exercise types in middle-aged obese women This study aimed to investigate the effects of 8 weeks of aerobic and resistance exercises on apelin-12 and apelin-36 levels and thereby verify the effects of different exercise types in obese, middle-aged women.

METHODS

Participants were middle-aged women aged 50-61 years, with no experience of systematic exercise in the last 6 months, and met the WHO obesity criteria for the Asia-Pacific region of waist circumference ≥ 80 cm and body fat percentage ≥ 30%. Subjects were selected and allocated to the aerobic exercise, resistance exercise, or no exercise group by block randomization. Body weight, body fat, and body mass index were measured by bioelectrical impedance analysis. Analysis of variance, the t-test, and Tukey's post-hoc test were performed.

RESULTS

A total of 24 participants were selected with eight participants in each group. Both aerobic and resistance exercises were effective in altering the physical composition, showing significant decreases in weight, waist circumference, BMI, and body fat. The aerobic and resistance exercise group showed a significant, positive change in apelin-12 levels.

CONCLUSIONS

In obese individuals, aerobic and resistance exercise were effective in improving obesity and reducing blood apelin-12 concentration, which is closely correlated with indicators of metabolic syndrome. Future research should focus on comparing the response of apelin to exercise in obese subjects treated with only dietary control and the response in the obese subjects of different ages and sex.

TRIAL REGISTRATION

No. 1040917-201,506-BR-153-04 , Clinical Research Information Service (CRIS), Republic of Korea (05 October 2018, retrospectively registered).

Components and Risk Factors of Metabolic Syndrome among Rural Nigerian Workers

Background:

Metabolic syndrome (MetS) is a serious public health risk predisposing the workforce to cardiovascular diseases and diabetes.

Aim:

The aim of this study was to determine the components and risk factors of MetS among Nigerian teachers and bank workers (BWs).

Settings and Design:

The cross-sectional study was conducted in Idemili South Local Government Area, Southeast Nigeria.

Materials and Methods:

The study involved 427 teachers and 66 BWs in 14 secondary schools and 5 microfinance banks, respectively. Data collection methods included questionnaire, lipid profile, fasting plasma glucose (FPG), weight, height, waist circumference, and blood pressure (BP) measurements. Inferential statistical analysis involved Pearson correlation and Chi square with Cochran–Mantel–Haenszel test. Significance was accepted at P < 0.05.

Results:

Most (73.3%) of the teachers were 40–60-year-olds; 75.8% of BWs were 19–39-year-olds (P < 0.01). Underweight (7.7%), overweight (26.8%), obesity (17.2%), impaired FPG (IFPG) (14.0%), hypertriglyceridemia (38.0%), and hypertension (40.0%) were prevalent with similarity (P > 0.05) between occupations, age, and gender. Females were more likely to have abdominal obesity (P < 0.01) than males. MetS prevalence was 20%. MetS was more likely among females (odds ratio [OR] =0.63, 95% confidence interval [CI] =0.471–0.841); workers with abdominal obesity (OR = 1.67, 95% CI = 1.210–2.295), IFPG (OR = 0.05, 95% CI = 0.008–0.347), raised diastolic BP (OR = 12.00, 95% CI = 2.177–66.134), and hypertriglyceridemia (OR = 1.55, 95% CI = 1.931–5.600); and those who often drank fluids other than water (OR = 0.11, 95% CI = 0.013–0.961).

Conclusion:

MetS was a problem of public health significance among the workers with higher prevalence among teachers, 40–60-year-olds, and females. Abdominal obesity was the strongest risk factor of metabolic syndrome among the workers.

[Factors associated with general obesity and the percentage of body fat of women during the menopause in the city of São Paulo, Brazil]

To verify the association between obesity and demographic, clinical and lifestyle variables in climacteric women, a cross-sectional study was conducted in outpatient clinics, with 469 women aged 40 to 65 years in the city of São Paulo, Brazil. The dependent variables were: obesity according to body mass index (BMI) and obesity according to percentage of body fat (% BF). The main explanatory variable was: climacteric phase (pre or postmenopausal); and control variables were: age; years of formal study; parity; menopausal hormone therapy (MHT) use; physical activity practice and smoking habit. Multiple regression analysis was performed using the Stata 9.2 software. According to the BMI, obesity was positively associated with parity (RR = 1.62, 95% CI = 1.11-2.37) and, negatively, with years of formal study (RP = 0.71, CI 95% = 0.55-0.91) and with physical activity practice (PR = 0.45, 95% CI = 0.33-0.61). According to the % BF, obesity was positively associated with parity (PR = 1.60, 95% CI = 1.03-2.49) and negatively with physical activity practice (PR = 0.43; 95% CI = 0.29-0.63). While being active physically was protective, multiparity was a risk factor for developing obesity for women in this study.

Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea

The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.

Prevalence of Metabolic Syndrome and its Related Risk Factors in the City of Oran, Algeria: the ISOR Study

BACKGROUND

Aging and lifestyle changes had led to an epidemiological transition, with a significant impact on the incidence of cardiovascular diseases in North Africa.

OBJECTIVE

The aim of this study was to determine the prevalence of metabolic syndrome and its associated factors, which were unknown, among an urban population in Algeria.

METHODS

During 2007-2009, 787 individuals aged 30-64 years, randomly selected from the list of insured persons residing in the city of Oran, participated in a clinical, anthropometric and biological survey. Participants were classified according to the National Cholesterol Education Program - Adult Treatment Panel (NCEP-ATP) III definition of metabolic syndrome.

RESULTS

The prevalence of metabolic syndrome was 20%, higher in women than men (25.9 vs 13.7%; P<.0001). Among the components of the syndrome, the most common risk factors observed in women were a low high-density lipoprotein (HDL) cholesterol concentration (60.4% vs 44.2% in men) and abdominal obesity (46.8% vs 30.1% in men) whereas men displayed more high blood pressure (42.5% vs 34.8% in women). In men, metabolic syndrome was more frequent in married and highly educated participants. In contrast, women with a high level of education and who had an intermediate level of physical activity seemed to be protected.

CONCLUSIONS

Metabolic syndrome, prevalent in the urban population of North Algeria, is associated with a high proportion of low HDL-cholesterol and abdominal obesity, especially among women. There is a need for prevention strategies involving promotion of physical activity for the whole population and screening for hypertension among men.

Sarcopenic obesity and physical performance in middle aged women: a cross-sectional study in Northeast Brazil

BACKGROUND

Sarcopenia and obesity have been independently associated with physical function decline, however little information is currently available on the relationship between sarcopenic obesity and physical performance, mainly in middle aged women. The present study aims to estimate the prevalence of sarcopenic obesity and to explore the relationship between sarcopenic obesity and physical performance in middle-aged women from Northeast Brazil.

METHODS

A cross-sectional study of women (40-65 years) living in Parnamirim, a city in Northeast Brazil (n = 491). Physical performance was assessed by grip strength, knee extensor and flexor strength (isometric dynamometry), gait speed, and chair stands. Using bioelectrical impedance analysis (BIA), appendicular skeletal muscle mass divided by height squared (kg / m(2)) was used to define sarcopenia. Waist circumference ≥ 88 cm was defined as abdominal obesity. Sarcopenic obesity was defined as the coexistence of obesity and sarcopenia. The physical performance outcomes were regressed in four groups defined by combinations of sarcopenia and obesity, adjusting for potential confounders (age, education and menopausal status).

RESULTS

Prevalence rates of the four obesity-sarcopenia groups were: Sarcopenic obesity (7.1 %), obesity (67.4 %), sarcopenia (12.4 %) and normal (13 %). Women with sarcopenic obesity had significantly lower grip strength, weaker knee extension and flexion and longer time to raise from a chair compared with non-obese and non-sarcopenic women (p.values < 0.001). Except for the chair stands, these statistically significant differences were also found between sarcopenic obese and obese women. There was no significant difference for gait speed across the four groups (p = 0.50).

CONCLUSION

Sarcopenic obesity was present in 7 % of this population of middle-aged women from Northeast Brazil and it was associated with poor physical performance. Sarcopenic obesity may occur in middle-aged women with performance limitations beyond pure sarcopenia-related muscle mass or obesity alone.

A comparison of the effects of estrogen and Cimicifuga racemosa on the lacrimal gland and submandibular gland in ovariectomized rats

This study aims to observe the effects of estradiol and Cimicifuga racemosa on the lacrimal gland and submandibular gland of ovariectomized rats. We randomly divided 20 adult female SD rats into four groups-a sham-operated group (SHAM), ovariectomized (OVX) group, ovariectomized group treated with estradiol (OVX+ E), and ovariectomized group treated with the isopropanolic extract of Cimicifuga racemosa (OVX+ iCR). The SHAM group and OVX group used distilled water to instead the drugs. Two weeks after ovariectomy, the estradiol and iCR were administered for 4 weeks. Next, we used H&E staining and electron microscopy to observe any histological changes in the lacrimal and submandibular glands and immunohistochemical staining to observe the expressions of cleaved caspase-3 (Casp-3) and Cu-Zn SOD (superoxide dismutase). The H&E staining find that both drugs can prevent the cells of area from shrinkage in the two kinds of gland. But under the electron microscopy, estradiol and iCR have different efficacy. Estradiol is more effective at protecting mitochondria in lacrimal gland acinar cells than iCR, and iCR is more effective at suppressing endoplasmic reticulum expansion than estradiol. Both estradiol and iCR have a similar protective function on mitochondria in the submandibular gland. The protective function of the two glands may inhibit apoptosis by suppressing the expression of Casp-3. In addition, iCR increases the expression of Cu-Zn SOD in duct system of submandibular gland. The results suggest that both estradiol and iCR confer a protective effect on the lacrimal and submandibular glands of ovariectomized rats via different mechanisms.

Vegan diet and blood lipid profiles: a cross-sectional study of pre and postmenopausal women

Background

Vegan diet has been associated with lower risk of cardiovascular diseases and mortality, partly due to its effects on serum lipid profiles. Lipid profiles [high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and triglycerides (TG)] have not been fully elucidated either in pre and postmenopausal vegans or in ovo-lacto vegetarians. This study aimed to compare lipid profiles among vegans, ovo-lacto vegetarians and omnivores.

Methods

Demographic data and lipid profiles were obtained from the 2002 Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia. Multivariate linear regression analysis was used to examine factors significantly and independently associated with different categories of veganism and to estimate the β value of lipid profiles in the dietary types.

Results

A total of 2397 premenopausal and 1154 postmenopausal participants who did not receive lipid lowering drugs were enrolled. Premenopausal vegans had significantly lower HDL-C and higher TG, LDL-C/HDL-C, total cholesterol (TC)/HDL-C and TG/HDL-C compared with omnivores. For postmenopausal women, vegans had lower TC while ovo-lacto vegetarians were observed with low HDL-C when compared with omnivores. Multivariate linear regression analyses showed that vegan and ovo-lacto vegetarian diets decreased HDL-C levels in premenopausal women (β = -7.63, p = 0.001 and β = -4.87, p = 0.001, respectively). There were significant associations between lower LDL-C and ovo-lacto vegetarian diets (β = -7.14, p = 0.008) and also between TG and vegan diet (β = 23.37, p = 0.008), compared with omnivorous diet. Post-menopausal women reported to have consumed either a vegan or an ovo-lacto vegetarian diet were at the risk of having low HDL-C unlike those that consumed omnivorous diets (β = -4.88, p = 0.015 and β = -4.48, p = 0.047). There were no significant changes in LDL-C in both pre and postmenopausal vegans.

Conclusions

Vegan diet was associated with reduced HDL-C level. Because of its effects on lowering HDL-C and LDL-C, ovo-lacto vegetarian diet may be more appropriate for premenopausal women.