1
|
Song WQ, Zhong WF, Gao J, Li ZH, Ren JJ, Shen D, Wang XM, Shen QQ, You FF, Fu Q, Li C, Chen H, Lv YB, Shi XM, Mao C. Metabolic obesity phenotypes and all-cause mortality among the Chinese oldest-old population: a prospective cohort study. Int J Obes (Lond) 2024; 48:1438-1446. [PMID: 38926462 DOI: 10.1038/s41366-024-01571-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 06/07/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The obesity paradox has been reported among older adults. However, whether the favorable effect of obesity is dependent on metabolic status remains largely unknown. We aimed to explore the association of metabolic obesity phenotypes and their changes with all-cause mortality among the Chinese oldest-old population. METHODS This prospective cohort study included 1207 Chinese oldest old (mean age: 91.8 years). Metabolic obesity phenotypes were determined by central obesity and metabolic status, and participants were classified into metabolically healthy obesity (MHO), metabolically unhealthy obesity (MUO), metabolically healthy non-obesity (MHN), and metabolically unhealthy non-obesity (MUN). The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by Cox regression models. RESULTS During 5.3 years of follow-up, 640 deaths were documented. Compared with non-obesity, obesity was associated with a decreased mortality risk among participants with metabolically healthy (HR, 0.75; 95% CI, 0.63-0.91) while this association was insignificant among metabolically unhealthy. Compared to MHO, MHN (HR, 1.27; 95% CI, 1.06-1.53) and MUN (HR, 1.49; 95% CI, 1.10-2.02) were significantly associated with an increased mortality risk. Compared to those with stable MHO, those transited from MHO to MUO demonstrated a higher mortality risk (HR, 1.81; 95% CI, 1.06-3.11). CONCLUSIONS MHO predicts better survival among the Chinese oldest-old population. These findings suggest that ensuring optimal management of metabolic health is beneficial and taking caution in weight loss based on the individual body weight for the metabolically healthy oldest-old adults.
Collapse
Affiliation(s)
- Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jian Gao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao-Jiao Ren
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiao-Qiao Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fang-Fei You
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qi Fu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Chuan Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Huan Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
| |
Collapse
|
2
|
Hernández-Pérez T, Paredes-López O. Selected Mesoamerican Crops - Anti-Obesity Potential and Health Promotion. A Review. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2024; 79:563-570. [PMID: 39105985 PMCID: PMC11410843 DOI: 10.1007/s11130-024-01211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 08/07/2024]
Abstract
Mesoamerica is the center of origin of a great number of food crops that nowadays are part of a healthy diet. Pre-Columbian civilizations utilized more than 90% of these foods as ingredient or in main dishes, as well as for remedies and religious ceremonies. Since several years ago, Mesoamerican foods have been recognized by their outstanding concentration of bioactive compounds, including, phenolic compounds, pigments, essential fatty acids, amino acids, peptides, carbohydrates and vitamins, which provide a great number of health benefits. As a result of their unique composition, these ancient crops have several positive effects, such as hypoglycemic, antioxidant, anti-obesity, anti-inflammatory, anti-ageing, neuroprotective, anti-diarrheal, and anti-hypercholesterolemic capacity. Hence, this review is focused mainly in the anti-obesity and antioxidant potential of some of the most cultivated, harvested, as well as commercialized and consumed, food crops native of Mesoamerica, like, nopal and its fruit (Opuntia ficus indica spp.), chia (Salvia hispanica L.), pumpkin (Cucurbita spp.) and cacao (Theobroma cacao).
Collapse
Affiliation(s)
- Talía Hernández-Pérez
- Centro de Investigación y de Estudios Avanzados del IPN (Instituto Politécnico Nacional), Irapuato, Guanajuato, 36824, México
| | - Octavio Paredes-López
- Centro de Investigación y de Estudios Avanzados del IPN (Instituto Politécnico Nacional), Irapuato, Guanajuato, 36824, México.
| |
Collapse
|
3
|
Kirk D, Baart AM, McLean J, Feskens EJM. Association between diet quality and all-cause mortality in a large Dutch cohort. PLoS One 2024; 19:e0302905. [PMID: 39178206 PMCID: PMC11343414 DOI: 10.1371/journal.pone.0302905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/16/2024] [Indexed: 08/25/2024] Open
Abstract
Food-based dietary guidelines are helpful for governments and health agencies to encourage healthy eating at the population level. In order to assess adherence to such guidelines, index scores have been developed, the version in the Netherlands being the Dutch Healthy Diet-index (2015) (DHD2015-index), which reflect adherence to the 2015 Dutch dietary guidelines. Because a higher diet quality, i.e. a higher adherence to the dietary guidelines, is associated with better health outcomes, a higher DHD2015-index score would also mean better outcomes on measures of health, such as all-cause mortality. The present study aimed to elucidate this by investigating the association between DHD2015-index score and mortality in the Dutch population using data from 97 999 participants in the Lifelines cohort study. For the analyses, Cox Proportional Hazards regression was used, whilst accounting for age, sex, physiological measurements, exercise, and biochemical and lifestyle variables. There was a strong negative association between DHD2015-index score and mortality. Hazard ratios for DHD2015-index scores below 60 were approximately 1.2x larger than the mean. Every 10 unit increase in DHD2015-index scores between 60 and 90 led to a 0.1 reduction in hazard ratio, and every 10 unit increase between 90 and the highest DHD2015-index scores led to a reduction in hazard ratios of 0.05. The hazard ratio for the lowest quartile of DHD2015-index scores was 1.14 (95% CI = 1.04-1.26), whereas that for the highest quartile was 0.88 (95% CI = 0.84-0.92). Our results show a clear inverse relationship between DHD2015-index score and all-cause mortality.
Collapse
Affiliation(s)
- Daniel Kirk
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, United Kingdom
| | - A. Mireille Baart
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | | | - Edith J. M. Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| |
Collapse
|
4
|
Galicia Ernst I, Worf I, Tarantino S, Hiesmayr M, Volkert D. Obesity in European nursing homes participating in nutritionDay 2016-2021-Prevalence and resident characteristics. Clin Obes 2024:e12697. [PMID: 39098644 DOI: 10.1111/cob.12697] [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] [Received: 11/08/2023] [Revised: 06/27/2024] [Accepted: 07/20/2024] [Indexed: 08/06/2024]
Abstract
The objective of this study is to assess obesity prevalence and characterize European nursing home (NH) residents with obesity comprehensively. Cross-sectional nutritionDay data from 2016 to 2021. Descriptive characterization of European NH residents ≥65 years with and without obesity. Binomial logistic regression to identify factors associated with obesity. A total of 11 327 residents (73.8% female, 86.4 ± 7.9 years, mean body mass index 25.3 ± 5.4 kg/m2) from 12 countries were analysed. Obesity prevalence was 17.7%, mostly class I (13.0%). Taking ≥5 drugs/day (OR 1.633; 95% confidence intervals 1.358-1.972), female sex (1.591; 1.385-1.832), being bed/chair-bound (1.357; 1.146-1.606), and having heart/circulation/lung disease (1.276; 1.124-1.448) was associated with increased obesity risk, older age (0.951; 0.944-0.958), mild (0.696; 0.601-0.805) and severe (0.591; 0.488-0.715) dementia, eating less than ¾ of lunch on nutritionDay (0.669; 0.563-0.793), needing assistance for eating (0.686; 0.569-0.825), and being identified by NH staff at risk for (0.312; 0.255-0.380) or with malnutrition (0.392; 0.236-0.619) decreased obesity risk. Almost one in five residents in European NH participating in nutritionDay is affected by obesity. Through a wide exploratory analysis, including data from 12 European countries, we confirmed previous findings and identified additional factors associated with obesity that should be considered in the daily care of affected residents.
Collapse
Affiliation(s)
- Isabel Galicia Ernst
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Isabella Worf
- CeMSIIS - Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Silvia Tarantino
- CeMSIIS - Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Michael Hiesmayr
- CeMSIIS - Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, Vienna, Austria
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| |
Collapse
|
5
|
Liu L, Shi H, Xie M, Sun Y, Nahata MC. Efficacy and safety of tirzepatide versus placebo in overweight or obese adults without diabetes: a systematic review and meta-analysis of randomized controlled trials. Int J Clin Pharm 2024:10.1007/s11096-024-01779-x. [PMID: 39037553 DOI: 10.1007/s11096-024-01779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/07/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Tirzepatide was approved to treat type 2 diabetes and obesity, but its efficacy and safety in patients without diabetes has not been investigated. AIM This meta-analysis aimed to evaluate the efficacy and safety of tirzepatide compared to placebo in overweight or obese patients without diabetes. METHOD PubMed, Embase and Cochrane were searched on January 18, 2024. Randomized controlled trials (RCTs) that used tirzepatide in overweight or obese adults without diabetes were included. Efficacy outcomes included the proportion of participants achieving weight loss targets, changes in body weight (%), body mass index (BMI), waist circumference (WC), and blood pressure (BP). Safety outcomes were commonly reported adverse events. Standardized mean differences (SMD) or odds ratios (OR) with 95% confidence intervals (CIs) were used for continuous and dichotomous outcomes, respectively. RESULTS Three RCTs with 3901 participants were included. Tirzepatide was associated with increased proportion of participants achieving weight loss targets, reduced body weight (SMD - 1.61, 95% CI - 2.20 to - 1.02), BMI (SMD - 2.13, 95% CI - 3.08 to - 1.18), WC (SMD - 0.91, 95% CI - 1.14 to - 0.69), and BP versus placebo. However, the risk of adverse events such as nausea (OR 4.26, 95% CI 2.60 to 3.81), vomiting (OR 8.35, 95% CI 5.19 to 13.45), and diarrhea (OR 3.57, 95% CI 2.80 to 4.57) was significantly higher for tirzepatide versus placebo. CONCLUSION Tirzepatide significantly reduced weight and improved metabolic markers among overweight or obese without diabetes. However, increased adverse events highlights the need for benefits versus risks assessment before initiation and continuous monitoring.
Collapse
Affiliation(s)
- Ligang Liu
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, 500 West 12th Ave., Columbus, OH, 43210, USA
| | - Hekai Shi
- Department of Bariatric and Metabolic Surgery, Fudan University Affiliated Huadong Hospital, Shanghai, China
| | - Merilyn Xie
- St. John's University College of Pharmacy and Health Sciences, New York, NY, USA
| | - Yuxiao Sun
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Milap C Nahata
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, 500 West 12th Ave., Columbus, OH, 43210, USA.
- College of Medicine, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
6
|
Ogata H, Isoyama Y, Nose-Ogura S, Nagai N, Kayaba M, Kruse JGS, Seleznov I, Kaneko M, Shigematsu T, Kiyono K. Allometric multi-scaling of weight-for-height relation in children and adolescents: Revisiting the theoretical basis of body mass index of thinness and obesity assessment. PLoS One 2024; 19:e0307238. [PMID: 39024324 PMCID: PMC11257299 DOI: 10.1371/journal.pone.0307238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
The body mass index (BMI), defined as weight in kilograms divided by height in meters squared, has been widely used to assess thinness and obesity in all age groups, including children and adolescents. However, the validity and utility of BMI as a reliable measure of nutritional health have been questioned. This study discusses the mathematical conditions that support the validity of BMI based on population statistics. Here, we propose a condition defined as allometric uni-scaling to ensure the validity of BMI as an objective height-adjusted measure. Any given centile curve, including the median curve, in a weight-for-height distribution should be approximated using power-law functions with the same scaling exponent. In contrast, when the scaling exponent varies depending on the position of the centile curve, it is called allometric multi-scaling. By introducing a method for testing these scaling properties using quantile regression, we analyzed a large-scale Japanese database that included 7,863,520 children aged 5-17 years. We demonstrated the remarkable multi-scaling properties at ages 5-13 years for males and 5-11 years for females, and the convergence to uni-scaling with a scaling exponent close to 2 as they approached 17 years of age for both sexes. We confirmed that conventional BMI is appropriate as an objective height-adjusted mass measure at least 17 years of age, close to adulthood, for both males and females. However, the validity of BMI could not be confirmed in younger age groups. Our findings indicate that the growth of children's weight-for-height relation is much more complex than previously assumed. Therefore, a single BMI-type formula cannot be used to assess thinness and obesity in children and adolescents.
Collapse
Affiliation(s)
- Hitomi Ogata
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Isoyama
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Sayaka Nose-Ogura
- JAPAN High Performance Sport Center, Department of Sports Medicine and Research, Japan Institute Sports Sciences, Tokyo, Japan
- Department of Obstetrics and Gynecology, University of Tokyo Hospital, Tokyo, Japan
| | - Narumi Nagai
- School of Human Science and Environment, University of Hyogo, Himeji, Japan
| | - Momoko Kayaba
- Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | | | - Ivan Seleznov
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Miki Kaneko
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Taiki Shigematsu
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Ken Kiyono
- Graduate School of Engineering Science, Osaka University, Osaka, Japan
| |
Collapse
|
7
|
Kennedy HL. Progress in Cardiac Conduction Disease and the Emergence of Artificial Intelligence in Epidemiological Research. JACC. ADVANCES 2024; 3:101007. [PMID: 39129985 PMCID: PMC11312773 DOI: 10.1016/j.jacadv.2024.101007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Affiliation(s)
- Harold L. Kennedy
- Department of Medicine and Cardiovascular Disease, University of Missouri School of Medicine, Columbia, Missouri, USA
| |
Collapse
|
8
|
Palatini P, Virdis A, Masi S, Mengozzi A, Casiglia E, Tikhonoff V, Cicero AFG, Ungar A, Parati G, Rivasi G, Salvetti M, Barbagallo CM, Bombelli M, Dell’Oro R, Bruno B, Lippa L, D’Elia L, Masulli M, Verdecchia P, Reboldi G, Angeli F, Cianci R, Mallamaci F, Cirillo M, Rattazzi M, Cirillo P, Gesualdo L, Russo E, Mazza A, Giannattasio C, Maloberti A, Volpe M, Tocci G, Iaccarino G, Nazzaro P, Galletti F, Ferri C, Desideri G, Viazzi F, Pontremoli R, Muiesan ML, Grassi G, Borghi C. Risk of Cardiovascular Events in Metabolically Healthy Overweight or Obese Adults: Role of LDL-Cholesterol in the Stratification of Risk. Diagnostics (Basel) 2024; 14:1314. [PMID: 39001205 PMCID: PMC11240609 DOI: 10.3390/diagnostics14131314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/08/2024] [Accepted: 06/10/2024] [Indexed: 07/16/2024] Open
Abstract
The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped according to BMI and metabolic status. Healthy metabolic status was identified with and without including LDL-cholesterol. The risk of MACE during 11.8 years of follow-up was evaluated with multivariable Cox regressions. Among the participants aged <70 years, high BMI was associated with an increased risk of MACE, whereas among the older subjects it was associated with lower risk. Compared to the group with normal weight/healthy metabolic status, the metabolically healthy participants aged <70 years who were overweight/obese had an increased risk of MACE with an adjusted hazard ratio of 3.81 (95% CI, 1.34-10.85, p = 0.012). However, when LDL-cholesterol < 130 mg/dL was included in the definition of healthy metabolic status, no increase in risk was found in the overweight/obese adults compared to the normal weight individuals (hazard ratio 0.70 (0.07-6.71, p = 0.75). The present data show that the risk of MACE is increased in metabolically healthy overweight/obese individuals identified according to standard criteria. However, when LDL-cholesterol is included in the definition, metabolically healthy individuals who are overweight/obese have no increase in risk.
Collapse
Affiliation(s)
- Paolo Palatini
- Department of Medicine, Studium Patavinum, University of Padova, 35128 Padua, Italy
| | - Agostino Virdis
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Stefano Masi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Edoardo Casiglia
- Department of Medicine, Studium Patavinum, University of Padova, 35128 Padua, Italy
| | | | | | - Andrea Ungar
- Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy
| | - Gianfranco Parati
- Istituto Auxologico Italiano, S. Luca Hospital, University of Milan-Bicocca, 20126 Milan, Italy;
- Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo, 20126 Milan, Italy
| | - Giulia Rivasi
- Department of Geriatric and Intensive Care Medicine, Careggi Hospital, University of Florence, 50121 Florence, Italy
| | - Massimo Salvetti
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Carlo Maria Barbagallo
- Biomedical Department of Internal Medicine and Specialistics, University of Palermo, 90100 Palermo, Italy
| | - Michele Bombelli
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy (R.D.); (G.G.)
| | - Raffaella Dell’Oro
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy (R.D.); (G.G.)
| | - Berardino Bruno
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Luciano Lippa
- Italian Society of General Medicine (SIMG), 67051 Avezzano, Italy
| | - Lanfranco D’Elia
- Department of Clinical Medicine and Surgery, Medical School, “Federico II” University of Naples, 80133 Naples, Italy
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, Medical School, “Federico II” University of Naples, 80133 Naples, Italy
| | | | - Gianpaolo Reboldi
- Department of Medical and Surgical Science, University of Perugia, 06100 Perugia, Italy;
| | - Fabio Angeli
- Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
- Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, 21100 Varese, Italy
| | - Rosario Cianci
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Francesca Mallamaci
- CNR-IFC, Clinical Epidemiology of Renal Diseases and Hypertension, Reggio Cal Unit, 89124 Reggio Calabria, Italy
| | - Massimo Cirillo
- Department of Public Health, “Federico II” University of Naples, 80133 Naples, Italy;
| | - Marcello Rattazzi
- Department of Medicine, University of Padova, 35128 Padua, Italy
- Medicina Interna 1°, Ca’ Foncello University Hospital, 31100 Treviso, Italy
| | - Pietro Cirillo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, Italy; (P.C.)
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, “Aldo Moro” University of Bari, 70122 Bari, Italy; (P.C.)
| | - Elisa Russo
- Department of Internal Medicine, University of Genoa, Policlinico San Martino, 16132 Genova, Italy (F.V.)
| | - Alberto Mazza
- Department of Internal Medicine, Hypertension Unit, General Hospital, 45100 Rovigo, Italy;
| | - Cristina Giannattasio
- Cardiology IV, ‘A. De Gasperis’ Department, Niguarda Ca’ Granda Hospital, 20162 Milano, Italy
| | - Alessandro Maloberti
- Cardiology IV, ‘A. De Gasperis’ Department, Niguarda Ca’ Granda Hospital, 20162 Milano, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, University of Rome Sapienza, 00161 Rome, Italy
- IRCCS San Raffaele, 00161 Rome, Italy
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant’Andrea Hospital, 00185 Rome, Italy;
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, “Federico II” University of Naples, 80133 Naples, Italy
| | - Pietro Nazzaro
- Department of Medical Basic Sciences, Neurosciences and Sense Organs, Medical School, University of Bari, 70122 Bari, Italy;
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Medical School, “Federico II” University of Naples, 80133 Naples, Italy
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Francesca Viazzi
- Department of Internal Medicine, University of Genoa, Policlinico San Martino, 16132 Genova, Italy (F.V.)
| | - Roberto Pontremoli
- Department of Internal Medicine, University of Genoa, Policlinico San Martino, 16132 Genova, Italy (F.V.)
| | - Maria Lorenza Muiesan
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy (R.D.); (G.G.)
| | - Claudio Borghi
- Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| |
Collapse
|
9
|
Wei Z, Nie G, Sadik CD, Shan D. Associations between body mass index and all-cause mortality among individuals with psoriasis: results from the NHANES database retrospective cohort study. Front Nutr 2024; 11:1407454. [PMID: 38903618 PMCID: PMC11188368 DOI: 10.3389/fnut.2024.1407454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/14/2024] [Indexed: 06/22/2024] Open
Abstract
Background Previous findings imply a potential positive association between BMI and all-cause mortality in individuals with psoriasis, yet direct evidence remains absent. This study aimed to fill this gap. Methods We utilized data from the National Health and Nutrition Examination Survey (NHANES) for the periods 2003-2006 and 2009-2014. Participants' BMI was categorized as lean (<25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). Psoriasis status was determined through self-reporting. The main outcome measured was all-cause mortality up to December 2019. We accounted for multiple covariates, such as sociodemographic factors and histories of smoking and alcohol consumption. Our statistical analyses mainly included Kaplan-Meier survival analysis, Restricted Cubic Spline (RCS) and Multivariate Cox Regression (MCR). We also applied propensity score matching (PSM) to verify the robustness of our findings. Results Among 22,876 participants, 618 (2.70%) reported a history of psoriasis. An overall effect from the MCR analysis showed that, among individuals with psoriasis, a higher baseline BMI was independently associated with an increased risk of all-cause mortality, noting a 5.5% rise in mortality risk per BMI unit [hazard ratio (HR) = 1.055, 95% CI: 1.004-1.110, p = 0.035]. This significant relationship persisted after PSM. A statistically significant positive correlation was consistent among males, smokers, and individuals younger than 60. However, no such association was found in individuals without a history of psoriasis. Additionally, no significant difference in mortality risk was found between lean and overweight groups with psoriasis, according to the RCS regression and stratified analysis. Conclusion Our findings indicated a trend that, higher BMIs significantly correlated with increased risks of all-cause mortality in people with psoriasis, particularly among obese ones. However, the impact of being overweight on this relationship remains underexplored. Moreover, the necessity to employ alternative metrics beyond BMI for body fat assessment to further investigate these associations is critical.
Collapse
Affiliation(s)
- ZhiHong Wei
- Department of Dermatology, Allergy, and Venereology, University of Lübeck, Lübeck, Germany
- School of Medicine, National University of Ireland, Galway, Ireland
| | - GuanHua Nie
- Institute for Experimental and Clinical Pharmacology and Toxicology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - Christian D. Sadik
- Department of Dermatology, Allergy, and Venereology, University of Lübeck, Lübeck, Germany
| | - Dan Shan
- Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom
| |
Collapse
|
10
|
Burgess S, Sun YQ, Zhou A, Buck C, Mason AM, Mai XM. Body mass index and all-cause mortality in HUNT and UK biobank studies: revised non-linear Mendelian randomisation analyses. BMJ Open 2024; 14:e081399. [PMID: 38749693 PMCID: PMC11097829 DOI: 10.1136/bmjopen-2023-081399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVES To estimate the shape of the causal relationship between body mass index (BMI) and mortality risk in a Mendelian randomisation framework. DESIGN Mendelian randomisation analyses of two prospective population-based cohorts. SETTING Individuals of European ancestries living in Norway or the UK. PARTICIPANTS 56 150 participants from the Trøndelag Health Study (HUNT) in Norway and 366 385 participants from UK Biobank recruited by postal invitation. OUTCOMES All-cause mortality and cause-specific mortality (cardiovascular, cancer, non-cardiovascular non-cancer). RESULTS A previously published non-linear Mendelian randomisation analysis of these data using the residual stratification method suggested a J-shaped association between genetically predicted BMI and mortality outcomes with the lowest mortality risk at a BMI of around 25 kg/m2. However, the 'constant genetic effect' assumption required by this method is violated. The reanalysis of these data using the more reliable doubly-ranked stratification method provided some indication of a J-shaped relationship, but with much less certainty as there was less precision in estimates at the lower end of the BMI distribution. Evidence for a harmful effect of reducing BMI at low BMI levels was only present in some analyses, and where present, only below 20 kg/m2. A harmful effect of increasing BMI for all-cause mortality was evident above 25 kg/m2, for cardiovascular mortality above 24 kg/m2, for cancer mortality above 30 kg/m2 and for non-cardiovascular non-cancer mortality above 26 kg/m2. In UK Biobank, the association between genetically predicted BMI and mortality at high BMI levels was stronger in women than in men. CONCLUSION This research challenges findings from previous conventional observational epidemiology and Mendelian randomisation investigations that the lowest level of mortality risk is at a BMI level of around 25 kg/m2. Our results provide some evidence that reductions in BMI will increase mortality risk for a small proportion of the population, and clear evidence that increases in BMI will increase mortality risk for those with BMI above 25 kg/m2.
Collapse
Affiliation(s)
- Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Yi-Qian Sun
- Department of Clinical and Molecular Medicine (IKOM), Norges teknisk-naturvitenskapelige universitet, Trondheim, Norway
- Department of Pathology, Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Center for Oral Health Services and Research Mid-Norway (TkMidt), Trondheim, Norway
| | - Ang Zhou
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | | | - Amy M Mason
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Xiao-Mei Mai
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
11
|
Godziuk K, Hawker GA. Obesity and body mass index: Past and future considerations in osteoarthritis research. Osteoarthritis Cartilage 2024; 32:452-459. [PMID: 38354848 DOI: 10.1016/j.joca.2024.02.003] [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: 09/01/2023] [Revised: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 02/16/2024]
Abstract
Obesity is an important topic for the osteoarthritis (OA) scientific community. However, the predominant use of body mass index (BMI) to define obesity in OA research is associated with uncertainties and limitations. These include an inability to discern fat and muscle mass, account for sex-differences in fat distribution, or identify adiposity-related health impairments. A focus on BMI in OA research may influence weight bias in clinical practice and impact disparities in access to effective OA treatments. To ensure that our understanding and approaches to improve health outcomes for individuals with or at risk for OA continues to advance in the next decade, future research will need to consider alternative measures beyond BMI for obesity identification and align with evolving obesity science. OA researchers must be aware of issues associated with weight stigma and work to minimize negative generalizations based on BMI.
Collapse
Affiliation(s)
- Kristine Godziuk
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
| | - Gillian A Hawker
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
12
|
Benz E, Pinel A, Guillet C, Capel F, Pereira B, De Antonio M, Pouget M, Cruz-Jentoft AJ, Eglseer D, Topinkova E, Barazzoni R, Rivadeneira F, Ikram MA, Steur M, Voortman T, Schoufour JD, Weijs PJM, Boirie Y. Sarcopenia and Sarcopenic Obesity and Mortality Among Older People. JAMA Netw Open 2024; 7:e243604. [PMID: 38526491 DOI: 10.1001/jamanetworkopen.2024.3604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Importance Sarcopenia and obesity are 2 global concerns associated with adverse health outcomes in older people. Evidence on the population-based prevalence of the combination of sarcopenia with obesity (sarcopenic obesity [SO]) and its association with mortality are still limited. Objective To investigate the prevalence of sarcopenia and SO and their association with all-cause mortality. Design, Setting, and Participants This large-scale, population-based cohort study assessed participants from the Rotterdam Study from March 1, 2009, to June 1, 2014. Associations of sarcopenia and SO with all-cause mortality were studied using Kaplan-Meier curves, Cox proportional hazards regression, and accelerated failure time models fitted for sex, age, and body mass index (BMI). Data analysis was performed from January 1 to April 1, 2023. Exposures The prevalence of sarcopenia and SO, measured based on handgrip strength and body composition (BC) (dual-energy x-ray absorptiometry) as recommended by current consensus criteria, with probable sarcopenia defined as having low handgrip strength and confirmed sarcopenia and SO defined as altered BC (high fat percentage and/or low appendicular skeletal muscle index) in addition to low handgrip strength. Main Outcome and Measure The primary outcome was all-cause mortality, collected using linked mortality data from general practitioners and the central municipal records, until October 2022. Results In the total population of 5888 participants (mean [SD] age, 69.5 [9.1] years; mean [SD] BMI, 27.5 [4.3]; 3343 [56.8%] female), 653 (11.1%; 95% CI, 10.3%-11.9%) had probable sarcopenia and 127 (2.2%; 95% CI, 1.8%-2.6%) had confirmed sarcopenia. Sarcopenic obesity with 1 altered component of BC was present in 295 participants (5.0%; 95% CI, 4.4%-5.6%) and with 2 altered components in 44 participants (0.8%; 95% CI, 0.6%-1.0%). An increased risk of all-cause mortality was observed in participants with probable sarcopenia (hazard ratio [HR], 1.29; 95% CI, 1.14-1.47) and confirmed sarcopenia (HR, 1.93; 95% CI, 1.53-2.43). Participants with SO plus 1 altered component of BC (HR, 1.94; 95% CI, 1.60-2.33]) or 2 altered components of BC (HR, 2.84; 95% CI, 1.97-4.11) had a higher risk of mortality than those without SO. Similar results for SO were obtained for participants with a BMI of 27 or greater. Conclusions and Relevance In this study, sarcopenia and SO were found to be prevalent phenotypes in older people and were associated with all-cause mortality. Additional alterations of BC amplified this risk independently of age, sex, and BMI. The use of low muscle strength as a first step of both diagnoses may allow for early identification of individuals at risk for premature mortality.
Collapse
Affiliation(s)
- Elizabeth Benz
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alexandre Pinel
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Christelle Guillet
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Frederic Capel
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
| | - Bruno Pereira
- Unit of Biostatistics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Marie De Antonio
- Unit of Biostatistics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Melanie Pouget
- Department of Clinical Nutrition, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | | | - Doris Eglseer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Eva Topinkova
- Department of Geriatrics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Rocco Barazzoni
- Department of Medical, Technological and Translational Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marinka Steur
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Josje D Schoufour
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Faculty of Sports and Nutrition, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, the Netherlands
| | - Yves Boirie
- Human Nutrition Unit, Clermont Auvergne University, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche en Nutrition Humaine, Clermont-Ferrand, France
- Department of Clinical Nutrition, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| |
Collapse
|
13
|
Alabi TA, Badru OA. Slim north, fat south: explaining regional differences in abnormal weights in Nigeria. J Biosoc Sci 2024; 56:207-231. [PMID: 38031718 DOI: 10.1017/s0021932023000238] [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] [Indexed: 12/01/2023]
Abstract
Weight abnormalities (underweight, overweight, and obesity) can cause life-threatening ailments. This study investigates disparities in the prevalence of underweight, overweight, and obesity between northern and southern Nigeria and their associated factors. Using the 2018 Nigeria Demographic and Health Survey (NDHS), the study analysed a sample of 12,333 women with complete records of body mass index. The study found that southern women had lower odds of being underweight than women in the north, but the reverse was the case for overweight and obesity. The prevalence of underweight was 11.6%, and it varies from 6.9% in the southern state of Enugu to 31.6% in the northern state of Jigawa. The national prevalence of overweight was 17.9%, ranging from 6.7% in Jigawa State of the northern region to 39.9% in Lagos State of the south. Similarly, the prevalence of obesity in the north was 6.1% compared to 14.4% in the south, with Anambra State of the southern region recording the highest figure of 35.5% compared to 2.1% in the Yobe State of the northern region. In all, the rate of abnormal weight was significantly higher in the south than in the north. However, the type of weight abnormality varies between the two regions. Religion, education, use of contraceptives, and wealth were associated with the three forms of abnormal weights. However, while religion was significantly associated with obesity in the north, the association was not significant in the south. This study found that wealth and education have dissimilar influences on overnutrition. While the odds of being overweight and obese increase with wealth, being educated up to a secondary level significantly reduces the odds in Nigeria and across the two regions.
Collapse
Affiliation(s)
- Tunde A Alabi
- Department of Sociology, Faculty of Social Sciences, University of Lagos, Lagos, Nigeria
- Department of Sociology, Faculty of Humanities, University of Cape Town, Cape Town, South Africa
| | - Oluwaseun A Badru
- University of Iowa, Iowa City, IA, USA
- Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Institute of Human Virology, Abuja, Nigeria
| |
Collapse
|
14
|
Kim SJ, Tworoger SS, Rosen BP, McLaughlin JR, Risch HA, Narod SA, Kotsopoulos J. Impact of Pre-Diagnostic Risk Factors on Short- and Long-Term Ovarian Cancer Survival Trajectories: A Longitudinal Observational Study. Cancers (Basel) 2024; 16:972. [PMID: 38473333 PMCID: PMC11154316 DOI: 10.3390/cancers16050972] [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: 12/28/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Tumor- and treatment-related factors are established predictors of ovarian cancer survival. New studies suggest a differential impact of exposures on ovarian cancer survival trajectories (i.e., rapidly fatal to long-term disease). This study examined the impact of pre-diagnostic risk factors on short- and long-term ovarian cancer survival trajectories in the Canadian context. This population-based longitudinal observational study included women diagnosed with invasive epithelial ovarian cancer from 1995 to 2004 in Ontario. Data were obtained from medical records, interviews, and the provincial cancer registry. Extended Cox proportional hazard models estimated the association between risk factors and all-cause and ovarian cancer-specific mortality by survival time intervals (<3 years (i.e., short-term survival), 3 to <6 years, 6 to <10 years, and ≥10 years (i.e., long-term survival)). Among 1421 women, histology, stage, and residual disease were the most important predictors of all-cause mortality in all survival trajectories, particularly for short-term survival. Reproductive and lifestyle factors did not strongly impact short-term overall survival but were associated with long-term overall survival. As such, among long-term survivors, history of breastfeeding significantly decreased the risk of all-cause mortality (HR 0.65; 95% CI 0.46, 0.93; p < 0.05), whereas smoking history (HR 1.75; 95% CI 1.27, 2.40; p < 0.05) and obesity (HR 1.81; 95% CI 1.24, 2.65; p < 0.05) significantly increased the risk of all-cause mortality. The findings were consistent with ovarian cancer-specific mortality. These findings suggest that pre-diagnostic exposures differentially influence survival time following a diagnosis of ovarian cancer.
Collapse
Affiliation(s)
- Shana J. Kim
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5S 1B2, Canada; (S.J.K.); (S.A.N.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Shelley S. Tworoger
- Division of Oncological Sciences, Knight Cancer Institute, Oregon Health and Sciences, Portland, OR 97201, USA;
| | - Barry P. Rosen
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada;
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada
| | - John R. McLaughlin
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada;
- Public Health Ontario, Toronto, ON M5G 1M1, Canada
| | - Harvey A. Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT 06520, USA;
| | - Steven A. Narod
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5S 1B2, Canada; (S.J.K.); (S.A.N.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Joanne Kotsopoulos
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON M5S 1B2, Canada; (S.J.K.); (S.A.N.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| |
Collapse
|
15
|
Carrasquillo O, Cueto V. Central Adiposity and Mortality Among Hispanic and Latino Adults-Moving Away From the Body Mass Index. JAMA Netw Open 2024; 7:e2351000. [PMID: 38227317 DOI: 10.1001/jamanetworkopen.2023.51000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Affiliation(s)
| | - Victor Cueto
- University of Miami, Miller School of Medicine, Miami, Florida
| |
Collapse
|
16
|
Fosdahl MA, Berg B, Risberg MA, Øiestad BE, Holm I. Body Mass Index, Quality of Life and Activity Limitation Trajectories over 2 Years in Patients with Knee or Hip Osteoarthritis: A Dual Trajectory Approach Based on 4265 Patients Included in the AktivA Quality Register. J Clin Med 2023; 12:7094. [PMID: 38002706 PMCID: PMC10672133 DOI: 10.3390/jcm12227094] [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: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: Recent studies claim that weight-neutral approaches emphasizing physical activity might be as effective as weight-loss-centered approaches for improving pain and physical function in patients with knee and hip osteoarthritis. The objectives were to identify distinctive groups of individuals with similar BMI, quality of life and activity limitation trajectories over two years, to compare the overall differences between BMI trajectory groups for baseline variables and to explore the probabilities of the quality of life and activity limitation trajectory groups conditional on the BMI group. (2) Methods: Baseline data for age, gender, BMI, quality of life, activity limitations, pain, general health, knee or hip osteoarthritis and follow-up data on BMI, quality of life and activity limitations at 3, 12 and 24 months were retrieved from the "Active with osteoarthritis" (AktivA) electronic quality register. Group-based trajectory modeling was used to identify distinct trajectories for BMI, quality of life and activity limitations. (3) Results: 4265 patients were included in the study. Four distinct BMI trajectories were identified, normal weight (31%), slightly overweight (43%), overweight (20%) and obese (6%). At baseline, there were highly significant differences between all BMI groups, pain increased and age and general health decreased with higher BMI. Irrespective of weight category, minimal changes in BMI were found over the two-year follow-up period. Over 80% of the participants showed moderate-to-considerable improvements both in quality of life and activity limitations. (4) Conclusions: Almost 70% of the participants belonged to the overweight trajectories. Despite no significant weight reduction over the two years, eight in every 10 participants improved their quality of life and reduced their activity limitations after participating in the AktivA program.
Collapse
Affiliation(s)
- Merete Aarsland Fosdahl
- Division of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, Norway (M.A.R.)
- Department of Clinical Neurosciences for Children, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - Bjørnar Berg
- Centre for Intelligent Musculoskeletal Health, Faculty of Health Science, Oslo Metropolitan University, 0130 Oslo, Norway;
| | - May Arna Risberg
- Division of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, Norway (M.A.R.)
- Department of Sports Medicine, Norwegian School of Sport Sciences, 0863 Oslo, Norway
| | - Britt Elin Øiestad
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, 0130 Oslo, Norway;
| | - Inger Holm
- Division of Orthopaedic Surgery, Oslo University Hospital, 0424 Oslo, Norway (M.A.R.)
- Department of Interdisciplinary Health Sciences, Medical Faculty, University of Oslo, 0318 Oslo, Norway
| |
Collapse
|
17
|
Prillaman M. Why BMI is flawed - and how to redefine obesity. Nature 2023; 622:232-233. [PMID: 37821595 DOI: 10.1038/d41586-023-03143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
|