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Mabeza RM, Mao Y, Maynard K, Lee C, Benharash P, Yetasook A. Bariatric Surgery Outcomes in Geriatric Patients: A Contemporary, Nationwide Analysis. Surg Obes Relat Dis 2022; 18:1005-1011. [DOI: 10.1016/j.soard.2022.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/02/2022] [Accepted: 04/17/2022] [Indexed: 12/13/2022]
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The NESTORE e-Coach: Designing a Multi-Domain Pathway to Well-Being in Older Age. TECHNOLOGIES 2022. [DOI: 10.3390/technologies10020050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the coaching strategies of the NESTORE e-coach, a virtual coach for promoting healthier lifestyles in older age. The novelty of the NESTORE project is the definition of a multi-domain personalized pathway where the e-coach accompanies the user throughout different structured and non-structured coaching activities and recommendations. The article also presents the design process of the coaching strategies, carried out including older adults from four European countries and experts from the different health domains, and the results of the tests carried out with 60 older adults in Italy, Spain and The Netherlands.
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Taleb S, Boulaba K, Yousfi A, Taleb N, Difallah B, Negrichi S. Associations between body mass index, waist circumference, waist circumference to-height ratio, and hypertension in an Algerian adult population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:46514-46522. [PMID: 32681329 DOI: 10.1007/s11356-020-10122-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
The aim of our study was to analyze the associations between anthropometric measures and high blood pressure (HBP) in Algerian patients. A cross-sectional study was conducted among 785 adults with normal BMI (248), overweight (253), and obese (284), who were assessed with measurement of systolic and diastolic blood pressure, weight, height, and waist circumference (WC). Body mass index (BMI) and waist circumference-to-height ratio (WHtR) were calculated. We released receiver operating characteristic (ROC) curves for each anthropometric parameter to assess its discriminant power predictive of HBP in patients. Obese had a higher mean weight, WC, WHtR, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), total cholesterol (TC), and triglycerides (TG) than overweight and normal weight. The prevalence of hypertension and diabetes was higher in obese than overweight and normal weight. Results showed that obesity increased the risk of hypertension by a factor of 1.54 (95% CI [1.15, 2.06], (p = 0.004). Pearson's correlation data analysis showed that there was no relationship between systolic blood pressure and anthropometric parameters (BMI, WC, and WHtR). Only DBP was negatively associated with WHtR in the overweight group. All these parameters had areas under the curve between 0.409 and 0.618.The cutoff value of anthropometric WHtR parameters associated with the risk of hypertension was higher among women than men regardless of the BMI group considered. Contrary to the data of the literature, the discriminating power of anthropometry in the prediction of the HBP is limited or absent whatever the value of the BMI.
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Affiliation(s)
- Salima Taleb
- FESSNL. Applied Biology Department, University Larbi Tbessi-Tebessa, 12000, Tebessa, Algeria.
- INATAA, University of Constantine 1, Constantine, Algeria.
- Laboratory of Water and Environment, University Larbi Tbessi, 12000, Tebessa, Algeria.
| | - Kafila Boulaba
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Ahlem Yousfi
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Nada Taleb
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Basma Difallah
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
| | - Samira Negrichi
- FESSNL. Biology of Living Beings Department, University Larbi Tbessi.Tebessa, 12000, Tebessa, Algeria
- Laboratory of Water and Environment, University Larbi Tbessi, 12000, Tebessa, Algeria
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Stavrinou P, Aphamis G, Andreou E, Pantzaris M, Giannaki C. Association of body composition with functional capacity and cognitive function in older adults living in nursing homes. Curr Aging Sci 2021; 15:77-82. [PMID: 34465282 DOI: 10.2174/1874609814666210831155002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Older adults living in nursing homes have an increased risk of adverse outcomes. However, the role of body composition in vital health and quality of life parameters such as functional capacity and cognitive function is less studied in this group of older adults compared to community-dwelling counterparts. OBJECTIVE The aim of the present study was to examine the association of body composition with functional capacity and cognitive function in nursing home residents. METHODS Fifty-three older adults (82.8±7.3 years) were enrolled in this study and they underwent body composition evaluation, functional capacity and cognitive function measurements. RESULTS The results showed a high prevalence of obesity accompanied by functional capacity limitations and cognitive impairment in older adults living in nursing homes. Partial correlations, controlling for age, showed that body fat percentage was positively correlated with sit-to-stand-5 (r=0.310, p=0.025) and timed-up-and-go (r=0.331, p=0.017), and negatively correlated with handgrip strength test results (r=-0.431, p<0.001), whereas greater lean body mass was associated with better sit-to-stand-5 (r=-0.410, p=0.003), handgrip strength (r=0.624, p<0.001) and cognitive function performance (r=0.302, p=0.037). CONCLUSIONS These important associations reinforce the need to develop effective healthy lifestyle interventions targeting both lean mass and body fat to combat functional and cognitive decline in nursing home residents.
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Affiliation(s)
- Pinelopi Stavrinou
- Department of Life & Health Sciences, University of Nicosia, Nicosia. Cyprus
| | - George Aphamis
- Department of Life & Health Sciences, University of Nicosia, Nicosia. Cyprus
| | - Eleni Andreou
- Department of Life & Health Sciences, University of Nicosia, Nicosia. Cyprus
| | - Marios Pantzaris
- The Cyprus Institute of Neurology and Genetics, University of Cyprus, Nicosia. Cyprus
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Amann U, Heier M, Thilo C, Linseisen J, Meisinger C. Determinants of prehospital coronary heart disease death. Sci Rep 2021; 11:17134. [PMID: 34429463 PMCID: PMC8385003 DOI: 10.1038/s41598-021-96575-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/30/2021] [Indexed: 12/28/2022] Open
Abstract
Limited data on prehospital and early in-hospital coronary heart disease (CHD) deaths is available. Aims of this study were to provide a comprehensive description on CHD cases and to analyse determinants of prehospital death. From a population-based myocardial infarction (MI) registry in Augsburg, Germany we included 12,572 CHD cases aged 25-74 years between 2003-2017 and 4754 CHD cases aged 75-84 years between 2009-2017. Multivariable logistic regression models were conducted to identify patient characteristics associated with prehospital death compared to 28-day survival. In patients aged 25-74 years, 1713 (13.6%) died prehospital, 941 (7.5%) died within the first 24 h in-hospital and 560 (4.5%) died within the 2nd and 28th day after the acute event; in patients aged 75-84 years the numbers were 1263 (26.6%), 749 (15.8%) and 329 (6.9%), respectively. In both age groups increasing age, actual smoking or nicotine abuse, previous MI, angina pectoris and previous stroke were more likely and hypertension was less likely in cases, who died prehospital compared to 28-day survivors. For example, in the 25-74 years old we revealed an adjusted odds ratio (OR) of 4.53 (95% CI 3.84-5.34) for angina pectoris and an OR of 0.69 (95% CI 0.57-0.85) for hypertension. In cases aged 25-74 years, an association of living alone (OR 1.26, 95% CI 1.06-1.49) and diabetes (OR 1.20, 95% CI 1.03-1.41) with prehospital death was found. Whereas in cases aged 75-84 years, chronic obstructive pulmonary disease (OR 2.20, 95%CI 1.69-0.2.85) was associated with prehospital death. In summary, we observed high prehospital and early in-hospital case fatality. Besides classical cardiac risk factors, the impact of living alone on prehospital death was more important in patients aged 25-74 years than in older patients.
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Affiliation(s)
- Ute Amann
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Margit Heier
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany.,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Christian Thilo
- Department of Medical Clinic I-Cardiology, Hospital of Rosenheim, Rosenheim, Germany
| | - Jakob Linseisen
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.,Chair of Epidemiology, University of Augsburg, At University Hospital Augsburg, Augsburg, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, LMU Munich, Munich, Germany
| | - Christa Meisinger
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.,Chair of Epidemiology, University of Augsburg, At University Hospital Augsburg, Augsburg, Germany
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De Matteis C, Cariello M, Graziano G, Battaglia S, Suppressa P, Piazzolla G, Sabbà C, Moschetta A. AST to Platelet Ratio Index (APRI) is an easy-to-use predictor score for cardiovascular risk in metabolic subjects. Sci Rep 2021; 11:14834. [PMID: 34290320 PMCID: PMC8295377 DOI: 10.1038/s41598-021-94277-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
Visceral obesity is characterized by a low-grade inflammatory systemic state that contributes to the genesis of non-alcoholic fatty liver disease (NAFLD), frequently associated with liver fibrosis. Non-invasive serum markers have recently emerged as reliable, easy-to-use scores to predict liver fibrosis. NAFLD is often linked to metabolic and cardiovascular risk. Thus, in this cross-sectional study, we investigated in a population of 1225 subjects if AST to Platelet Ratio Index (APRI), one of the non-invasive liver fibrosis serum markers, can predict cardiovascular risk (CVR). APRI has been previously validated as an efficient score to predict liver fibrosis in viral hepatitis patients with a cut-off of 0.5 for fibrosis and 1.5 for cirrhosis. Our study showed that APRI significantly correlates with CVR and determines, when elevated, a significant increase in CVR for both genders, especially females. This spike in CVR, observed when APRI is elevated, is relatively high in patients in the age of 51–65 years, but it is significantly higher in younger and premenopausal women, approaching risk values usually typical of men at the same age. Taken together, our data highlighted the role of APRI as a reliable predictor easy-to-use score for CVR in metabolic patients.
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Affiliation(s)
- Carlo De Matteis
- INBB, National Institute for Biostructures and Biosystems, Viale delle Medaglie d'Oro 305, 00136, Rome, Italy
| | - Marica Cariello
- INBB, National Institute for Biostructures and Biosystems, Viale delle Medaglie d'Oro 305, 00136, Rome, Italy
| | - Giusi Graziano
- INBB, National Institute for Biostructures and Biosystems, Viale delle Medaglie d'Oro 305, 00136, Rome, Italy
| | - Stefano Battaglia
- Clinica Medica "Cesare Frugoni", Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.,Depatment of Tissues and Organs Transplantation and Cellular Therapies, "Aldo Moro" University of Bari, Bari, Italy
| | - Patrizia Suppressa
- Clinica Medica "Cesare Frugoni", Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Giuseppina Piazzolla
- Clinica Medica "Cesare Frugoni", Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Carlo Sabbà
- Clinica Medica "Cesare Frugoni", Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Antonio Moschetta
- INBB, National Institute for Biostructures and Biosystems, Viale delle Medaglie d'Oro 305, 00136, Rome, Italy. .,Clinica Medica "Cesare Frugoni", Department of Interdisciplinary Medicine, Aldo Moro University of Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.
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Okoro TE, Jumbo J. Cardiovascular event risk estimation among residents of a rural setting in Bayelsa state, Nigeria. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2021; 11:300-315. [PMID: 34322301 PMCID: PMC8303047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/11/2021] [Indexed: 06/13/2023]
Abstract
Cardiovascular diseases (CVD) are a leading cause of death worldwide. There is a rising prevalence of CVDs in Nigeria, including in rural communities. The present study assessed the total CVD risk among two rural communities in Bayelsa State, South-south Nigeria. Adults aged ≥ 40 years in 264 randomly selected households in two rural communities in Bayelsa State were interviewed in this descriptive cross-sectional survey. Using a structured questionnaire, data on socio-demographic characteristics, anthropometry, blood pressure (BP) and random blood sugar measurements were obtained. The WHO/ISH risk assessment chart for the African sub-region was used to estimate the 10-year total risk of fatal or non-fatal CVD events using five predictor variables: age, gender, smoking, systolic BP, and coexistence of diabetes mellitus (DM). Of the 264 participants, majority was men (70.1%) and married (93.2%). Mean age was 50.9±8.1 years. Most participants were overweight (53.4%), add salt to food on table (97.0%), lead a sedentary lifestyle (79.2%) and greater than a third of participants (36.7%) were known hypertensive patients. Using the WHO/ISH risk prediction chart for Africa, 90.0% and 10.0% of the study population had low and moderate risk, respectively of developing cardiovascular events in 10 years. As the age of participants increases, the 10-year risk of a cardiovascular event increased (X 2-48.9; P-0.001). History of hypertension (X 2-20.0; P-0.001), DM (X 2-5.87; P-0.016) and smoking (X 2-23.42; P-0.001) were significantly related to the level of 10-year cardiovascular event risk. Sex showed no significant relationship. There is a high prevalence of several cardiovascular risk factors in this rural population, though the 10-year risk of CV event is still low. CVD risk in rural communities requires awareness, monitoring and an integrated approach in their prevention, detection, and treatment.
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Turner A, Veysey M, Keely S, Scarlett CJ, Lucock M, Beckett EL. Genetic Variation in the Bitter Receptors Responsible for Epicatechin Detection Are Associated with BMI in an Elderly Cohort. Nutrients 2021; 13:nu13020571. [PMID: 33572225 PMCID: PMC7914776 DOI: 10.3390/nu13020571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/01/2021] [Accepted: 02/07/2021] [Indexed: 11/16/2022] Open
Abstract
Globally, more than one-third of adults are overweight. Overweight and obesity are complex and multifaceted conditions, associated with an increased risk of chronic illness and early mortality. While there are known risk factors, these alone do not fully explain the varying outcomes between individuals. Recently, taste receptors have been proposed to have a role in the risk for obesity. These receptors are expressed throughout the gastrointestinal tract. In this system, they may be involved in modulating dietary intake and metabolic processes. The taste 2 family of receptors (T2Rs) detects bitter compounds. Receptors T2R4 and T2R5 detect (-)-epicatechin (epicatechin), an antioxidant polyphenol, which may have protective effects against obesity. However, the potential role for taste receptors in this association has not been explored. This study assessed whether polymorphisms in TAS2R4 (rs2233998 and rs2234001) and TAS2R5 (rs2227264) were associated with body mass index (BMI). Genotyping (Taqman qPCR assays) was performed on DNA extracted from blood samples (n = 563) from an elderly cohort. Homozygosity for the minor allele of all polymorphisms was significantly associated with a lower BMI in males. The TAS2R4-rs2233998 CC genotype, the TAS2R4-rs2234001 CC genotype and the TAS2R5-rs2227264 TT genotype were associated with lower BMI (2.1, 2.1 and 2.2 units; p = 0.002, 0.003 and 0.001, respectively). Epicatechin intake was not associated with BMI and genotype was not associated with epicatechin intake. This suggests that the association between TAS2R genotype and elevated BMI risk occurs through altered extra-oral responses and not directly via altered epicatechin intake.
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Affiliation(s)
- Alexandria Turner
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah 2258, Australia; (C.J.S.); (M.L.); (E.L.B.)
- Correspondence: ; Tel.: +(02)-4348-4158
| | - Martin Veysey
- School of Medicine and Public Health, University of Newcastle, Ourimbah 2258, Australia;
- Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Simon Keely
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan 2308, Australia;
- Hunter Medical Research Institute, New Lambton Heights 2305, Australia
| | - Christopher J. Scarlett
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah 2258, Australia; (C.J.S.); (M.L.); (E.L.B.)
| | - Mark Lucock
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah 2258, Australia; (C.J.S.); (M.L.); (E.L.B.)
| | - Emma L. Beckett
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah 2258, Australia; (C.J.S.); (M.L.); (E.L.B.)
- Hunter Medical Research Institute, New Lambton Heights 2305, Australia
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Rosenberg DE, Anderson ML, Renz A, Matson TE, Lee AK, Greenwood-Hickman MA, Arterburn DE, Gardiner PA, Kerr J, McClure JB. Reducing Sitting Time in Obese Older Adults: The I-STAND Randomized Controlled Trial. J Aging Phys Act 2020; 28:864-874. [PMID: 32498040 PMCID: PMC9067913 DOI: 10.1123/japa.2019-0470] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors tested the efficacy of the "I-STAND" intervention for reducing sitting time, a novel and potentially health-promoting approach, in older adults with obesity. METHODS The authors recruited 60 people (mean age = 68 ± 4.9 years, 68% female, 86% White; mean body mass index = 35.4). The participants were randomized to receive the I-STAND sitting reduction intervention (n = 29) or healthy living control group (n = 31) for 12 weeks. At baseline and at 12 weeks, the participants wore activPAL devices to assess sitting time (primary outcome). Secondary outcomes included fasting glucose, blood pressure, and weight. Linear regression models assessed between-group differences in the outcomes. RESULTS The I-STAND participants significantly reduced their sitting time compared with the controls (-58 min per day; 95% confidence interval [-100.3, -15.6]; p = .007). There were no statistically significant changes in the secondary outcomes. CONCLUSION I-STAND was efficacious in reducing sitting time, but not in changing health outcomes in older adults with obesity.
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10
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Marcos-Pardo PJ, González-Gálvez N, Espeso-García A, Abelleira-Lamela T, López-Vivancos A, Vaquero-Cristóbal R. Association among Adherence to the Mediterranean Diet, Cardiorespiratory Fitness, Cardiovascular, Obesity, and Anthropometric Variables of Overweight and Obese Middle-Aged and Older Adults. Nutrients 2020; 12:nu12092750. [PMID: 32927609 PMCID: PMC7551167 DOI: 10.3390/nu12092750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to evaluate the independent and combined associations between adherence to the Mediterranean diet (AMedDiet), cardiorespiratory fitness (CRF), and different parameters of overweight and obese middle-aged and older adults. Sixty-two participants were enrolled in this cross-sectional study. Fat mass was measured with Dual energy X-ray absorptiometry. AMedDiet and physical activity (PA) were assessed with the PREDIMED and Global PA Questionnaire (GPAQ). Maximal aerobic power was assessed using the 6-min walk test. Systolic (SBP) and diastolic (DBP) blood pressure (BP) were measured with Omron M6, and double product (DP) and mean BP (MBP) were calculated. Kinanthropometry proportionality variables related to obesity were also calculated. Participants with a low CRF as an independent factor or together with a low AMedDiet obtained significantly higher BP, total and trunk fat mass, and proportionality variables (all p ˂ 0.0001). According to the multiple nonlinear regression analysis, Vo2max, AMedDiet, and sex explained 53.4% of SBP, with this formula: 238.611 − (3.63*Vo2max) + (0.044*Vo2max2) − (13.051*AMedDiet) + (0.68*AMedDiet2) + (12.887*sex). SBP and p rediction SBP with the new formula showed a correlation of 0.731 (p ˂ 0.0001); showing a difference between the values of −0.278 (p = 0.883). In conclusion, CRF as an independent factor and combined with AMedDiet can be associated with BP, body composition, and proportionality in overweight and obese middle-aged and older adults.
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Affiliation(s)
- Pablo J. Marcos-Pardo
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
| | - Noelia González-Gálvez
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
- Correspondence: ; Tel.: +34-968-278-824
| | - Alejandro Espeso-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
| | - Tomás Abelleira-Lamela
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
| | - Abraham López-Vivancos
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
| | - Raquel Vaquero-Cristóbal
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
- Sports Injury Prevention Research Group, Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain
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11
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Pouwels S, Buise MP, Twardowski P, Stepaniak PS, Proczko M. Obesity Surgery and Anesthesiology Risks: a Review of Key Concepts and Related Physiology. Obes Surg 2020; 29:2670-2677. [PMID: 31127496 DOI: 10.1007/s11695-019-03952-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The obesity epidemic is swelling to epic proportions. Obese patients often suffer from a combination of hypertension, dyslipidemia, and type 2 diabetes mellitus (T2DM), also known as the "metabolic syndrome." The metabolic syndrome is an independent predictor of cardiac dysfunction and cardiovascular disease and a risk factor for perioperative morbidity and mortality. In this paper, we discuss the perioperative risk factors and the need for advanced care of obese patients needing general anesthesia for (bariatric) surgical procedures based on physiological principles.
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Affiliation(s)
- Sjaak Pouwels
- Department of Surgery, Haaglanden Medical Center, Lijnbaan 32, 2512 VA, The Hague, The Netherlands.
| | - Marc P Buise
- Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Pawel Twardowski
- Department of Anesthesia and Intensive Care, University Medical Center, Gdansk University, Gdansk, Poland
| | - Pieter S Stepaniak
- Department of Operating Rooms, Catharina Hospital, Eindhoven, The Netherlands
| | - Monika Proczko
- Department of Surgery, University Medical Center, Gdansk University, Gdansk, Poland
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12
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Xu C, Yan T, Liu H, Mao R, Peng Y, Liu Y. Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in Obese Elder Patients: a Systematic Review and Meta-analysis. Obes Surg 2020; 30:3408-3416. [DOI: 10.1007/s11695-020-04577-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Portugal-Nunes C, Castanho TC, Moreira PS, Magalhães R, Marques P, Costa P, Palha JA, Sousa N, Santos NC, Bessa JM. The moderator effect of age in the association between mood and adiposity in the elderly is specific for the subcutaneous adipose compartment: An MRI study. Int J Geriatr Psychiatry 2020; 35:113-121. [PMID: 31657069 DOI: 10.1002/gps.5226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 09/24/2019] [Indexed: 12/23/2022]
Abstract
UNLABELLED The positive association between obesity and depressive mood in young- and middle-age individuals is a phenomenon with major clinical implications in public health. Interestingly, the trend of this association in older individuals is not clear, given the conflicting results of multiple studies. Since aging is accompanied by changes in body fat distribution, we questioned whether age is a modulator of such association. This study explores the role of age in the association between mood and general (body mass index [BMI]) and abdominal adiposity (waist circumference [WC]) in older adults characterizing the different abdominal adipose tissue compartments (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT]) with magnetic resonance imaging (MRI) techniques. METHODS One hundred twenty aged community-dwelling individuals (≥50 y of age) were assessed regarding depressive mood (Geriatric Depression Scale) and adiposity (BMI and WC). From these, 96 were assessed for SAT and VAT using MRI. RESULTS Using multiple linear regression models, depressive mood was positively associated with BMI, WC, and VAT. Age was a significant moderator of the association between depressive mood and BMI, WC, and SAT: positive in younger participants and null or negative in older participants. On the other hand, higher VAT was significantly associated with a more depressive mood, independently of age. CONCLUSIONS This study identifies age as a relevant moderator in the association between depressive mood and adiposity in the elderlies. Furthermore, the body fat compartment analysis revealed that the effect of age is specific for the SAT, suggesting its protective role in depressive mood.
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Affiliation(s)
- Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Teresa Costa Castanho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joana Almeida Palha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
| | - João Miguel Bessa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Clinical Academic Center-Braga, Braga, Portugal
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Metabolic syndrome and metabolically healthy status in adults with overweight or obesity, expressing no desire to lose weight. Obes Res Clin Pract 2019; 14:47-53. [PMID: 31883739 DOI: 10.1016/j.orcp.2019.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/14/2019] [Accepted: 11/28/2019] [Indexed: 12/27/2022]
Abstract
AIM To examine the prevalence of metabolic syndrome (MetS) and metabolically healthy status (MHS) in adults with excess weight, who express no desire to lose weight (DLW). METHODS We used the National Health and Nutrition Examination Survey (2011-2016) to conduct a cross-sectional analysis of 4509 adults with excess weight. The prevalence of MetS and MHS was estimated by a DLW status. The prevalence ratios (PRs) were estimated, adjusting for demographic characteristics, to compare the prevalence of MetS and MHS between those with and without a DLW. RESULTS Among adults who were overweight, the crude prevalence of MetS was 28.9% (95% CI 23.7, 34.1) in the no-DLW group and 36.0% (95% CI 31.9, 40.0) in the DLW group (adjusted PR 0.88; 95% CI 0.70, 1.11). Among adults with obesity, the crude prevalence of MetS was 60.0% (95% CI 52.3, 67.6) in the no-DLW group and 63.2% (95% CI 60.0, 66.4) in the DLW group (adjusted PR 1.00; 95% CI 0.88, 1.14). Among adults who were overweight, the prevalence of MHS was 17.5% (95% CI 13.4, 22.2) in the no-DLW group, and 9.5% (95% CI 7.6, 11.6) in the DLW group (adjusted PR 1.27; 95% CI 0.96, 1.69). Nearly all adults with obesity had at least one component of MetS regardless of DSW status. CONCLUSIONS One in four overweight adults and three in five obese adults without a DLW had MetS in the U.S. A majority of adults who were overweight or obese without a DSW had at least one component of MetS.
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Hwang S, Cho YS, Kang NL. Association between body mass index and fitness in Korean adults according to the lump mean value and Gaussian fitting. Med Hypotheses 2019; 135:109471. [PMID: 31760249 DOI: 10.1016/j.mehy.2019.109471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/29/2019] [Accepted: 11/01/2019] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the body mass index (BMI) for the best fitness and effective exercise. This study analyzed data from the Korean national fitness assessment by the Korea Institute of Sport Science (2017). The fitness tests considered were sit-up, standing long jump (SLJ), 20-m multi-stage shuttle run (20-m MSSR), and 10-m shuttle run (10-m SR) tests. The BMIs for the best fitness and widths of the fitness distributions were calculated using the lump mean value and Gaussian fitting. The values of BMI (kg/m2) associated with the best sit-up, SLJ, 20-m MSSR, and 10-m SR scores were 23.4, 22.6, 22.2, and 22.6 for males and 19.0, 18.5, 18.6, and 18.6 for females. The widths (kg/m2) of the sit-up, SLJ, 20-m MSSR, and 10-m SR distributions were 3.65, 3.42, 3.73, and 2.86 for males and 4.84, 4.88, 4.45, and 4.35 for females. The results show that the BMI can be reduced the most and fitness can be increased effectively by the 20-m MSSR for males and the SLJ for females, which could be used to establish personal exercise aims.
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Affiliation(s)
- Sungu Hwang
- Department of Nanomechatronics Engineering, Pusan National University, Miryang 50463, Republic of Korea
| | - Young-Seuk Cho
- Department of Statistics, Pusan National University, Pusan 46241, Republic of Korea
| | - Nam Lyong Kang
- Department of Nanomechatronics Engineering, Pusan National University, Miryang 50463, Republic of Korea.
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Cao L, Jiang Y, Li Q, Wang J, Tan S. Exercise Training at Maximal Fat Oxidation Intensity for Overweight or Obese Older Women: A Randomized Study. J Sports Sci Med 2019; 18:413-418. [PMID: 31427862 PMCID: PMC6683615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/21/2019] [Indexed: 06/10/2023]
Abstract
The purpose was to study the therapeutic effects of 12 weeks of supervised exercise training at maximal fat oxidation intensity (FATmax) on body composition, lipid profile, cardiovascular function, and physical fitness in overweight or obese older women. Thirty women (64.2 ± 5.1 years old; BMI 27.1 ± 2.3 kg/m2; body fat 41.3 ± 4.6%) were randomly allocated into the Exercise or Control groups. Participants in the Exercise group were trained at their individualized FATmax intensity (aerobic training), three days/week for one hour/day for 12 weeks. The Exercise group had significantly decreased body mass, BMI, fat mass, visceral trunk fat, and diastolic blood pressure. Furthermore, there were significant increases in high-density lipoprotein-cholesterol, predicted VO2max, left ventricular ejection fraction, and sit-and-reach performance. There were no changes in the measured variables of the Control group. These outcomes indicate that FATmax is an effective exercise intensity to improve body composition and functional capacity for older women with overweight or obesity.
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Affiliation(s)
- Liquan Cao
- Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - Yan Jiang
- Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - Qingwen Li
- Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
| | - Jianxiong Wang
- Faculty of Health, Engineering, and Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Sijie Tan
- Department of Health and Exercise Science, Tianjin University of Sport, Tianjin, China
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Factors affecting safe and healthy diet in older adults in Italy: results of a preliminary study performed in a community-dwelling sample. Public Health Nutr 2019; 23:432-438. [PMID: 31439061 DOI: 10.1017/s1368980019002301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate, through a questionnaire, older adults' demographic and socio-economic characteristics, knowledge, attitudes and practices in terms of food safety and healthy diet; and to develop dietary and hygiene indices able to represent participants' nutritional and food safety behaviour, exploring their association with demographic and socio-economic factors. DESIGN One-year cross-sectional study. SETTING Gemelli Teaching Hospital (Rome, Italy). PARTICIPANTS People aged ≥65 years, Italian speaking, accessing the Centre of Ageing Medicine. RESULTS Mean age of the sample was 74 (sd 7·7) years. Subjective perception of a safe diet was high: 64·2 % of respondents believed they have a balanced diet. Interviewees got informed about proper nutrition mainly from television, magazines, newspapers, Internet (29·9 %) and from health professionals (34·8 %) such as dietitians, whereas 15·4 % from general practitioners. Regarding food safety, 33·8 % of participants reported to consume expired food, even more than once per month; between 80 and 90 % of participants reported to follow food safety practices during preparation and cooking, even though 49·3 % defrosted food at room temperature. Calculated dietary and hygiene indices showed that the elderly participants were far from having optimal nutritional and food safety behaviours. CONCLUSIONS These results suggest it is necessary to increase the awareness of older adults in the matter of healthy diet and food safety. Specific and targeted educational interventions for the elderly and their caregivers could improve the adoption of recommended food safety practices and safe nutritional behaviours among older adults.
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Sun DS, Lee H, Yim HW, Won HS, Ko YH. The impact of sarcopenia on health-related quality of life in elderly people: Korean National Health and Nutrition Examination Survey. Korean J Intern Med 2019; 34:877-884. [PMID: 29172406 PMCID: PMC6610192 DOI: 10.3904/kjim.2017.182] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/04/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/AIMS The purpose of the study is to investigate the associations between sarcopenia and health-related quality of life in elderly men and women in Korea. METHODS In a cross-sectional study using data from 2008 to 2011 Korean National Health and Nutrition Examination Survey, 4,937 adults aged 60 years and older who underwent a dual-energy X-ray absorptiometry scan were included in the study. Sarcopenia is defined as an appendicular skeletal muscle index of two standard deviations or more below the mean for young, healthy reference populations. The health-related quality of life was measured using the EuroQol-5 dimension questionnaire. RESULTS The overall prevalence of sarcopenia was 6.6% in these Korean people over the age of 60 years: 11.1% for men and 3.2% for women. Sarcopenic men tended to have lower income, lower physical activity, lower body mass index, and smaller waist circumference compared with nonsarcopenic men. Sarcopenic women tended to have higher body mass index and larger waist circumference compared with nonsarcopenic women. Sarcopenic men showed higher impairments in mobility, self-care, usual activities, and pain/discomfort compared with nonsarcopenic men. Women with sarcopenia also showed higher impairments in mobility, self-care, usual activities, and anxiety/depression compared with nonsarcopenic women. Sarcopenia showed an association with impairments in selfcare for men, and with impairments in self-care, usual activities, and anxiety/depression for women, after adjusting for other confounding factors. CONCLUSION There is a significant association between sarcopenia and impaired health-related quality of life in this elderly Korean population, and these results differ between men and women.
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Affiliation(s)
- Der Sheng Sun
- Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
| | - Hyunyong Lee
- Clinical Research Coordinating Center, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Sung Won
- Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
- Correspondence to Hye Sung Won, M.D. Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu 11765, Korea Tel: +82-31-820-5247 Fax: +82-31-847-2719 E-mail:
| | - Yoon Ho Ko
- Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
- Correspondence to Hye Sung Won, M.D. Department of Internal Medicine, College of Medicine, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu 11765, Korea Tel: +82-31-820-5247 Fax: +82-31-847-2719 E-mail:
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Ambakederemo TE, Chikezie EU. Assessment of some traditional cardiovascular risk factors in medical doctors in Southern Nigeria. Vasc Health Risk Manag 2018; 14:299-309. [PMID: 30498356 PMCID: PMC6207391 DOI: 10.2147/vhrm.s176361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Almost one third of deaths globally are caused by cardiovascular diseases (CVDs). Certain occupations may promote the development and worsening of risk factor for CVDs. We assessed some traditional cardiovascular risk factors and lifestyle choices that may predispose to CVDs in medical doctors in a tertiary health facility in Southern Nigeria. STUDY DESIGN Cross-sectional study. PARTICIPANTS AND METHODS One hundred sixty-nine apparently healthy medical doctors were recruited. A structured self-administered questionnaire was used to gather data on CVD risk factors. Anthropometric and blood pressure (BP) measurements were taken. RESULTS Majority were males (68.0%), aged 20-39 years (43.8%), single (62.7%), and house officers (58.0%) with<1 year (48.5%) work experience. Over half were either overweight or obese. While 77.2% of those not centrally obese were males, only about 22.8% of females did not meet the criteria for central obesity (P-value < 0.05). While respondents had BP in prehypertensive (48.2%), stage 1 (18.5%), or stage 2 hypertension (3.6%) ranges, only 7.7% had a previous diagnosis of hypertension. Only 25.4% took fruits on a daily basis and engaged in aerobic exercises up to 30 minutes daily or at least 3-5 times a week. Other poor lifestyle choices included non-lean meat intake (76.8%), low water intake (88.2%), and junk food and soda drinks intake (daily 28%, weekly 51.2%). CONCLUSION Findings of a high prevalence of overweight/obesity, physical inactivity, and junk food intake and low fruits intake among doctors is worrisome. There is a need to educate doctors on adopting healthier lifestyles to reduce risk of CVDs.
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Affiliation(s)
| | - Eze Uzoechi Chikezie
- Department of Mental Health, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa, Nigeria
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Buch A, Keinan-Boker L, Kis O, Carmeli E, Izkhakov E, Ish-Shalom M, Berner Y, Shefer G, Marcus Y, Stern N. Severe central obesity or diabetes can replace weight loss in the detection of frailty in obese younger elderly - a preliminary study. Clin Interv Aging 2018; 13:1907-1918. [PMID: 30349209 PMCID: PMC6183587 DOI: 10.2147/cia.s176446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose Unwanted weight loss is one of the established criteria for the diagnosis of frailty. However, the relevance of this criterion to detect frailty in obese older adults has not been assessed. In particular, with the exception of malignancy, unwanted weight loss is not commonly seen in older obese subjects. Therefore, we tested the possibility that some obesity phenotypes and/or diabetes might be more useful in the detection of frailty in this setting. Patients and methods A preliminary cross-sectional study of 50 consecutive subjects was conducted at The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center. Inclusion criteria were: young elderly (aged 65–75 years), with general and/or abdominal obesity, without cancer. Frailty was assessed directly using the Fried model, the five-item fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale. Eventually, in the assessment of frailty, the weight loss criterion was replaced by one or several of obesity/diabetes-related variables each time: severity of obesity by body mass index, waist circumference (and their interaction), body fat, and diabetes. The receiver operating characteristic curves for functional impairment indices were plotted to compare the usefulness of the frailty accepted and adjusted models. Results The prevalence of frailty and pre-frailty in this cohort were 7/50 (14%) and 27/50 (54%), respectively, but unwanted weight loss was seen in three subjects (6%) only. The level of abdominal obesity had the strongest correlation with functional score (r=0.292, P<0.05). Frailty models which included either severe abdominal obesity or diabetes in lieu of unwanted weight loss had good sensitivity rates per each frailty score as compared with the original Fried model. Conclusion For detecting and/or screening for the frailty syndrome in obese young elderly, the level of abdominal obesity or diabetes may provide a useful marker.
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Affiliation(s)
- Assaf Buch
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel, .,Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel,
| | - Lital Keinan-Boker
- School of Public Health, University of Haifa, Haifa, Israel.,Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Ofer Kis
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel,
| | - Eli Carmeli
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Department of Physical Therapy, University of Haifa, Haifa, Israel
| | - Elena Izkhakov
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel,
| | - Maya Ish-Shalom
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel,
| | - Yitshal Berner
- The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel, .,Meir Medical Center, Kfar Saba, Israel
| | - Gabi Shefer
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel,
| | - Yonit Marcus
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel,
| | - Naftali Stern
- The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel, .,The Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel,
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Buch A, Carmeli E, Shefer G, Keinan-Boker L, Berner Y, Marcus Y, Goldsmith R, Stern N. Cognitive impairment and the association between frailty and functional deficits are linked to abdominal obesity in the elderly. Maturitas 2018; 114:46-53. [PMID: 29907246 DOI: 10.1016/j.maturitas.2018.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 05/22/2018] [Accepted: 05/29/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To evaluate whether specific obesity phenotypes in community-dwelling elderly: (a) affect differently the relationship between frailty and functional impairment and (b) are related to cognitive impairment. STUDY DESIGN A post-hoc cross-sectional analysis of the last Israeli national health and nutrition survey of the elderly (≥ 65 yrs.; n = 1619). MAIN OUTCOME MEASURES We implemented a previously validated frailty model based on frailty-related variables that were obtained in the survey. Mild cognitive impairment was defined using the Mini-Mental State Examination (a score <24 and >17). The Katz's scale of activities of daily living was used for functional assessment. Data were clustered according to different obesity phenotypes using measured body mass index (BMI) and waist circumference (WC). RESULTS The link between frailty and disability was most prominent in subjects with abdominal obesity who were non-obese by BMI: compared with non-obese subjects as defined by WC and BMI, the odds ratio (OR) for functional limitations in this phenotype was 8.34 (95 % CI, 2.14-32.48) for pre-frail subjects and 69.26 (10.58-453.55) for frail subjects. The rate of cognitive impairment was 3.3 times higher (p = .023) in women who were obese by WC but not by BMI. CONCLUSIONS In elderly people with a large WC and BMI < 30 kg/m2, disability is more tightly linked to frailty than for any other form of obesity. Cognitive impairment was more prominent in women with central obesity and BMI < 30 kg/m2 than in the other anthropometric phenotypes. WC should be used for early detection of individuals at risk of progression of frailty to functional incapacity.
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Affiliation(s)
- Assaf Buch
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel.
| | - Eli Carmeli
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Department of Physical Therapy, University of Haifa, Haifa, Israel
| | - Gabi Shefer
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Lital Keinan-Boker
- School of Public Health, University of Haifa, Haifa, Israel; Israel Center for Disease Control, Israel Ministry of Health, Ramat Gan, Israel
| | - Yitshal Berner
- The Sackler Faculty of Medicine, Tel-Aviv University, Israel; Meir Medical Center, Kfar Saba, Israel
| | - Yonit Marcus
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | | | - Naftali Stern
- Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel; The Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Cho BY, Seo DC, Lin HC, Lohrmann DK, Chomistek AK. BMI and Central Obesity With Falls Among Community-Dwelling Older Adults. Am J Prev Med 2018; 54:e59-e66. [PMID: 29433954 DOI: 10.1016/j.amepre.2017.12.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/30/2017] [Accepted: 12/18/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION This study examined the associations of BMI category and central obesity status, with falls among community-dwelling older adults in the U.S. METHODS Data were drawn from the 2012 and 2014 U.S. Health and Retirement Study, a nationally representative longitudinal panel study funded by the National Institute of Aging. The study participants were U.S. community-dwelling older adults aged ≥65 years (N=3,383). Multiple logistic regression and Poisson regression analyses examined the associations of BMI category and central obesity (waist circumference >102 cm in men and >88 cm in women) with experiencing a fall and fall injury, after adjusting for all other covariates. A prospective analysis was conducted in which independent variables from 2012 were examined in relation to dependent variables measured in the same participants in 2014. RESULTS Overall, 35.2% of older adults experienced at least one fall in the past 2 years. Compared with those who were not, centrally obese older adults were more likely to experience a fall (AOR=1.37, 95% CI=1.01, 1.85) and fall more frequently (incidence rate ratio=1.15, 95% CI=1.03, 1.29). Fallers in the obese BMI category were less likely than normal-weight fallers to experience a fall injury (AOR=0.56, 95% CI=0.35, 0.91). CONCLUSIONS These findings suggest that (1) central obesity be measured when assessing older adults' fall risk and (2) specific community prevention strategies for centrally obese older adults be developed to better prevent falls and fall-related injuries.
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Affiliation(s)
- Beom-Young Cho
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Dong-Chul Seo
- Indiana University School of Public Health, Bloomington, Indiana.
| | - Hsien-Chang Lin
- Indiana University School of Public Health, Bloomington, Indiana
| | - David K Lohrmann
- Indiana University School of Public Health, Bloomington, Indiana
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Van Aller C, Lara J, Stephan BCM, Donini LM, Heymsfield S, Katzmarzyk PT, Wells JCK, Prado CM, Siervo M. Sarcopenic obesity and overall mortality: Results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999-2004. Clin Nutr 2018; 38:264-270. [PMID: 29499977 DOI: 10.1016/j.clnu.2018.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/05/2018] [Accepted: 01/12/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES There is no consensus on the definition of sarcopenic obesity (SO), resulting in inconsistent associations of SO with mortality risk. We aim to evaluate association of dual energy x-ray absorptiometry (DXA) SO models with mortality risk in a US adult population (≥50 years). SUBJECTS/METHODS The study population consisted of 3577 participants aged 50 years and older from the 1999-2004 National Health and Nutrition and Examination Survey with mortality follow-up data through December 31, 2011. Difference in survival time in people with and without SO defined by three body composition DXA models (Model 1: body composition phenotype model; Model 2: Truncal Fat Mass (TrFM)/Appendicular Skeletal Muscle Mass (ASM) ratio model; Model 3: Fat Mass (FM)/Fat Free Mass (FFM) ratio). The differences between the models were assessed by the acceleration failure time model, and expressed as time ratios (TR). RESULTS Participants age 50-70 years with SO had a significantly decreased survival time, according to the body composition phenotype model (TR: 0.92; 95% CI: 0.87-0.97), and TrFM/ASM ratio model (TR: 0.88; 95% CI: 0.81-0.95). The FM/FFM ratio model did not detect significant differences in survival time. Participants with SO aged 70 years and older did not have a significantly decreased survival time, according to all three models. CONCLUSIONS A SO phenotype increases mortality risk in people of age 50-70 years, but not in people aged 70 years and older. The application of the body composition phenotype and the TrFM/ASM ratio models may represent useful diagnostic approaches to improve the prediction of disease and mortality risk.
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Affiliation(s)
- Carla Van Aller
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Jose Lara
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK
| | - Lorenzo Maria Donini
- Department of Experimental Medicine- Medical Pathophysiology, Food Science and Endocrinology Section, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Jonathan C K Wells
- Childhood Nutrition Research Centre, Institute of Child Health, University College of London, 30 Guilford Street, WC1N 1EH, London, UK
| | - Carla M Prado
- Department of Agriculture, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Mario Siervo
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle on Tyne, NE4 5PL, UK.
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Kar S, Naik B, Majella M, Nachiappan D. Overweight and obesity among elderly in an urban slum of Puducherry: A facility-based descriptive study. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2018. [DOI: 10.4103/cjhr.cjhr_110_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Purpose of Review In this review, we summarise the evidence on the association between cardiovascular disease (CVD) and cognitive impairment and explore the role of the nitric oxide (NO) pathway as a causal mechanism. Recent Findings Evidence from epidemiological studies suggests that the presence of CVD and its risk factors in midlife is associated with an increased risk of later life cognitive impairment and dementia. It is unclear what is driving this association but risk may be conveyed via an increase in neurodegeneration (e.g. amyloid deposition), vascular changes (e.g. small vessel disease) and mechanistically due to increased levels of oxidative stress and inflammation as well as changes in NO bioavailability. Summary CVDs and dementia are major challenges to global health worldwide. The NO pathway may be a promising biological candidate for future studies focused on reducing not only CVD but also risk of cognitive decline and dementia.
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Abstract
This study examines the link between health and housework among older couples. For those out of the paid labor force, many of the standard arguments about relative resources and time availability no longer hold. Women spend more time on domestic tasks than men at any age; however, it is unclear how health shapes the household division of labor based on gender among older adults. This study examines the relative effect of three dimensions of health. Women's poor health increases the chance of an equal division of labor, but the gender nature of household tasks may limit women's ability to cut back.
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Affiliation(s)
- Claudia Geist
- a Department of Sociology , University of Utah , Salt Lake City , Utah , USA
| | - Jennifer Tabler
- b Department of Sociology and Anthropology , University of Texas Rio Grande Valley , Edinburg , Texas , USA
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Taleban S, Elquza E, Gower-Rousseau C, Peyrin-Biroulet L. Cancer and inflammatory bowel disease in the elderly. Dig Liver Dis 2016; 48:1105-11. [PMID: 27289334 DOI: 10.1016/j.dld.2016.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 12/11/2022]
Abstract
Cancer may be a complication of inflammatory bowel disease (IBD) or its treatments. In older Crohn's disease and ulcerative colitis patients, the risk of malignancy is of particular concern. IBD diagnosis at an advanced age is associated with earlier development of colitis-associated colorectal cancer. Thiopurine use in older IBD patients is tied to an increased risk of non-Hodgkin's lymphoma, nonmelanoma skin cancer, and urinary tract cancers. Additionally, older age is accompanied by multimorbidity, an increased risk of malnutrition, and decreased life expectancy, factors that complicate the management of cancer in the elderly. The optimal approach to the increased risk of malignancy in older age IBD is appropriate cancer screening and medical treatment. This may include age-specific colorectal cancer screening and limiting UV radiation exposure. With a growing number of older IBD patients, further studies are necessary to delineate the risk of cancer in this population.
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Affiliation(s)
- Sasha Taleban
- Division of Gastroenterology, University of Arizona College of Medicine, Tucson, AZ, United States; University of Arizona Center of Aging, Department of Medicine, Tucson, AZ, United States.
| | - Emad Elquza
- Hematology/Oncology, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Health Economics, EPIMAD Registery, Regional House of Clinical Research, Regional University Hospital, Lille Cedex, France; Lille Inflammation Research International Center, LIRIC-UMR 995 Inserm, Lille University 2, Lille University Hospital, Lille University, France
| | - Laurent Peyrin-Biroulet
- Inserm U954 and Department of Gastroenterology, Nancy University Hospital, Lorraine University, Vandœuvre-lès-Nancy, France
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Otitoola O, Oldewage-Theron W, Egal A. Trends in the development of obesity in elderly day care attendees in Sharpeville, South Africa, from 2007-2011. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2016. [DOI: 10.1080/16070658.2015.11734520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Xu KY, Wisnivesky JP, Martynenko M, Mhango G, Busse PJ, Wolf MS, Holguin F, Federman AD. Assessing the association of obesity and asthma morbidity in older adults. Ann Allergy Asthma Immunol 2016; 117:33-7. [PMID: 27234936 DOI: 10.1016/j.anai.2016.04.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Obesity is a robust predictor of poor asthma control in younger adults. Given the high prevalence of asthma and obesity in older Americans, weight reduction could benefit asthma management in this population. OBJECTIVE To assess the association between obesity and asthma outcomes among older adults. METHODS We recruited from urban primary care clinics a prospective cohort of nonsmoking individuals with asthma who were 60 years or older without a history of other respiratory diseases. At baseline, body mass index (BMI) measurements were classified as normal (BMI, 18-25), overweight (BMI, 25-30), or obese (BMI, >30). Measures of asthma morbidity (Asthma Control Questionnaire [ACQ], and Mini Asthma Quality of Life Questionnaire [Mini-AQLQ]) and asthma-related resource utilization (inpatient or outpatient) were taken at baseline and at 3- and 12-month interviews. We used generalized estimating equation models to assess associations between obesity and asthma outcomes after controlling for potential confounders. RESULTS Of the 437 older adults with asthma in the study, 17% had a normal BMI, 32% were overweight, and 51% were obese. Unadjusted analyses revealed that obesity was associated with lower ACQ scores (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.09-1.31) and poorer Mini-AQLQ scores (OR, 1.21; 95% CI, 1.11-1.33). Adjusted analyses revealed no significant association between obesity and ACQ (OR, 1.05; 95% CI, 0.96-1.15) and Mini-AQLQ (OR, 1.08; 95% CI, 0.99-1.19). CONCLUSION Our study suggests that obesity is not independently associated with worse asthma outcomes in older adults, reflecting potential differences in the mechanisms that link obesity with asthma control in older vs younger populations.
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Affiliation(s)
- Kevin Y Xu
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York; Graduate Program in Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Melissa Martynenko
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Grace Mhango
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paula J Busse
- Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michael S Wolf
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Fernando Holguin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alex D Federman
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
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Trivedi V, Jean RE, Genese F, Fuhrmann KA, Saini AK, Mangulabnan VD, Bavishi C. Impact of Obesity on Outcomes in a Multiethnic Cohort of Medical Intensive Care Unit Patients. J Intensive Care Med 2016; 33:97-103. [PMID: 27139008 DOI: 10.1177/0885066616646099] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE To examine the association of obesity with in-hospital mortality and complications during critical illness. METHODS We performed a retrospective analysis of a multiethnic cohort of 699 patients admitted to medical intensive care unit between January 2010 and May 2011 at Mount Sinai St. Luke's and Mount Sinai West Hospitals, tertiary care centers in New York City. Multivariate logistic regression analysis was used to evaluate the association between obesity (body mass index [BMI] ≥ 30] and in-hospital mortality. Subgroup analysis was performed in elderly patients (age ≥65 years). RESULTS Compared to normal BMI, obese patients had lower in-hospital mortality (24.4% vs 17.6%, P = .04). On multivariate analysis, obesity was independently associated with lower in-hospital mortality (odds ratio [OR]: 0.49, 95% confidence interval [CI]: 0.27-0.89, P = .018). There was no significant difference in rates of mechanical ventilation, reintubation, and vasopressor requirement across BMI categories. In subgroup analysis, elderly obese patients did not display lower in-hospital mortality (adjusted OR: 0.85, 95% CI: 0.40-1.82, P = .68). CONCLUSION Our study supports the hypothesis that obesity is associated with decreased mortality during critical illness. However, this finding was not observed among elderly obese patients. Further studies should explore the interaction between age, obesity, and outcomes in critical illness.
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Affiliation(s)
- Vrinda Trivedi
- 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA.,2 Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | - Raymonde E Jean
- 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA
| | - Frank Genese
- 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA
| | - Katherine A Fuhrmann
- 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA
| | - Anjeet K Saini
- 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA
| | - Van Derick Mangulabnan
- 3 Division of Pulmonary and Critical Care Medicine, Keck Hospital of University of Southern California, Los Angeles, CA, USA
| | - Chirag Bavishi
- 1 Division of Pulmonary and Critical Care Medicine, Mount Sinai St. Luke's and Mount Sinai West Hospitals, New York, NY, USA
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Ferraz MJ, Marques ARA, Appelman MD, Verhoek M, Strijland A, Mirzaian M, Scheij S, Ouairy CM, Lahav D, Wisse P, Overkleeft HS, Boot RG, Aerts JM. Lysosomal glycosphingolipid catabolism by acid ceramidase: formation of glycosphingoid bases during deficiency of glycosidases. FEBS Lett 2016; 590:716-25. [PMID: 26898341 DOI: 10.1002/1873-3468.12104] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 12/19/2022]
Abstract
Glycosphingoid bases are elevated in inherited lysosomal storage disorders with deficient activity of glycosphingolipid catabolizing glycosidases. We investigated the molecular basis of the formation of glucosylsphingosine and globotriaosylsphingosine during deficiency of glucocerebrosidase (Gaucher disease) and α-galactosidase A (Fabry disease). Independent genetic and pharmacological evidence is presented pointing to an active role of acid ceramidase in both processes through deacylation of lysosomal glycosphingolipids. The potential pathophysiological relevance of elevated glycosphingoid bases generated through this alternative metabolism in patients suffering from lysosomal glycosidase defects is discussed.
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Affiliation(s)
- Maria J Ferraz
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - André R A Marques
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Monique D Appelman
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Marri Verhoek
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Anneke Strijland
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Mina Mirzaian
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Saskia Scheij
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Cécile M Ouairy
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Daniel Lahav
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Patrick Wisse
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Herman S Overkleeft
- Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Rolf G Boot
- Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
| | - Johannes M Aerts
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands.,Department of Medical Biochemistry, Leiden Institute of Chemistry, Leiden University, The Netherlands
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Lakshminarayanan B, Stanton C, O'Toole PW, Ross RP. Compositional dynamics of the human intestinal microbiota with aging: implications for health. J Nutr Health Aging 2014. [PMID: 25389954 DOI: 10.1007/s12603-014-0513-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The human gut contains trillions of microbes which form an essential part of the complex ecosystem of the host. This microbiota is relatively stable throughout adult life, but may fluctuate over time with aging and disease. The gut microbiota serves a number of functions including roles in energy provision, nutrition and also in the maintenance of host health such as protection against pathogens. This review summarizes the age-related changes in the microbiota of the gastrointestinal tract (GIT) and the link between the gut microbiota in health and disease. Understanding the composition and function of the gut microbiota along with the changes it undergoes overtime should aid the design of novel therapeutic strategies to counteract such alterations. These strategies include probiotic and prebiotic preparations as well as targeted nutrients, designed to enrich the gut microbiota of the aging population.
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Affiliation(s)
- B Lakshminarayanan
- R. Paul Ross, Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland. , Tel: 00353 (0)25 42229, Fax: 00353 (0)25 42340
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Lakshminarayanan B, Stanton C, O'Toole PW, Ross RP. Compositional dynamics of the human intestinal microbiota with aging: implications for health. J Nutr Health Aging 2014; 18:773-86. [PMID: 25389954 DOI: 10.1007/s12603-014-0549-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The human gut contains trillions of microbes which form an essential part of the complex ecosystem of the host. This microbiota is relatively stable throughout adult life, but may fluctuate over time with aging and disease. The gut microbiota serves a number of functions including roles in energy provision, nutrition and also in the maintenance of host health such as protection against pathogens. This review summarizes the age-related changes in the microbiota of the gastrointestinal tract (GIT) and the link between the gut microbiota in health and disease. Understanding the composition and function of the gut microbiota along with the changes it undergoes overtime should aid the design of novel therapeutic strategies to counteract such alterations. These strategies include probiotic and prebiotic preparations as well as targeted nutrients, designed to enrich the gut microbiota of the aging population.
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Affiliation(s)
- B Lakshminarayanan
- R. Paul Ross, Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland. , Tel: 00353 (0)25 42229, Fax: 00353 (0)25 42340
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Tyrovolas S, Haro JM, Polychronopoulos E, Mariolis A, Piscopo S, Valacchi G, Makri K, Zeimbekis A, Tyrovola D, Bountziouka V, Gotsis E, Metallinos G, Katsoulis Y, Tur JA, Matalas A, Lionis C, Panagiotakos D. Factors associated with components of arterial pressure among older individuals (the multinational MEDIS study): the role of the Mediterranean diet and alcohol consumption. J Clin Hypertens (Greenwich) 2014; 16:645-51. [PMID: 25056587 DOI: 10.1111/jch.12370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 06/04/2014] [Accepted: 06/04/2014] [Indexed: 12/01/2022]
Abstract
The aim of this work was to evaluate factors associated with arterial blood pressure in a sample of older Mediterranean people without known cardiovascular disease. During 2005 to 2011, 2813 older (aged 65-100 years) individuals from 22 Mediterranean islands and the rural Mani region (Peloponnesus) voluntarily enrolled. Standard procedures were used to determine arterial BP and pulse pressure and for the evaluation of dietary habits (including tea and alcoholic beverages consumption), lifestyle, and anthropometric and clinical characteristics of the participants. Participants who reported low alcohol consumption (ie, 0-1 glasses per day) were less likely to have hypertension (odds ratio, 0.34; 95% confidence interval, 0.14-0.84) as compared with those who reported high alcohol consumption (ie, 5+ glasses per day). Adherence to the Mediterranean diet was inversely associated with mean arterial pressure (β coefficient, -0.18; 95% confidence interval, -0.33 to -0.16). Alcohol drinking remains an important modifiable risk factor for hypertension. Adherence to the Mediterranean diet was associated with decreased arterial peripheral resistance.
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Affiliation(s)
- Stefanos Tyrovolas
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain; Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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So ES. Waist circumference and health-related quality of life by sex in the Korean elderly. J Aging Health 2014; 26:887-99. [PMID: 24788716 DOI: 10.1177/0898264314531618] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aims to explore the impact of differential degrees of obesity on health-related quality of life (HRQL) by sex in the Korean elderly. METHOD We analyzed data on those aged between 65 and 74 years from the Korean National Health and Nutrition Examination Survey (KNHANES) using multiple regression analysis. RESULTS Compared with the lowest waist circumference (WC) quintile, the women in the fourth and fifth quintiles demonstrated significantly lower unadjusted HRQL but not the men in any quintiles. Whereas higher WC quintiles impaired mobility, usual activities, and pain/discomfort in women, the fourth WC quintile improved usual activities in men. After adjustment, only the women of the highest WC quintile reported impaired mobility. DISCUSSION Extreme obesity worsens mobility, and comorbidity in combination with obesity worsens HRQL in elderly women. Monitoring and controlling comorbidity and maintaining adequate WC decreases the risks of lowered HRQL in Korean elderly women.
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Affiliation(s)
- Eun Sun So
- Chonbuk National University, Jeonju-si, Republic of Korea
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Ellis A, Crowe K, Lawrence J. Obesity-related inflammation: implications for older adults. J Nutr Gerontol Geriatr 2014; 32:263-90. [PMID: 24224937 DOI: 10.1080/21551197.2013.842199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The combination of age-related increases in obesity and inflammation can lead to chronic disease, decreased strength, and physical disability. Lifestyle interventions that include moderate caloric restriction along with aerobic and resistance exercise have shown improvements in metabolic outcomes, strength, and physical function in obese older adults. Although few weight loss studies have addressed diet quality, evidence summarized in this review suggests that encouraging intake of antioxidant-rich fruits and vegetables, high-quality protein, low-glycemic index carbohydrates, and omega-3 fatty acids may further ameliorate obesity-related inflammation. Future controlled trials are indicated to examine the effects of incorporating these foods into multimodal weight loss interventions.
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Affiliation(s)
- Amy Ellis
- a Department of Human Nutrition , University of Alabama , Tuscaloosa , Alabama , USA
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Buys DR, Roth DL, Ritchie CS, Sawyer P, Allman RM, Funkhouser EM, Hovater M, Locher JL. Nutritional risk and body mass index predict hospitalization, nursing home admissions, and mortality in community-dwelling older adults: results from the UAB Study of Aging with 8.5 years of follow-up. J Gerontol A Biol Sci Med Sci 2014; 69:1146-53. [PMID: 24589863 DOI: 10.1093/gerona/glu024] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Nutritional risk and low BMI are common among community-dwelling older adults, but it is unclear what associations these factors have with health services utilization and mortality over long-term follow-up. The aim of this study was to assess prospective associations of nutritional risk and BMI with all-cause, nonsurgical, and surgical hospitalization; nursing home admission; and mortality over 8.5 years. METHODS Data are from 1,000 participants in the University of Alabama at Birmingham Study of Aging, a longitudinal, observational study of older black and white residents of Alabama aged 65 and older. Nutritional risk was assessed using questions associated with the DETERMINE checklist. BMI was categorized as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), class I obese (30.0-34.9), and classes II and III obese (≥35.0). Cox proportional hazards models were fit to assess risk of all-cause, nonsurgical, and surgical hospitalization; nursing home admission; and mortality. Covariates included social support, social isolation, comorbidities, and demographic measures. RESULTS In adjusted models, persons with high nutritional risk had 51% greater risk of all-cause hospitalization (95% confidence interval: 1.14-2.00) and 50% greater risk of nonsurgical hospitalizations (95% confidence interval: 1.11-2.01; referent: low nutritional risk). Persons with moderate nutritional risk had 54% greater risk of death (95% confidence interval: 1.19-1.99). BMI was not associated with any outcomes in adjusted models. CONCLUSIONS Nutritional risk was associated with all-cause hospitalizations, nonsurgical hospitalizations, and mortality. Nutritional risk may affect the disablement process that leads to health services utilization and death. These findings point to the need for more attention on nutritional assessment, interventions, and services for community-dwelling older adults.
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Affiliation(s)
| | - David L Roth
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Patricia Sawyer
- Division of Gerontology, Geriatrics and Palliative Care, Comprehensive Center for Healthy Aging, and
| | - Richard M Allman
- Division of Gerontology, Geriatrics and Palliative Care, Comprehensive Center for Healthy Aging, and Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center Alabama
| | | | | | - Julie L Locher
- Department of Health Care Organizations and Policy, University of Alabama at Birmingham
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Abstract
The prevalence of obesity is rising progressively, even among older age groups. By the year 2030 to 2035 over 20% of the adult US population and over 25% of the Europeans will be aged 65 years or older. The predicted prevalence of obesity in Americans, 60 years and older was 37% in 2010. The predicted prevalence of obesity in Europe in 2015 varies between 20% and 30% dependent on the model used. This means 20.9 million obese 60 years or older people in the United States in 2010 and 32 million obese elders in 2015 in EU. Although cutoff values of body mass index, waist circumference, and percentages of fat mass have not been defined for the elderly, it is clear from several meta-analyses that mortality and morbidity associated with overweight and obesity only increases at a body mass index >30 kg/m(2). Thus, treatment should only be offered to patients who are obese rather than overweight and who have functional impairments, metabolic complications, or obesity-related diseases, that can benefit from weight loss. The weight loss therapy should minimize muscle and bone loss and vigilance as regards the development of sarcopenic obesity--a combination of an unhealthy excess of body fat with a detrimental loss of muscle and fat-free mass including bone--is important. Lifestyle intervention should be the first step and consists of a diet with a 500 kcal energy deficit and an adequate intake of protein of high biological quality, together with calcium and vitamin D, behavioral therapy, and multicomponent exercise. Multicomponent exercise includes flexibility training, balance training, aerobic exercise, and resistance training. The adherence rate in most studies is around 75%. Knowledge of constraints and modulators of physical inactivity should be of help to engage the elderly in physical activity. The role of pharmacotherapy and bariatric surgery in the elderly is largely unknown as in most studies people aged 65 years and older were excluded.
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Alzheimer's disease promotion by obesity: induced mechanisms-molecular links and perspectives. Curr Gerontol Geriatr Res 2012; 2012:986823. [PMID: 22701480 PMCID: PMC3373073 DOI: 10.1155/2012/986823] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Accepted: 04/10/2012] [Indexed: 01/08/2023] Open
Abstract
The incidence of AD is increasing in parallel with the increase in life expectancy. At the same time the prevalence of metabolic syndrome and obesity is reaching epidemic proportions in western populations. Stress is one of the major inducers of visceral fat and obesity development, underlying accelerated aging processes. Adipose tissue is at present considered as an active endocrine organ, producing important mediators involved in metabolism regulation as well as in inflammatory mechanisms. Insulin and leptin resistance has been related to the dysregulation of energy balance and to the induction of a chronic inflammatory status which have been recognized as important cofactors in cognitive impairment and AD initiation and progression. The aim of this paper is to disclose the correlation between the onset and progression of AD and the stress-induced changes in lifestyle, leading to overnutrition and reduced physical activity, ending with metabolic syndrome and obesity. The involved molecular mechanisms will be briefly discussed, and advisable guide lines for the prevention of AD through lifestyle modifications will be proposed.
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Ageing, adiposity indexes and low muscle mass in a clinical sample of overweight and obese women. Obes Res Clin Pract 2012; 6:e1-e90. [DOI: 10.1016/j.orcp.2011.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 04/28/2011] [Accepted: 05/14/2011] [Indexed: 11/17/2022]
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Bailey-Downs LC, Sosnowska D, Toth P, Mitschelen M, Gautam T, Henthorn JC, Ballabh P, Koller A, Farley JA, Sonntag WE, Csiszar A, Ungvari Z. Growth hormone and IGF-1 deficiency exacerbate high-fat diet-induced endothelial impairment in obese Lewis dwarf rats: implications for vascular aging. J Gerontol A Biol Sci Med Sci 2011; 67:553-64. [PMID: 22080499 DOI: 10.1093/gerona/glr197] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Previous studies suggest that the age-related decline in circulating growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels significantly contribute to vascular dysfunction in aging by impairing cellular oxidative stress resistance pathways. Obesity in elderly individuals is increasing at alarming rates, and there is evidence suggesting that elderly individuals are more vulnerable to the deleterious cardiovascular effects of obesity than younger individuals. However, the specific mechanisms through which aging, GH/IGF-1 deficiency, and obesity interact to promote the development of cardiovascular disease remain unclear. To test the hypothesis that low circulating GH/IGF-1 levels exacerbate the pro-oxidant and proinflammatory vascular effects of obesity, GH/IGF-1-deficient Lewis dwarf rats and heterozygous control rats were fed either a standard diet or a high-fat diet (HFD) for 7 months. Feeding an HFD resulted in similar relative weight gains and increases in body fat content in Lewis dwarf rats and control rats. HFD-fed Lewis dwarf rats exhibited a relative increase in blood glucose levels, lower insulin, and impaired glucose tolerance as compared with HFD-fed control rats. Analysis of serum cytokine expression signatures indicated that chronic GH/IGF-1 deficiency exacerbates HFD-induced inflammation. GH/IGF-1 deficiency also exacerbated HFD-induced endothelial dysfunction, oxidative stress, and expression of inflammatory markers (tumor necrosis factor-α, ICAM-1) in aortas of Lewis dwarf rats. Overall, our results are consistent with the available clinical and experimental evidence suggesting that GH/IGF-1 deficiency renders the cardiovascular system more vulnerable to the deleterious effects of obesity.
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Affiliation(s)
- Lora C Bailey-Downs
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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Siervo M, Arnold R, Wells JCK, Tagliabue A, Colantuoni A, Albanese E, Brayne C, Stephan BCM. Intentional weight loss in overweight and obese individuals and cognitive function: a systematic review and meta-analysis. Obes Rev 2011; 12:968-83. [PMID: 21762426 DOI: 10.1111/j.1467-789x.2011.00903.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
High adiposity in middle age is associated with higher dementia risk. The association between weight loss and cognitive function in older adults is still controversial. A meta-analysis was undertaken to estimate the effectiveness of intentional weight loss on cognitive function in overweight and obese adults. A structured strategy was used to search randomized and non-randomized studies reporting the effect of intentional and significant weight loss on cognitive function in overweight and obese subjects. Information on study design, age, nutritional status, weight-loss strategy, weight lost and cognitive testing was extracted. A random-effect meta-analysis was conducted to obtain summary effect estimates for memory and attention-executive domains. Twelve studies met inclusion criteria. Seven were randomized trials and the remaining five included a control group. A low-order significant effect was found for an improvement in cognitive performance with weight loss in memory (effect size 0.13, 95% CI 0.00-0.26, P=0.04) and attention/executive functioning (effect size 0.14, 95% CI 0.01-0.27, P<0.001). Studies were heterogeneous in study design, sample selection, weight-loss intervention and assessment of cognitive function. Weight loss appears to be associated with low-order improvements in executive/attention functioning and memory in obese but not in overweight individuals.
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Affiliation(s)
- M Siervo
- Human Nutrition and Physiology, Department of Neuroscience, University of Naples, Naples, Italy.
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