Therapeutic Treatment for Abdominal Obesity in Adults

Spatial analysis of the prevalence of abdominal obesity in middle-aged and older adult people in China: exploring the relationship with meteorological factors based on gender differences

Background

In recent years, the incidence of abdominal obesity among the middle-aged and older adult population in China has significantly increased. However, the gender disparities in the spatial distribution of abdominal obesity incidence and its relationship with meteorological factors among this demographic in China remain unclear. This gap in knowledge highlights the need for further research to understand these dynamics and inform targeted public health strategies.

Methods

This study utilized data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) to analyze the incidence of abdominal obesity among the middle-aged and older adult population in China. Additionally, meteorological data were collected from the National Meteorological Information Center. Using Moran's I index and Getis-Ord Gi* statistical methods, the spatial distribution characteristics of abdominal obesity incidence were examined. The influence of various meteorological factors on the incidence of abdominal obesity in middle-aged and older adult males and females was investigated using the q statistic from the Geodetector method. Furthermore, Multi-Scale Geographically Weighted Regression (MGWR) analysis was employed to explore the impact of meteorological factors on the spatial heterogeneity of abdominal obesity incidence from a gender perspective.

Results

The spatial distribution of abdominal obesity among middle-aged and older adult individuals in China exhibits a decreasing trend from northwest to southeast, with notable spatial autocorrelation. Hotspots are concentrated in North and Northeast China, while cold spots are observed in Southwest China. Gender differences have minimal impact on spatial clustering characteristics. Meteorological factors, including temperature, sunlight, precipitation, wind speed, humidity, and atmospheric pressure, influence incidence rates. Notably, temperature and sunlight exert a greater impact on females, while wind speed has a reduced effect. Interactions among various meteorological factors generally demonstrate bivariate enhancement without significant gender disparities. However, gender disparities are evident in the influence of specific meteorological variables such as annual maximum, average, and minimum temperatures, as well as sunlight duration and precipitation, on the spatial heterogeneity of abdominal obesity incidence.

Conclusion

Meteorological factors show a significant association with abdominal obesity prevalence in middle-aged and older adults, with temperature factors playing a prominent role. However, this relationship is influenced by gender differences and spatial heterogeneity. These findings suggest that effective public health policies should be not only gender-sensitive but also locally adapted.

Systems genetics analysis of human body fat distribution genes identifies adipocyte processes

Excess abdominal fat is a sexually dimorphic risk factor for cardio-metabolic disease and is approximated by the waist-to-hip ratio adjusted for body mass index (WHRadjBMI). Whereas this trait is highly heritable, few causal genes are known. We aimed to identify novel drivers of WHRadjBMI using systems genetics. We used two independent cohorts of adipose tissue gene expression and constructed sex- and depot-specific Bayesian networks to model gene-gene interactions from 8,492 genes. Using key driver analysis, we identified genes that, in silico and putatively in vitro, regulate many others. 51-119 key drivers in each network were replicated in both cohorts. In other cell types, 23 of these genes are found in crucial adipocyte pathways: Wnt signaling or mitochondrial function. We overexpressed or down-regulated seven key driver genes in human subcutaneous pre-adipocytes. Key driver genes ANAPC2 and RSPO1 inhibited adipogenesis, whereas PSME3 increased adipogenesis. RSPO1 increased Wnt signaling activity. In differentiated adipocytes, MIGA1 and UBR1 down-regulation led to mitochondrial dysfunction. These five genes regulate adipocyte function, and we hypothesize that they regulate fat distribution.

Systems genetics analysis of human body fat distribution genes identifies Wnt signaling and mitochondrial activity in adipocytes

BACKGROUND

Excess fat in the abdomen is a sexually dimorphic risk factor for cardio-metabolic disease. The relative storage between abdominal and lower-body subcutaneous adipose tissue depots is approximated by the waist-to-hip ratio adjusted for body mass index (WHRadjBMI). Genome-wide association studies (GWAS) identified 346 loci near 495 genes associated with WHRadjBMI. Most of these genes have unknown roles in fat distribution, but many are expressed and putatively act in adipose tissue. We aimed to identify novel sex- and depot-specific drivers of WHRadjBMI using a systems genetics approach.

METHODS

We used two independent cohorts of adipose tissue gene expression with 362 - 444 males and 147 - 219 females, primarily of European ancestry. We constructed sex- and depot- specific Bayesian networks to model the gene-gene interactions from 8,492 adipose tissue genes. Key driver analysis identified genes that, in silico and putatively in vitro, regulate many others, including the 495 WHRadjBMI GWAS genes. Key driver gene function was determined by perturbing their expression in human subcutaneous pre-adipocytes using lenti-virus or siRNA.

RESULTS

51 - 119 key drivers in each network were replicated in both cohorts. We used single-cell expression data to select replicated key drivers expressed in adipocyte precursors and mature adipocytes, prioritized genes which have not been previously studied in adipose tissue, and used public human and mouse data to nominate 53 novel key driver genes (10 - 21 from each network) that may regulate fat distribution by altering adipocyte function. In other cell types, 23 of these genes are found in crucial adipocyte pathways: Wnt signaling or mitochondrial function. We selected seven genes whose expression is highly correlated with WHRadjBMI to further study their effects on adipogenesis/Wnt signaling (ANAPC2, PSME3, RSPO1, TYRO3) or mitochondrial function (C1QTNF3, MIGA1, PSME3, UBR1).Adipogenesis was inhibited in cells overexpressing ANAPC2 and RSPO1 compared to controls. RSPO1 results are consistent with a positive correlation between gene expression in the subcutaneous depot and WHRadjBMI, therefore lower relative storage in the subcutaneous depot. RSPO1 inhibited adipogenesis by increasing β-catenin activation and Wnt-related transcription, thus repressing PPARG and CEBPA. PSME3 overexpression led to more adipogenesis than controls. In differentiated adipocytes, MIGA1 and UBR1 downregulation led to mitochondrial dysfunction, with lower oxygen consumption than controls; MIGA1 knockdown also lowered UCP1 expression.

SUMMARY

ANAPC2, MIGA1, PSME3, RSPO1, and UBR1 affect adipocyte function and may drive body fat distribution.

Effect of a Novel Sugar Blend on Weight and Cardiometabolic Health among Healthy Indian Adults: A Randomized, Open-Label Study

Obesity is one of the major factors contributing to noncommunicable diseases (NCDs), which is associated with a high intake of a sugar-rich diet. Sugar blend (a novel combination of sugar and stevia) has half the calories of sugar with the same sweetness at recommended use and offers better compliance. A randomized controlled trial was conducted to evaluate the efficacy and safety of this sugar blend in normal to mildly overweight subjects with a body mass index (BMI) of 23−26 kg/m. Sixty subjects were categorized into Group A: Sugar group (n = 30), and Group B: Sugar blend group (n = 30). The primary outcomes evaluated were weight, waist circumference, hip circumference, waist/hip ratio, BMI, and the secondary outcomes evaluated were lipid profile, random blood sugar, and HbA1c. All these parameters were assessed at baseline, 30 days, 60 days, and 90 days. Group B showed a significantly higher weight loss (p = 0.013) at 90 days compared with Group A. A significant reduction in waist circumference (p < 0.0001) by 4.4 cm was noted at 90 days, in addition to reduction in total cholesterol (p < 0.0001), triglyceride (p = 0.006), LDL cholesterol (p = 0.0490), and VLDL cholesterol (p = 0.006) in Group B compared with the baseline. The study revealed that the sugar blend is an effective formulation in reducing weight, anthropometric factors, and other related metabolic parameters. It has been proven to be well tolerated and promotes weight loss when used in conjunction with a daily balanced diet and exercise plan.

What Drives Abdominal Obesity in Peru? A Multilevel Analysis Approach Using a Nationally Representative Survey

Abdominal obesity (AO) is a serious public health threat due to its increasing prevalence and effect on the development of various non-communicable diseases. A multilevel analysis of the 2019 Demographic and Family Health Survey (ENDES in Spanish) using the Latin American Diabetes Association (ALAD in Spanish) cut-off points was carried out to evaluate the individual and contextual factors associated with AO in Peru. A total of 30,585 individuals 18 years and older were included in the analysis. The prevalence of AO among Peruvians in 2019 was 56.5%. Individuals of older age (aOR 4.64; 95% CI: 3.95-5.45), women (aOR 2.74; 95% CI: 2.33-3.23), individuals with a higher wealth index (aOR 2.81; 95% CI: 2.40-3.30) and having only secondary education (aOR 1.45; 95% CI: 1.21-1.75) showed increased odds of presenting AO compared to their peers. At a contextual level, only the Human Development Index (aOR 1.59; 95% CI: 1.17-2.16) was associated with the development of AO. A high Human Development Index is the contextual factor most associated with AO. It is necessary to formulate and implement new public health policies focused on these associated factors in order to reduce the prevalence of OA and prevent the excessive burden of associated noncommunicable diseases.

Ashtanga Yoga Ethics-Based Yoga Versus General Yoga on Anthropometric Indices, Trigunas, and Quality of Life in Abdominal Obesity: A Randomized Control Trial

INTRODUCTION

The philosophical tenets of yoga such as Ashtanga yoga (AY) and Trigunas are seldom considered while designing yoga programs for chronic diseases. This randomized control trial explored the impact of AY principle-based yoga on the anthropometric indices, personality traits, and quality of life (QoL) in abdominal obesity (AO).

MATERIALS AND METHODS

Sixty-two participants with AO were randomized (n = 31 in each arm) into an AY arm or general yoga (GY) arm. For 12 weeks, both the AY and the GY received the same yoga protocol; however, the AY received an additional AY-based orientation session fortnightly. Changes in waist circumference, hip circumference (HC), height, weight, body mass index (BMI), waist-hip ratio, Vedic Personality Inventory for gunas, and World Health Organization QoL-BREF were measured at baseline and at the end of 12 weeks.

RESULTS

By the end of 12 weeks, the AY arm significantly differed from the GY arm in HC (P = 0.05) and BMI scores (P = 0.03). The AY arm has shown a significant increase in the sattva guna (P < 0.001) and reduction in the rajas (P < 0.001) and tamas gunas (P = 0.03). There was a significant improvement in the physical and social QoL domain, whereas the other variables examined remained insignificant. The increase in sattva guna was negatively correlated with waist circumference (P = -0.489) and BMI (r = -0.553).

CONCLUSION

Exposing participants to progressive AY philosophy can change the personality traits which are further associated with melioration in the determiners of AO. Future yoga programs for chronic disorders may consider including AY philosophy for substantive outcomes.

Electro-acupuncture for central obesity: randomized, patient-assessor blinded, sham-controlled clinical trial protocol

BACKGROUND

Obesity is a common medical condition. Among all the classifications of obesity, central obesity is considered to be a significant threat on the health of individuals. Scientific researches have demonstrated that the accumulation of intra-abdominal fat is associated with higher metabolic and cardiovascular disease risks independently from Body Mass Index (BMI). Our previous research found that the combination of electro-acupuncture and auricular acupressure could significantly reduce the body weight and the BMI compared to sham control group.

METHODS/DESIGN

This is a patient-assessor blinded, randomized, sham-controlled clinical trial on electro-acupuncture for central obesity. One hundred sixty-eight participants with central obesity will be randomly assigned to two groups, which are the acupuncture group and the sham control group. The whole study duration will be 8-week treatment plus 8-week follow up. The primary outcome is the change in waist circumference before and after the treatment. The secondary outcomes include the changes in hip circumference, waist-to-hip circumference ratio, BMI and body fat percentage during the treatment and follow-up.

CONCLUSION

The trial will evaluate the efficacy and safety of electro-acupuncture for central obesity compared with sham acupuncture. The study may provide the solid evidence of electro-acupuncture on central obesity in Hong Kong.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03815253 ,Registered 24 Jan 2019.

Applicability of time-restricted eating for the prevention of lifestyle-dependent diseases in a working population: results of a pilot study in a pre-post design

Background: The ongoing epidemic of lifestyle-dependent diseases in industrialized countries threatens to overtax the health and social systems of these nations. New approaches beyond the usual therapeutic and preventive measures which have been applied so far must be tested. A paradigm shift with regard to nutrition and associated illness is overdue. Time-restricted eating (TRE) offers a low-threshold and easy-to-implement lifestyle change which may have what it takes for broad, population-wide applicability and a widely diversified range of possible effects. In this pilot study, we examine the feasibility and adherence of TRE in healthy adult employees. Methods: Pre-post design study with healthy volunteers from the staff of Ulm University and Ulm University Hospital. Participants were asked to reduce their daily eating time to 8-9 hours for three months. Surrounding the eating time, they were allowed drinks other than water for 12 hours, and water for the rest of the day. Anthropometric measurements were taken by trained staff, and blood samples were taken at baseline and follow-up. Pre- and post-data on lifestyle, health and health-related quality of life (HRQoL, recorded with the Visual Analog Scale (VAS) of the EuroQol 5-Dimension (EQ-5D)), and attitudes towards TRE were collected in questionnaires. During the course of the study, timing of the first and the last meal, as well as sleep duration and quality, were assessed in diaries. Primary outcome was the percentage of days with achievement of the fasting goal out of the total number of days recorded per participant. Results: Sixty-three participants (aged 47.8±10.5 years, 86% female) were recruited and started the intervention immediately after the baseline assessment. Two persons dropped out while all others finished the study. Ratings of compatibility of TRE with professional activities were good in 78% of participants, neither good nor difficult in 3%, and 18% reported to have encountered some difficulties. On average, the fasting target was reached on 72.2±18.9% of the recorded days. After three months of TRE, participants showed moderate reductions in weight (-1.3±2.3 kg, p≤0.001) and waist circumference (-1.7±3.2 cm, p≤0.001). HRQoL increased significantly by 5.8±12.4 (p=0.008) points between baseline and follow-up. Conclusion: TRE is feasible and well accepted, even in regularly employed persons, and may improve HRQoL. TRE may help to reduce obesity and abdominal obesity in adult working people, thereby preventing lifestyle-dependent diseases; however, volunteers need more guidance to increase effects.

Adherence to Time-Restricted Feeding and Impact on Abdominal Obesity in Primary Care Patients: Results of a Pilot Study in a Pre-Post Design

The epidemic of lifestyle-dependent diseases and the failure of previous interventions to combat the main causes demand an alternative approach. Abdominal obesity is associated with most of these diseases and is a good target for therapeutic and preventive measures. Time-restricted feeding (TRF) offers a low-threshold, easy-to-implement lifestyle-modification concept with promising results from animal testing. Here, we describe a pilot study of TRF with abdominally obese participants (waist-to-height ratio, WHtR ≥0.5) in a general practitioner's office. Participants (n = 40, aged 49.1 ± 12.4, 31 females) were asked to restrict their daily eating time to 8-9 hours in order to prolong their overnight fasting period to 15-16 hours. Questionnaires, anthropometrics, and blood samples were used at baseline and at follow-up. After three months of TRF, participants had reached the fasting target, on average, on 85.5 ± 15.2% of all days recorded. Waist circumference (WC) was reduced by -5.3 ± 3.1cm (p < 0.001), and three participants reached a WHtR <0.5. HbA1c was diminished by -1.4 ± 3.5 mmol/mol (p = 0.003). TRF may be an easily understandable and readily adoptable lifestyle change with the potential to reduce abdominal obesity and lower the risk for cardiometabolic diseases. Further well-designed studies are necessary to investigate the applicability and usefulness of TRF for public health.