Assessment of Risk Factors for Development of Overweight and Obesity among Soldiers of Polish Armed Forces Participating in the National Health Programme 2016-2020

Sleep deprivation induced fat accumulation in the visceral white adipose tissue by suppressing SIRT1/FOXO1/ATGL pathway activation

Sleep is critical for maintaining overall health. Insufficient sleep duration and poor sleep quality are associated with various physical and mental health risks and chronic diseases. To date, plenty of epidemiological research has shown that sleep disorders are associated with the risk of obesity, which is usually featured by the expansion of adipose tissue. However, the underlying mechanism of increased fat accumulation upon sleep disorders remains unclear. Here we demonstrated that sleep deprivation (SD) caused triglycerides (TG) accumulation in the visceral white adipose tissue (vWAT), accompanied by a remarkable decrease in the expression of adipose triglyceride lipase (ATGL) and other two rate-limiting lipolytic enzymes. Due to the key role of ATGL in initiating and controlling lipolysis, we focused on investigating the signaling pathway leading to attenuated ATGL expression in vWAT upon SD in the following study. We observed that ATGL downregulation resulted from the suppression of ATGL transcription, which was mediated by the reduction of the transcriptional factor FOXO1 and its upstream regulator SIRT1 expression in vWAT after SD. Furthermore, impairment of SIRT1/FOXO1/ATGL pathway activation and lipolysis induced by SIRT1 inhibitor EX527 in the 3 T3-L1 adipocytes were efficiently rescued by the SIRT1 activator resveratrol. Most notably, resveratrol administration in SD mice revitalized the SIRT1/FOXO1/ATGL pathway activation and lipid mobilization in vWAT. These findings suggest that targeting the SIRT1/FOXO1/ATGL pathway may offer a promising strategy to mitigate fat accumulation in vWAT and reduce obesity risk associated with sleep disorders.

The Risk of Orthorexia and the Prevalence of Emotional Eating Behaviours among Polish Military Flying Personnel in Relation to Body Mass Index (BMI) and Sociodemographic Factors

BACKGROUND

Proper nutrition has a positive impact on health. Paradoxically, excessive preoccupation with healthy eating may lead to the emergence of abnormal eating behaviours and increase the risk of developing disorders. The aim of this study was to assess the risk of orthorexia (ON) and the prevalence of emotional eating (EE) in military flying personnel of the Polish Air Force in relation to BMI and sociodemographic factors.

METHODS

This study included 760 soldiers (including 60 females) taking part in the National Health Programme 2021-2025. The ORTO-15 questionnaire and EEQ were used to assess the risk of ON and EE.

RESULTS

The risk of ON occurred in 28.9% of military flying personnel and was significantly more frequent in soldiers with a normal weight (46.4%), under 40 years of age (42.7%), and with higher education (42.7%). The prevalence of EE was found in approximately 12.3% of the respondents and was significantly more common in soldiers with diagnosed obesity (17.5%), women (21.7%), and soldiers with higher education (13.6). Other sociodemographic variables did not differentiate the results of the ORTO-15 questionnaire and EEQ.

CONCLUSIONS

The obtained results indicate that the problem of eating disorders also occurs in military populations. The necessity of continuing research in this area is discussed.

Weight regain, body composition, and metabolic responses to weight loss in weight cycling athletes: A systematic review and meta-analyses

Depending on the nature of their sports, athletes may be engaged in successive weight loss (WL) and regain, conducing to "weight cycling." The aims of this paper were to systematically (and meta-analytically when possible) analyze the post-WL recovery of (i) body weight and (ii) fat mass; fat-free mass; and performance and metabolic responses in weight cycling athletes (18-55 years old, body mass index < 30 kg.m-2 ). MEDLINE, Embase, and SPORTDiscus databases were explored. The quality and risk of bias of the 74 included studies were assessed using the quality assessment tool for quantitative studies. Thirty-two studies were eligible for meta-analyses. Whatever the type of sports or methods used to lose weight, post-WL body weight does not seem affected compared with pre-WL. While similar results are observed for fat-free mass, strength sports athletes (also having longer WL and regain periods) do not seem to fully recover their initial fat mass (ES: -0.39, 95% CI: [-0.77; -0.00], p = 0.048, I2  = 0.0%). Although the methods used by athletes to achieve WL might prevent them from a potential post-WL fat overshooting, further studies are needed to better understand WL episodes consequences on athletes' performance as well as short- and long-term physical, metabolic, and mental health.

Influence of staple line reinforcement on the occurrence of bleeding complications following laparoscopic sleeve gastrectomy: a retrospective analysis

Introduction

Laparoscopic sleeve gastrectomy (LSG) has gained prominence as a therapeutic option for obesity and metabolic diseases. The choice of staple line reinforcement technique in LSG remains a subject of debate, particularly concerning postoperative bleeding complications.

Aim

The aim of this retrospective analysis is to assess the influence of different staple line reinforcement techniques on the occurrence of bleeding complications LSG.

Material and methods

We conducted a retrospective analysis of patients undergoing LSG between September 2021 and April 2023 at our institution. Patients were stratified into two groups based on the staple line reinforcement method: continuous suturing (n = 53) and clipping (n = 28). Surgical outcomes, including operative time, length of hospital stay, and bleeding complications, were assessed. Complications were classified using the Clavien-Dindo classification.

Results

Continuous suturing was associated with a significantly longer operative time (88.15 min vs. 74.64 min, p < 0.05) but a similar length of hospital stay. Notably, no bleeding complications occurred in the continuous suturing group, while the clipping group experienced postoperative bleeding in 7.14% of cases (p < 0.05). Continuous suturing exhibited a slightly higher incidence of minor complications classified as Class I in the Clavien-Dindo classification (7.55% vs. 0%).

Conclusions

This retrospective analysis suggests that continuous suturing may provide enhanced hemostasis along the staple line, reducing the risk of postoperative bleeding compared to clipping. Despite the longer operative time and a slightly higher rate of minor complications, the clinical significance of these findings should be considered within the context of individual patient risk profiles.

Randomized Controlled Trials to Treat Obesity in Military Populations: A Systematic Review and Meta-Analysis

In recent years, overweight and obesity have reached an alarmingly high incidence and prevalence worldwide; they have also been steadily increasing in military populations. Military personnel, as an occupational group, are often exposed to stressful and harmful environments that represent a risk factor for disordered eating, with major repercussions on both physical and mental health. This study aims to explore the effectiveness of weight loss interventions and assess the significance of current obesity treatments for these populations. Three online databases (PubMed, PsycInfo, and Web of Science) were screened to identify randomized controlled trials (RCTs) aiming to treat obesity in active-duty military personnel and veterans. Random-effects meta-analyses were conducted for body weight (BW) and body mass index (BMI) values, both longitudinally comparing treatment groups from pre-to-post intervention and cross-sectionally comparing the treatment group to controls at the end of the intervention. A total of 21 studies were included: 16 cross-sectional (BW: n = 15; BMI: n = 12) and 16 longitudinal (BW: n = 15; BMI: n = 12) studies were meta-analyzed, and 5 studies were narratively synthesized. A significant small overall BW and BMI reduction from baseline to post-intervention was observed (BW: g = -0.10; p = 0.015; BMI: g = -0.32; p < 0.001), together with a decreased BMI (g = -0.16; p = 0.001) and nominally lower BW (g = -0.08; p = 0.178) in the intervention group compared to controls at the post-intervention time-point. Despite limitations, such as the heterogeneity across the included interventions and the follow-up duration, our findings highlight how current weight loss interventions are effective in terms of BW and BMI reductions in military populations and how a comprehensive approach with multiple therapeutic goals should be taken during the intervention.

Evaluation of health behaviours of Polish Army soldiers in relation to demographic factors, body weight and type of Armed Forces

OBJECTIVES

The aim of this article is to assess the health behaviors of Polish Army soldiers participating in the National Health Programme 2016-2020 in relation to types of armed forces, BMI and selected demographic factors.

MATERIAL AND METHODS

Anthropometric and questionnaire data were obtained in a group of 1229 soldiers of the Polish Armed Forces (PAF) from military units from all over Poland. Health behaviors patterns were assessed using the Health Behavior Inventory (HBI), developed by Juczyński.

RESULTS

The HBI of PAF soldiers was 79.9±12.68, indicating an aver- age score. Statistically significant differences were found in the HBI values and in the individual categories of health behaviors according to the type of armed forces. The highest scores in each category of health behaviors were obtained by the Air Force (AF) soldiers. The lowest HBI score was obtained by the Land Forces and Territorial Defence Forces soldiers. Soldiers with higher education obtained significantly higher scores in such health categories as proper eating habits, preventive behaviors and health practices, compared to respondents with secondary education. Soldiers residing in cities had statistically significantly higher health behaviors intensities in all categories, compared to village residents. A significantly higher score in all health categories was noted in soldiers with normal body weight compared to those with diagnosed obesity. There was no significant relationship between the age of the respondents and health behaviors.

CONCLUSIONS

The study found that factors such as type of armed forces, BMI, place of residence and education level were significant for the adoption of health behaviors by PAF. The level of health practices was significant- ly higher among AF soldiers compared to other types of armed forces. It seems necessary to further disseminate education on pro-health behaviors, especially among soldiers with obesity through participation in organized training and psychodietetic consultations as part of the National Health Programme. Int J Occup Med Environ Health. 2023;36(4):437-49.

Body Composition and Cardiovascular Risk: A Study of Polish Military Flying Personnel

(1) Background: Military personnel worldwide exhibit high rates of obesity. Obesity, and especially visceral obesity, contribute to various health issues, including type 2 diabetes and cardiovascular diseases (CVD). While BMI is commonly used to diagnose obesity, it has limitations and does not consider factors like fat distribution or muscle mass. This study aims to assess the relationship between BMI, percent body fat, waist circumference (WC), waist-to-height ratio (WHtR), and cardiovascular risk factors in Polish military flying personnel. Methods: This study involved 200 men from the Polish Air Force aged 38.8 ± 8.5 years. Anthropometric tests, body composition tests, and tests of biochemical markers of CVD were conducted. (2) Results: The prevalence of overweight and obesity varied based on the evaluation criterion; they were present in 63.5% of soldiers by BMI and in 52.5% by percent body fat; abdominal obesity was present in almost half (47%) of the surveyed soldiers according to WC and in 62.5% according to WHtR. All markers of obesity correlated positively with various biochemical markers of CVD, and 8.5% of subjects met the criteria for metabolic syndrome. (3) Conclusions: The prevalence of obesity in Polish military flying personnel, regardless of the evaluation criterion, is associated with significant metabolic complications in the form of lipid disorders and insulin resistance.

Coronary heart disease risk factors among academic workers based on the Jakarta Cardiovascular Score: A cross-sectional study

Change in lifestyle leads to change in disease patterns from infectious diseases and malnutrition to degenerative diseases, such as coronary heart disease (CHD). The increasing prevalence of cardiovascular diseases among Indonesian workers and the general public will not only burden medical care expenses but also reduce work productivity, leading to more work-related injuries and work-related losses. The aim of this study was to determine the risk factors for CHD (age, sex, blood pressure, smoking, diabetes mellitus, body mass index, and weekly physical activity) and the CHD risk level among university workers. A cross-sectional study was conducted at workers at School of Medicine, Universitas Malikussaleh, Lhokseumawe, Indonesia. The risk level of CHD was calculated using Jakarta Cardiovascular Score and predicting model analyzed with multiple logistic regression model. Our data found that 58.2%, 25.5% and 16.3% of the university workers had low-, medium- and high-risk to have CHD. The final model indicted that the risk of heart disease was determined by gender, age, and the presence of hypertension and diabetes mellitus. Being male had odds ratio (OR) 30.84, aged >41 years old had OR 11.52, having hypertension had OR 4.87 and having diabetes mellitus had OR 13.99 for having high risk of CHD compared to female, those younger than 41 years old, having no hypertension and having no diabetes mellitus, respectively. In conclusion, our data suggests that more than 15% the respondents (university employees) have high risk of CHD and being male and older, and having hypertension and diabetes mellitus are associated with risk of CHD. Implantation of the preventive measures is therefore important to be implemented at the universities.

Bariatric Surgery Should Be Offered to Active-Duty Military Personnel: a Retrospective Study of the Canadian Armed Forces' Experience

PURPOSE

Like most Western armies, obesity affects Canadian Armed Forces (CAF) personnel. Bariatric surgery is an effective treatment for obesity. However, this is not yet accepted for active-duty soldiers in most countries. The CAF have approved bariatric surgery since 2005. Our aim is to assess weight loss, resolution of obesity-related comorbidities, and impacts of bariatric surgery on military careers.

MATERIALS AND METHODS

We retrospectively reviewed the perioperative data, long-term bariatric results, and military outcomes of 108 CAF active-duty military personnel who underwent bariatric surgery in Canada over a 61-month period.

RESULTS

The cohort was predominantly male (66.7%) with a mean preoperative body mass index (BMI) of 43.6 ± 5.8 kg/m². Roux-Y gastric bypass was performed in 59 patients, sleeve gastrectomy in 29, and gastric banding in 20. All the surgeries were performed laparoscopically. The total body weight loss at the last follow-up visit was 22.5 ± 11.0%. Remission or improvement of hypertension was observed in 91.2%, diabetes in 85.7%, gastroesophageal reflux disorder (GERD) in 43.6%, sleep apnea in 43.1%, and dyslipidemia in 42.9%. One patient (0.9%) was medically released due to postoperative complications. Fifteen patients (13.9%) were deployed postoperatively. The combined deployable and possibly deployable statuses increased from 35.4% preoperatively to 47.9% postoperatively.

CONCLUSION

This is the largest series of bariatric surgeries performed in active-duty military personnel. Bariatric surgery is effective and safe and improves deployability without impairing military careers. These results are relevant to the military of many industrialized countries. Bariatric surgery should be considered for all active-duty military personnel who meet surgical criteria for the treatment of obesity.

Association between Diet, Physical Activity and Nutritional Status of Male Border Guard Officers

The main factors that determine the effectiveness and reliability of duties and tasks performed by border guard officers, are very good health and maintaining a high level of psychophysical fitness that depend mainly on adequate diet and physical activity and thus, nutritional status. The aim of the study was to verify the correlations between dietary habits, physical activity level and selected nutritional status indicators. One hundred and sixty-nine male border guard officers participated in the study. A 61-item food frequency questionnaire (FFQ) was used to assess dietary habits and a long-form International Physical Activity Questionnaire (IPAQ) was used to assess physical activity. Fat mass was determined by bioelectrical impedance analysis (BIA) and bone calcification was assessed by the dual energy X-ray absorptiometry (DXA). Many correlations between dietary habits, as well as the physical activity of officers and body mass index (BMI), fat mass index (FMI) and visceral fat level (VFL) were found, while bone mineral density (BMD T-score) negatively correlated only with two food groups and 6 out of 61 products but did not correlate with physical activity. The results also confirmed many poor dietary habits and abnormalities in nutritional status. Thus, there is a need for nutritional education and further monitoring of health-related behaviors, as well as monitoring the nutritional status of border guard officers.