Health risks associated with high waist circumference: A systematic review

Prevalence of obesity and overweight in an adult population of Tehran metropolis

Purpose

Obesity is a chronic low-grade inflammatory condition with increasing global prevalence and is associated with cardiovascular diseases. In this study, we aimed to investigate the prevalence of obesity in the Tehran cohort study (TeCS) population.

Methods

We used the data collected by systematic random sampling during the recruitment phase of TeCS. The data comprised 4215 households from all districts of the Tehran metropolis, from which 8296 adults aged ≥ 35 years participated between May 2016 and February 2019. Sociodemographic data, medical history, laboratory tests, and anthropometric measurements were gathered from the participants. Participants with missing data were excluded from the final analysis. Finally, the data was analyzed using SPSS version 23, and distribution maps were created by Stata 14.2.

Results

A total of 8211 participants (53.9% women) with an average age of 53.7 ± 12.6 years were studied. The age-weighted prevalence of overweight and obese among women was (37.5% [95% confidence interval (CI): 34.5, 40.6] and 35.5% [95% CI: 32.6 -38.6]) compared to men (47% [95% CI: 43.6, 50.3] and 22.9% [95% CI: 20.1 -25.8]). The prevalence of substantially increased risk of metabolic complications (SIRMC) based on waist circumference (WC) and waist-to-hip ratio (WHR) was 49.2% (95% CI: 46.3 -52.2) and 75.5% (95% CI: 72.7 -78.1) respectively.

Conclusions

The prevalence of obesity in Tehran (29.3%) was much higher than in previous reports, particularly among older people, women, and socioeconomically underdeveloped districts. After age 55, more than 80% of women had SIRMC compared to 30% of men.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01365-4.

Factors associated with cardiovascular disease: A comparative study of the UK Asian diaspora and residents of India

INTRODUCTION

The aim of this paper is to investigate what factors are associated to cardiovascular disease and what differences exists between Asians living in the UK (from the English Longitudinal Study of Ageing) and the Asians living in India (from the Longitudinal Ageing Study in India).

METHODS

Logistic regression was used to investigate how demographic and physical performance factors were associated with cardiovascular disease using data from Wave 6 of the English Longitudinal Study of Ageing and Wave 1 of the Longitudinal Study of Ageing in India, with the main variable of interest being country of residence, Asians in England or Asians in India.

RESULTS

A total of 83,997 participants were included in the analyses. In the primary analysis, 73,396 participants from LASI were compared to 171 Asians in ELSA. After adjusting for age, blood pressure, resting heart rate, sex, waist circumference, gait, handgrip strength and standing balance, there was a statistically significant difference for the outcome of CVD between Whites ELSA (reference) and the participants of LASI (odds ratio = 0.77; 95% confidence interval = 0.60 to 0.99). There were no significant differences in CVD between the LASI participants, Asian ELSA, and the Non-White but not Asian ELSA groups.

DISCUSSION

No difference was found between Asians that live in India compared to ethnic minorities living in England, including Asians, after adjusting for confounders, but was found between Whites in ELSA compared to LASI participants. A key limitation was the massive disparity in sample sizes between the ELSA subgroups and LASI. Further work is required where comparable sample sizes and longitudinal analyses allow trends to be identified and to investigate the factors associated with the difference in CVD between two similar ethnicities living in distinct locations.

CONCLUSION

After adjusting for risk factors, there was no difference in CVD between localised Asians and the ethnic minorities in the UK, but there was a difference between the majority ethnicities in the respective countries.

Predictors of weight and waist gain in US South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

Background

Weight and waist gain are significant concerns in adulthood. Both weight and waist gain are particularly important among South Asians, a high-risk group known to develop chronic cardiometabolic complications at any body mass index compared to other racial and ethnic groups.

Objective

The aim of this study was to investigate factors predicting weight and waist gain in a longitudinal cohort of US South Asians, a high-risk group for developing obesity-related complications.

Methods

We used data from Mediators of Atherosclerosis in South Asians Living in America study (MASALA) exam 1 (2010-2013) and exam 2 (2015-2018), with a mean 4.8 years of follow-up.

Results

Of 634 participants studied (42.7% women, mean age 55 years, BMI 25.7 kg/m2, weight 70.4 kg at exam 1), 34.7% had gained ≥5% weight and 32.3% gained ≥5% waist at exam 2. In the adjusted models, older age, higher number of years of US residence, and having diabetes were associated with lower odds of weight gain; being female and having higher adiponectin were associated with higher odds of weight gain. Being female, employed full or part time, or retired were associated with lower odds of waist gain. Being single, separated/divorced, having a higher leptin and a higher C-reactive protein level were associated with higher odds of waist gain.

Conclusions

South Asian subgroups with higher risk of weight and/or waist gain may benefit from targeted interventions to improve health outcomes.

Healthy Aging and its Determinants Among Community-dwelling Older Persons in East Coast, Malaysia: A Multidimensional Assessment

Objectives

Exploring the possibility of healthy aging among older persons is crucial for achieving optimal health in the growing older population. This study aimed to determine the prevalence, pattern, and determinants of healthy aging among older persons in Terengganu, Malaysia.

Methods

We conducted a community-based cross-sectional study involving older persons aged % 60 years. An interviewer-guided questionnaire, anthropometric measurements, and physical assessments were administered to operationalize healthy aging based on a multidimensional concept.

Results

Among the 765 older persons surveyed, only 14.1% (95% CI: 11.64?"16.59) were classified as healthy agers. Multiple logistic regression analysis revealed that superior intrinsic religiosity (odds ratio (OR) = 3.42; 95% CI: 1.34?"8.73), higher social interaction (OR = 2.82; 95% CI: 1.32?"6.04), larger calf circumference (OR = 2.05; 95% CI: 1.24?"3.38), taking water intake % 5 cups per day (OR = 2.01; 95% CI: 1.23?"3.30), better gait speed (OR = 1.71; 95% CI: 1.04?"2.80), having savings (OR = 1.71; 95% CI: 1.10?"2.66), and normal waist circumference (OR = 1.63; 95% CI: 1.04?"2.55) were found positively associated with healthy aging.

Conclusions

Only one in 10 older persons in the state met all the criteria for healthy aging. Specific aspects of religious status, social interaction, socioeconomic, behavioral, physical, and nutritional factors were found to predict healthy ageing in this population. These important determinants should be considered in developing a well-defined and comprehensive public health policy to promote healthy aging in the nation.

Sedentary Time and Prescription Medication Use Among US Adults: 2017-2018 National Health and Nutrition Examination Survey

BACKGROUND

Prescription medication usage has been used as a predictor of disease prevalence and overall health status. Evidence suggests an inverse relationship exists between polypharmacy, which is the use of 5 or more medications, and physical activity participation. However, there is limited evidence examining the relationship between sedentary time and polypharmacy in adults. The aim of this study was to examine the associations between sedentary time and polypharmacy in a large nationally representative sample of US adults.

METHODS

Study sample (N = 2879) included nonpregnant adult (≥20 y old) participants from the 2017-2018 National Health and Nutrition Examination Survey. Self-reported minutes per day of sedentary time were converted to hours per day. The dependent variable was polypharmacy (≥5 medications).

RESULTS

Analysis revealed that for every hour of sedentary time, there was 4% greater odds of polypharmacy (odds ratio, 1.04; 95% confidence interval, 1.00-1.07, P = .04) after adjusting for age, race/ethnicity, education, waist circumference, and the interaction term between race/ethnicity and education.

CONCLUSION

Our findings suggest increased sedentary time is associated with an increased risk of polypharmacy among a large nationally representative sample of US adults.

A North American study of anthropometric factors and semen quality

OBJECTIVE

To evaluate the association between anthropometric measures and semen parameters.

DESIGN

Cross-sectional study.

SUBJECTS

Male participants aged ≥21 years. We analyzed data from 659 males (1185 samples) participating in a semen testing substudy of the Pregnancy Online Study (PRESTO), a North American preconception cohort study. After enrollment, we invited males aged ≥21 years to perform at-home semen testing using the Trak system.

EXPOSURE(S)

Participants reported selected anthropometric variables (current weight, height, waist circumference, and weight at age 17 years) and covariate data via an online baseline questionnaire.

MAIN OUTCOME MEASURE(S)

We used generalized estimating equations models to estimate the percent difference in mean log-transformed semen parameter values and 95% confidence intervals (CI) for associations between selected anthropometric variables and semen volume (mL), sperm concentration (million/mL), and total sperm count (million), adjusting for sociodemographics, lifestyle factors, and medical history. We also evaluated World Health Organization-defined thresholds for low semen quality.

RESULT(S)

Percentage differences in mean log-transformed semen volume, sperm concentration, and total sperm count (95% CI) comparing current body mass index ≥35 vs. <25 kg/m2 were -6.3 (-15.8, 4.3), -6.4 (-24.6, 16.2), and -12.2 (-31.1, 11.8), respectively. Percentage differences (95% CIs) comparing waist circumferences of ≥42 vs. <31 inches were -4.2 (-15.0, 8.0), -6.4 (-27.6, 21.0), and -10.4 (-31.9, 17.9) for semen volume, sperm concentration, and total sperm count, respectively. Greater adult weight gain since age 17 years was associated with reduced semen volume (≥25 vs. <5 kg; percent difference, -9.7; 95% CI, -18.4, 0.1), but not sperm concentration or total sperm count. The highest categories of each anthropometric variable generally were associated with World Health Organization-defined low total sperm count (≤39 million).

CONCLUSION(S)

Selected anthropometric factors were associated modestly with poorer semen quality.

Concept of an Intervention for Sustainable Weight Loss in Postmenopausal Women with Overweight-Secondary Analysis of a Randomized Dietary Intervention Study

INTRODUCTION

The approach of an individual diet has great potential for sustainable weight reduction. Social support, participation and empowerment are also key factors for high motivation and compliance. So, the impact of an individual diet in combination with group sessions on weight loss in postmenopausal women with overweight was investigated.

METHODS

In this reanalysis of a controlled intervention study, postmenopausal women (n = 54; BMI 30.9 ± 3.4 kg/m²; 59 ± 7 years) were recruited receiving an energy restricted diet for 12 weeks, followed by a six-month follow-up phase. The women received 51 individual meal plans based on their habits and were trained in four group sessions.

RESULTS

Forty-six women completed the intervention phase, and 29 completed the follow-up. Average weight loss was -5.8 ± 3.0 kg (p < 0.001) after 12 weeks and was still significant at follow-up (-4.9 ± 5.4 kg, p < 0.001). Also, decreases in fat-free mass (-1.1 ± 1.2 kg, p < 0.001) and resting energy expenditure (-1096 ± 439 kJ/24 h, p < 0.001) were observed.

CONCLUSIONS

The individual nutrition approach with a focus on nutritype in combination with group sessions was effective for long-lasting weight loss in postmenopausal women. An important factor is close individual and group support.

Variants in JAZF1 are associated with asthma, type 2 diabetes, and height in the United Kingdom biobank population

Background: Asthma, type 2 diabetes (T2D), and anthropometric measures are correlated complex traits that all have a major genetic component. Objective: To investigate the overlap in genetic variants associated with these complex traits. Methods: Using United Kingdom Biobank data, we performed univariate association analysis, fine-mapping, and mediation analysis to identify and dissect shared genomic regions associated with asthma, T2D, height, weight, body mass index (BMI), and waist circumference (WC). Results: We found several genome-wide significant variants in and around the JAZF1 gene that are associated with asthma, T2D, or height with two of these variants shared by the three phenotypes. We also observed an association in this region with WC when adjusted for BMI. However, there was no association with WC when it was not adjusted for BMI or weight. Additionally, only suggestive associations between variants in this region and BMI were observed. Fine-mapping analyses suggested that within JAZF1 there are non-overlapping regions harboring causal susceptibility variants for asthma, T2D, and height. Mediation analyses supported the conclusion that these are independent associations. Conclusion: Our findings indicate that variants in the JAZF1 are associated with asthma, T2D, and height, but the associated causal variant(s) are different for each of the three phenotypes.

Effects of mindfulness-based interventions on anthropometric outcomes: A systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

The effects of mindfulness-based interventions (MBIs) on anthropometrics remain obscure. This review quantitatively synthesizes the effects of MBIs on decreasing body mass index (BMI), waist circumference (WC), weight, and percent body fat (%BF).

METHODS

Seven databases, including CINAHL Plus with Full Text, PubMed, PsycINFO, Cochrane, Web of Science Core Collection, Embase, and Sociological Abstracts were searched; studies with a comparison group were selected. Random-effects models were then applied to estimate the pooled effects (Hedge's g), while exploratory moderation analyses with mixed-effects models were performed to explore potential moderators of MBIs on anthropometrics.

RESULTS

The pooled effect size was -0.36 (p < .001) on BMI, -0.52 (p < .001) on WC, -1.20 (p < .004) on weight loss, and -0.43 (p = .389) on %BF. The long-term effects from baseline to follow-up and from post-intervention to follow-up were sustained on BMI (-0.37, p = .027; -.24, p = .065) and weight loss (-1.91, p = .027; -0.74, p = .011) respectively. For weight loss, adding mindful movement had greater effects than those without (-2.65 vs -0.39, p < .001).

CONCLUSION

Our findings support the short-term MBI effects on BMI reduction, WC, weight, and %BF, and long-term effects on reducing BMI and weight. Future efforts should focus on sustaining effects on reducing WC and %BF.

A longitudinal study evaluating adverse childhood experiences and obesity in adulthood using the Canadian Longitudinal Study on Aging (CLSA)

BACKGROUND

Adverse childhood experiences (ACEs) are a risk factor for obesity; however, the causal mechanisms are not well understood. Objectives were to measure the impact of ACEs on adulthood obesity and to investigate whether the association was mediated by nutrition and stress.

METHODS

A longitudinal study was conducted using adults aged 46-90 years (n = 26 615) from the Canadian Longitudinal Study on Aging. Participants were asked to recall ACEs from <18 years of age. Body mass index (BMI), waist circumference and per cent body fat were measured (2015-18) and obesity was defined using standard cut points. Nutrition was measured using data from the Short Diet Questionnaire and stress was measured using allostatic load. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% CIs for each obesity measure. Causal mediation methods were used to determine whether nutrition and stress were mediators.

RESULTS

There were 66% of adults who had experienced one or more ACE. The odds of obesity defined by BMI and waist circumference increased in a dose-response manner with increasing number of ACEs (P trend <0.001). For instance, adults with four to eight ACEs, compared with none, had greater odds of obesity, defined by BMI (adjusted OR: 1.54; 95% CI: 1.28-1.75) and waist circumference (adjusted OR: 1.30; 95% CI: 1.15-1.47). There was no evidence of mediation by stress or nutrition.

CONCLUSIONS

Adversity experienced in early life is strongly associated with obesity among Canadian adults. Further research is needed to identify other mechanisms for this association to inform obesity prevention strategies.

Relationship Between Heart Disease and Obesity Indicators Among Adults: A Secondary Data Analysis

Background Body mass index (BMI), waist circumference (WC), and hip circumference (HC) determine obesity. Several studies have examined the association between obesity and many diseases, including heart disease, and found it to be a substantial risk factor. However, the relationship between heart disease and obesity has not been investigated. This study investigated the relationship between heart disease and obesity indicators among adults encompassing sociodemographic and lifestyle factors. Methodology This cross-sectional study included data from 3,574 individuals who participated in the 2011-2014 National Survey of Midlife Development in the United States refresher. The presence or absence of heart conditions such as irregular heartbeat, heart murmur, heart attack, and heart failure was determined using self-reported questionnaires. The association between heart disease and obesity indicators such as BMI, WC, HC, and waist-to-hip ratio (WHR) was investigated using linear regression. Results After controlling for all factors, the findings demonstrated a significant relationship between heart disease and BMI, WC, and HC high scores of 1.12 kg/m², 0.63 inches, and 0.81 inches, respectively. A higher score in all obesity indicators was linked to being 65 years or older; male gender (for HC); having a school/college level of education; being unmarried, divorced, or widowed; having a history of smoking; and avoiding alcohol use. Conclusions Heart disease and sociodemographic and lifestyle factors are substantially associated with a high score in all obesity indicators. The findings of this study are important because they can assist healthcare providers in implementing different therapies to prevent high BMI, WC, HC, and WHR.

Effects of curcumin/turmeric supplementation on obesity indices and adipokines in adults: A grade-assessed systematic review and dose-response meta-analysis of randomized controlled trials

In the present study, we explored the effect of curcumin/turmeric supplementation on anthropometric indices of obesity, leptin, and adiponectin. We searched PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar up to August 2022. Randomized clinical trials (RCTs) investigating the impact of curcumin/turmeric on obesity indices and adipokines were included. We applied the Cochrane quality assessment tool to evaluate the risk of bias. The registration number is CRD42022350946. Sixty eligible RCTs, with a total sample size of 3691 individuals were included for quantitative analysis. We found that supplementation with curcumin/turmeric significantly reduced body weight (WMD: -0.82 kg, 95% CI: -1.30, -0.35; p = 0.001), body mass index (WMD: -0.30 kg/m² , 95% CI: -0.53, -0.06, p = 0.013), waist circumference (WMD: -1.31 cm, 95% CI: -1.94, -0.69, p < 0.001), body fat percentage (WMD: -0.88%, 95% CI: -1.51, -0.25, p = 0.007), leptin (WMD = -4.46 ng/mL; 95% CI: -6.70, -2.21, p < 0.001), and increased adiponectin (WMD = 2.48 μg/mL; 95% CI: 1.34, 3.62, p < 0.001). Overall, our study shows that supplementation with curcumin/turmeric significantly improves anthropometric indices of obesity and adiposity-related adipokines (leptin and adiponectin). However, due to high between-studies heterogeneity, we should interpret the results with caution.

Dietary Intake Correlated to Waist-To-Hip Ratio in Patients on Maintenance Hemodialysis

OBJECTIVE

Individuals with end-stage kidney disease (ESKD) receiving maintenance hemodialysis (MHD) are at risk for protein-energy wasting (PEW). Inadequate dietary intake and altered anthropometrics are two criteria of the PEW diagnosis. This study explored whether individuals with ESKD on MHD meet the National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF-KDOQI) 2020 guidelines for nutritional adequacy on a dialysis treatment day (DD) and explored the relationship between dietary energy [DEI] and protein [DPI] intake and anthropometrics.

METHODS

This was a secondary analysis of clinical and demographic data for 142 adults from the Rutgers Nutrition and Kidney Disease database. The study assessed the relationships between DEI, DPI, and anthropometrics, including body mass index (BMI), BMI category, waist circumference, and waist-to-hip ratio (WHR) using Pearson's or Spearman's correlation and one-way ANOVA.

RESULTS

The sample had a median age of 55.7 years; 58% were male, 83.8% were Black/African American, with a median dialysis vintage of 42.0 months (e.g., 3.5 years). Seventy-five percent of the data sample were overweight or obese. The WHR was 1.0 ± 0.8 cm for males and 0.9 ± 0.1 for females. DEI and DPI on a DD did not meet the NKF-KDOQI 2020 guidelines. Median DEI was 17.6 ± 8.4 kcal/kg and DPI was 0.7 ± 0.4 g/kg. In the total sample, significant positive correlations were found between DEI (r = 0.74, P = 0.03) and DPI (r = 0.18, P = 0.037) and WHR. In females, a significant positive correlation was identified between DPI and WHR (r = 0.26, P = 0.046).

CONCLUSIONS

These findings suggest that the nutritional intake of individuals with ESKD receiving MHD is inadequate to meet NKF-KDOQI 2020 guidelines on a DD. WHR may be a useful tool to assess alterations in anthropometrics related to DEI or DPI in this population, but more research is warranted.

Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management

BACKGROUND

Obesity or excess body fat is a major global health challenge that has not only been associated with diabetes mellitus and cardiovascular disease but is also a major risk factor for the development of and mortality related to a subgroup of cancer. This review focuses on epidemiology, the relationship between obesity and the risk associated with the development and recurrence of cancer and the management of obesity.

METHODS

A literature search using PubMed and Google Scholar was performed and the keywords 'obesity' and cancer' were used. The search was limited to research papers published in English prior to September 2022 and focused on studies that investigated epidemiology, the pathogenesis of cancer, cancer incidence and the risk of recurrence, and the management of obesity.

RESULTS

About 4-8% of all cancers are attributed to obesity. Obesity is a risk factor for several major cancers, including post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and gallbladder cancer. Excess body fat results in an approximately 17% increased risk of cancer-specific mortality. The relationship between obesity and the risk associated with the development of cancer and its recurrence is not fully understood and involves altered fatty acid metabolism, extracellular matrix remodeling, the secretion of adipokines and anabolic and sex hormones, immune dysregulation, and chronic inflammation. Obesity may also increase treatment-related adverse effects and influence treatment decisions regarding specific types of cancer therapy. Structured exercise in combination with dietary support and behavior therapy are effective interventions. Treatment with glucagon-like peptide-1 analogues and bariatric surgery result in more rapid weight loss and can be considered in selected cancer survivors.

CONCLUSIONS

Obesity increases cancer risk and mortality. Weight-reducing strategies in obesity-associated cancers are important interventions as a key component of cancer care. Future studies are warranted to further elucidate the complex relationship between obesity and cancer with the identification of targets for effective interventions.

Effect of Inulin Intervention on Metabolic Control and Methylation of INS and IRS1 Genes in Patients with Type 2 Diabetes Mellitus

BACKGROUND AND AIMS

Currently, treatments are being sought to improve the control of type II diabetes mellitus (T2DM), and inulin has been shown to be effective in reducing glucose levels and other metabolic control parameters. These effects on metabolic control may be associated with changes in the epigenetic modulation of genes of the insulin pathway. Therefore, our objective is to determine the effect of agave inulin in metabolic control parameters and in INS and IRS1 genes' methylation in T2DM patients.

METHODS

This was a longitudinal experimental study with 67 Mexican participants who received an intervention of inulin agave (10 g daily) for 2 months. The methylation of the INS and IRS1 genes was determined by MSP.

RESULTS

For the INS gene, we found a significant decrease in the proportions of T2DM patients with methylated DNA after inulin intervention (p = 0.0001). In contrast, the difference in the proportions of the unmethylated IRS1 gene before and after the inulin intervention was not significant (p = 0.79). On the other hand, we observed changes in the number of T2DM patients' recommended categories for metabolic control depending on the methylation of INS and IRS1 genes before and after treatment with inulin.

CONCLUSION

For the first time, we report the modification in the methylation of two genes, INS and IRS1, of the insulin pathway and provide information on the possible relevant role of epigenetics as a key factor in positive changes in metabolic control parameters by inulin intake in T2DM patients.

Measurement of obesity in primary care practice: chronic conditions matter

Primary care providers can deliver tailored advice and support to patients who are overweight or have obesity. The 2020 Canadian Adult Obesity Practice Guideline for primary care providers recommended that patients’ waist circumference (WC) be measured if their height and weight place them in the overweight or Class I obesity category. The guideline does not recommend how often providers should measure WC nor describe how often this is measured in current practice. We reviewed electronic medical records (EMRs) of 707,819 Canadian adult patients aged 40 and older. Among them, 48.7% had 1 or more body mass index (BMI) recorded; 11.5% had at least 1 waist measurement recorded. Of those with a BMI classified as overweight or having Class I obesity, 23.7% had at least 1 WC measurement recorded, which differed by chronic disease. WC was documented in more patients who had diabetes mellitus (36.8%) than hypertension (26.1%), or osteoarthritis (24.3%). This difference may be reflective of more specific advice in diabetes guidelines. To our knowledge, this is the first study to describe documentation of WC measurement for patients who are overweight or have Class I obesity in Canadian primary care EMRs across obesity-related conditions.

Curcumin supplementation reduces blood glucose and serum lipids of Brazilian women with high waist circumference: a randomized clinical trial

Objective

To evaluate the effect of curcumin supplementation on the body compositions and biochemical parameters of Brazilian women with high waist circumferences.

Methods

This is a blind, randomized, placebo-controlled clinical trial conducted in 2016 with 35 Brazilian women with high waist circumference (WC). In total, 80 participants were randomized [38 in the placebo group (PG) and 42 in the supplemented group (SG)], but at the end of the protocol, 20 individuals in the PG and 15 in the SG were evaluated. The sample consumed one capsule of curcumin (500 mg/day) (Curcumin C3 Complex®) or a placebo for 90 days. Body weight, height, body mass index, WC, body fat, fat free mass, fasting glucose (FG), lipid profile [triglycerides (TGs), total cholesterol (TC), HDL-c and LDL-c], physical activity level and food intake (energy, carbohydrate, total fat and protein) data were evaluated before and after the intervention.

Results

Curcumin supplementation reduced body mass (p < 0.040) but did not alter other anthropometric parameters or body composition (p ≥ 0.050). In relation to the biochemical profile, the SG saw reductions in FG (p < 0.001), TGs (p < 0.001) and TC (p = 0.001) compared with the PG. At the baseline and during the intervention, the practice of physical activity and food intake did not differ between the SG and PG (p ≥ 0.050).

Conclusion

Curcumin supplementation improved the blood glucose and lipid profile of Brazilian women with high WC, without altering body composition. New studies with larger sample sizes and longer durations are important for identifying more robust data regarding the proposal of this work.

Neighbourhood deprivation and intersectional inequalities in biomarkers of healthy ageing in England

While social and spatial determinants of biomarkers have been reported, no previous study has examined both together within an intersectional perspective. We present a novel extension of quantitative intersectional analyses using cross-classified multilevel models to explore how intersectional positions and neighbourhood deprivation are associated with biomarkers, using baseline UK Biobank data (collected from 2006 to 2010). Our results suggest intersectional inequalities in biomarkers of healthy ageing are mostly established by age 40-49, but different intersections show different relationships with deprivation. Our study suggests that certain biosocial pathways are more strongly implicated in how neighbourhoods and intersectional positions affect healthy ageing than others.

From Young to Older, the 4 Phases Method Is Efficient in Promoting Quick Weight, BMI, and Waist Circumference Reductions

Background: Investigate the effectiveness of the scientific 4 Phases Method, a methodology developed by EMAGRECENTRO, which is based on a ketogenic approach (total carbohydrate intake <40 g/day; including fibers) associated with health coach assistance, in promoting reductions in body weight, body mass index (BMI), and waist circumference after 5 weeks of methodology application. Methods: Record files from 354 individuals, both sexes, aged between 18 and 67, who took part in the 4 Phases Method were used to develop this study. Age, sex, weight, height, BMI, waist circumference measurement, and the presence of ketone bodies in the urine were evaluated before (baseline) and after 5 weeks of the 4 Phases application. Results: In general, a significant reduction in body weight (−7.8 ± 1.2 kg, p < 0.0001), BMI (−2.8 ± 0.4 kg/m2, p < 0.0001), and waist circumference measurement (−7.6 ± 0.4 cm, p < 0.0001) was found after the application of the 4 Phases Method, regardless of age, gender, and BMI. Conclusions: Taken together, our results demonstrated that the 4 Phases Method was able to promote significant body weight, BMI, and waist circumference reductions in the short term, particularly by associating a ketogenic intake strategy with a regular close follow-up weekly consultation with a health coach assistance.

Modification and refinement of three‐dimensional reconstruction to estimate body volume from a simulated single‐camera image

Objective

Body volumes (BV) are used for calculating body composition to perform obesity assessments. Conventional BV estimation techniques, such as underwater weighing, can be difficult to apply. Advanced machine learning techniques enable multiple obesity-related body measurements to be obtained using a single-camera image; however, the accuracy of BV calculated using these techniques is unknown. This study aims to adapt and evaluate a machine learning technique, synthetic training for real accurate pose and shape (STRAPS), to estimate BV.

Methods

The machine learning technique, STRAPS, was applied to generate three-dimensional (3D) models from simulated two-dimensional (2D) images; these 3D models were then scaled with body stature and BV were estimated using regression models corrected for body mass. A commercial 3D scan dataset with a wide range of participants (n = 4318) was used to compare reference and estimated BV data.

Results

The developed methods estimated BV with small relative standard errors of estimation (<7%) although performance varied when applied to different groups. The BV estimated for people with body mass index (BMI) < 30 kg/m² (1.9% for males and 1.8% for females) were more accurate than for people with BMI ≥ 30 kg/m² (6.9% for males and 2.4% for females).

Conclusions

The developed method can be used for females and males with BMI < 30 kg/m² in BV estimation and could be used for obesity assessments at home or clinic settings.

The impact of apical periodontitis, non-surgical root canal retreatment and periapical surgery on serum inflammatory biomarkers

AIM

The aim of the study was to measure serum levels of molecular markers of inflammation in patients undergoing non-surgical root canal retreatment (Re-RCT) and periapical surgery (PS) for the treatment of apical periodontitis and to establish if such levels are influenced by the size of apical radiolucencies at baseline and by the treatment outcome.

METHODOLOGY

A total of 115 participants were recruited (n = 50 Controls, n = 35 Re-RCT, n = 30 PS). Preoperative periapical radiographs and cone beam CT (CBCT) scans of teeth were taken. Blood was collected from treatment groups at baseline, 3-, 6-, and 12-month post-treatment and from controls at baseline and 12 months. Serum levels of IL-1β, IL-6, IL-8, TNF-α, Pentraxin 3, ICAM-1, VCAM-1, hs-CRP, FGF-23, MMP-2, MMP-8, MMP-9, C3 and ADMA were analysed using multiplex immunoassay and enzyme-linked immunosorbent assay. Different time points within the same group were compared using Wilcoxon signed-rank test, and differences between groups were analysed using the Mann-Whitney test. Non-linear association between different factors was assessed using Spearman's correlation.

RESULTS

Preoperative serum levels of FGF-23, IL-1β, hs-CRP and ADMA were significantly higher in the diseased groups compared with controls (p < .001; p = .008; p < .001; p = .013, respectively). The preoperative size of the radiolucency was associated with increased levels of FGF-23, IL-1β and IL-6. At 3-months following treatment, IL-1β, IL-8, hs-CRP, C3, MMP-2 and MMP-9 levels increased compared with baseline in treatment groups. IL-1β and IL-8 further increased at 6 months, whereas FGF-23, hs-CRP, C3, MMP2 and MMP-9 decreased. One-year post-treatment, FGF-23, pentraxin-3 and ADMA were significantly reduced below baseline levels. At the 1-year review, CBCT revealed that 25.9% of treated cases completely healed, while 63% were healing, and 11.1% failed. Treatment outcome was found to be influenced by preoperative levels of ADMA and IL-8 levels at 6 months.

CONCLUSIONS

Both symptomatic and asymptomatic apical periodontitis (AP) can contribute to increased levels of molecular markers of inflammation. A further transient inflammatory markers rise after root canal retreatment and apical surgery were demonstrated. Successful endodontic treatment and periapical surgery result in a long-term reduction in inflammatory marker levels.

Differences among Sociodemographic Variables, Physical Fitness Levels, and Body Composition with Adherence to Regular Physical Activity in Older Adults from the EXERNET Multicenter Study

The aim of this study was to explore the differences among between adherence to physical activity (PA) and sociodemographic variables, body composition, and physical fitness levels in older adults (>65 years). A number of 2712 participants (2086 female; 76.92%) ranging from 65 to 92 years, participated in the study. Stages of change (SoC) for PA from the transtheoretical model of change (TTM), together with different sociodemographic variables, physical fitness tests (Senior Fitness Test), and waist and hip circumferences were evaluated. Significant differences were found in age, gender, educational level, current income, physical fitness test, and body composition (all of them, p < 0.05), according to the different SoC. Greater adherence to PA practice (action and maintenance stages) was related to better academic level, higher economic income, the male gender, better results in the physical fitness test, and healthier anthropometrics perimeters. Future research is needed to identify the relationship between these variables longitudinally.

Simulation of 3D Body Shapes for Pregnant and Postpartum Women

Several studies have reported that pre-pregnant women’s body mass index (BMI) affects women’s weight gain with complications during pregnancy and the postpartum weight retention. It is important to control the BMI before, during and after pregnancy. Our objectives are to develop a technique that can compute and visualize 3D body shapes of women during pregnancy and postpartum in various gestational ages, BMI, and postpartum durations. Body changes data from 98 pregnant and 83 postpartum women were collected, tracked for six months, and analyzed to create 3D model shapes. This study allows users to simulate their 3D body shapes in real-time and online, based on weight, height, and gestational age, using multiple linear regression and morphing techniques. To evaluate the results, precision tests were performed on simulated 3D pregnant and postpartum women’s shapes. Additionally, a satisfaction test on the application was conducted on new 149 mothers. The accuracy of the simulation was tested on 75 pregnant and 74 postpartum volunteers in terms of relationships between statistical calculation, simulated 3D models and actual tape measurement of chest, waist, hip, and inseam. Our results can predict accurately the body proportions of pregnant and postpartum women.

A Systematic Review and Meta-Analysis of Lipid Signatures in Post-traumatic Stress Disorder

BACKGROUND

Research assessing lipid levels in individuals diagnosed with post-traumatic stress disorder (PTSD) has yielded mixed results. This study aimed to employ meta-analytic techniques to characterize the relationship between the levels of lipid profiles and PTSD.

METHODS

We performed meta-analyses of studies comparing profiles and levels of lipids between PTSD patients and healthy individuals by searching Embase, Ovid Medline, Scopus, PsycINFO, and Cochrane databases for the studies until March 2021. Meta-analyses were performed using random-effects models with the restricted maximum-likelihood estimator to synthesize the effect size assessed by standardized mean difference (SMD) across studies.

FINDINGS

A total of 8,657 abstracts were identified, and 17 studies were included. Levels of total cholesterol (TC) (SMD = 0.57 95% CI, 0.27-0.87, p = 0.003), low-density lipoprotein (LDL) (SMD = 0.48, 95% CI, 0.19-0.76, p = 0.004), and triglyceride (TG) (SMD = 0.46, 95% CI, 0.22-0.70, p = 0.001) were found to be higher, while levels of high-density lipoprotein (HDL) (SMD = -0.47, -0.88 to -0.07, p = 0.026) were found to be lower in PTSD patients compared to healthy controls. Subgroup analysis showed that TG levels were higher in PTSD patients who were on or off of psychotropic medications, both < 40 and ≥ 40 years of age, and having body mass index of < 30 and ≥ 30 compared to healthy controls.

INTERPRETATION

This work suggested dysregulation of lipids in PTSD that may serve as biomarker to predict the risk. The study will be useful for physicians considering lipid profiles in PTSD patients to reduce cardiovascular morbidity and mortality.

Obesity Measures as Predictors of Type 2 Diabetes and Cardiovascular Diseases among the Jordanian Population: A Cross-Sectional Study

Obesity is strongly associated with cardiovascular diseases (CVD) and type 2 diabetes (T2D). This study aimed to use obesity measures, body mass index (BMI) and waist circumference (WC) to predict the CVD and T2D risk and to determine the best predictor of these diseases among Jordanian adults. A cross-sectional study was conducted at the governmental and military hospitals across Jordan. The study participants were healthy or previously diagnosed with CVD or T2D. The continuous variables were compared using ANOVA, and the categorical variables were compared using the X2 test. The multivariate logistic regression was used to predict CVD and T2D risk through their association with BMI and WC. The final sample consisted of 6000 Jordanian adults with a mean age of 41.5 ± 14.7 years, 73.6% females. The BMI (OR = 1.7, CI: 1.30–2.30, p < 0.001) was associated with a higher risk of T2D compared to WC (OR = 1.3, CI: 1.04–1.52, p = 0.016). However, our results showed that BMI was not associated with CVD risk, while the WC was significantly and positively associated with CVD risk (OR = 1.9, CI: 1.47–2.47, p < 0.001). In conclusion, an elevated BMI predicts a higher risk of T2D, while WC is more efficient in predicting CVD risk. Our results can be used to construct a population-specific intervention to reduce the risk of CVD and T2D among adults in Jordan and other countries with similar backgrounds.