Relationship between Obesity and Korean and Mediterranean Dietary Patterns: A Review of the Literature

Prevalence and determinants of obesity among individuals with diabetes in Indonesia

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911 DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), high HDL (POR=0.60; 95% CI: 0.46-0.78, and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity  among DM subjects; while higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions: The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.

Analysis of the Association between Retinal Artery Occlusion and Acute Ischaemic Stroke/ST-Elevation Myocardial Infarction and Risk Factors in Hungarian Patients

Background and Objectives: We aimed to analyse data on retinal artery occlusion (RAO) patients to explore correlations with acute ischaemic stroke (AIS), ST-elevation myocardial infarction (STEMI), and cardio/cerebrovascular comorbidities. Patients and Methods: Our retrospective cohort study included 169 RAO and 169 age- and gender-matched control patients. We examined the association of AIS, STEMI, and related comorbidities such as hypertension (HT), type 1 and type 2 diabetes (T1DM and T2DM, respectively), hyperlipidaemia, and ischaemic heart disease (IHD) with RAO. We also recorded atrial fibrillation in our RAO patients. Results: Our results demonstrated that RAO patients developed both AIS and STEMI at a significantly higher rate compared to controls (p < 0.001 for both). We also found that RAO patients had a significantly higher prevalence of HT and hyperlipidaemia (p1 = 0.005, p2 < 0.001) compared to controls. Multiple risk factors together significantly increased the odds of developing AIS and STEMI. Conclusions: Our results suggest that through identifying and treating the risk factors for RAO patients, we can reduce the risk of AIS, STEMI, and RAO of the fellow eye. Considering that ophthalmologists are often the first detectors of these cardiovascularly burdened patients, collaboration with colleagues from internal medicine, cardiology, and neurology is essential to achieve secondary prevention.

Dietary patterns associated with obesity outcomes in adults: an umbrella review of systematic reviews

OBJECTIVE

The aim of this umbrella review was to summarise the evidence from existing systematic reviews on the association between different dietary patterns (DP) and overweight or obesity outcomes in adults.

DESIGN

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched the MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science for systematic reviews reporting on DP and weight gain or overweight/obesity outcomes.

RESULT

We identified 16 systematic reviews with 143 unique studies published between 2001 and 2019. Overall quality scores ranged from 4 to 10. Six reviews in 2/11 cohort and 6/19 cross-sectional studies reported (statistically significant) decreased OR for obesity (range: 0·53 to 0·73 and 0·35 to 0·88, respectively) associated with the Mediterranean diet. Five reviews in 5/15 cohort and 10/45 cross-sectional studies reported an inverse association between diet quality and weight gain or BMI (β range: -1·3 to -0·09). Two reviews in 1/3 cohort and 1/2 cross-sectional studies reported a decreased risk of obesity (OR = 0·76) and weight gain (OR = 0·26), respectively, with fruit and vegetable intake. Five reviews of mixed DP in 3/40 cross-sectional studies reported an increased prevalence of obesity (OR = 1·19) or abdominal obesity (OR range: 1·07 to 1·27) with the Korean diet pattern.

CONCLUSIONS

Our umbrella review confirms the hypothesis that Mediterranean-type DP reduce the risk of obesity in adults. Although population-specific evidence of effective interventions is needed, characteristics of Mediterranean-type DP are important considerations for national obesity prevention strategies.

Effects of a Rice-Based Diet in Korean Adolescents Who Habitually Skip Breakfast: A Randomized, Parallel Group Clinical Trial

During adolescence, healthy eating habits are important, and regular meal intake has an especially positive effect on future health. However, the rate of skipping breakfast has gradually increased. Therefore, this study was conducted to evaluate the positive effects of a rice-based breakfast in Korean adolescents who usually skip breakfast. In this open parallel-group, randomized controlled trial, 105 middle and high school students aged 12-18 years who habitually skipped breakfast were recruited. They were randomly divided into three groups: the rice meal group (RMG, n = 35), wheat meal group (WMG, n = 35), and general meal group (GMG, n = 35). The RMG and WMG received a rice-based breakfast and wheat-based breakfast, respectively, for 12 weeks. After a 12-week intervention, the body fat mass (p < 0.05) and body mass index (p < 0.05) in the RMG were significantly lower than those in the other two groups, and the stress score was also significantly lower in the RMG (p < 0.05). Moreover, after the intervention, in the RMG only, compared to baseline levels, the relative theta (RT) wave activity significantly decreased in eight electrode sites, and the relative alpha (RA) wave activity increased significantly. Eating a rice-based breakfast has positive effects on body fat accumulation and cognitive function in Korean adolescents. Furthermore, a rice-based breakfast plan that is preferred by adolescents should be developed to assist them in developing healthy eating habits.