BMC Obesity最新文献

Background: Visceral adipose tissue (VAT) is known as an independent predictor of cardiometabolic risk and all-cause mortality, while increased physical activity has been shown to improve cardiometabolic risk. The purpose of the present study was to determine whether or not there is an association between objectively-measured physical activity and VAT in a community-based cohort of African-American adults, a population at higher-than-average risk for cardiometabolic diseases.

Methods: Free-living physical activity was quantified using accelerometry while VAT and abdominal subcutaneous fat were estimated using dual x-ray absorptiometry in a cohort of African Americans, ages 30-50 years, enrolled in the Modeling the Epidemiologic Transition Study. Univariate and multivariate analyses were used to determine the degree of association comparing moderate-to-vigorous physical activity (MVPA), vigorous activity, and sedentary behavior with measures of central adiposity including VAT, subcutaneous fat, and waist circumference.

Results: A total of 271 individuals with complete data were included in the analyses. Women, on average, had significantly more VAT and abdominal subcutaneous fat than men. There were statistically significant inverse univariate correlations between MVPA and measures of abdominal adiposity (-0.30, p < 0.001) and activity counts and adiposity (-0.31, p < 0.001) among both sexes. These significant associations remained after controlling for age, sex, and smoking status; neither alcohol consumption nor employment status were associated with abdominal adiposity. Time in sedentary behavior was not meaningfully associated with central adiposity in either sex (women: -0.02, p = 0.79; men: -0.21, p = 0.04).

Conclusions: To our knowledge, this study is the first to identify significant inverse associations between MVPA and measures of central adiposity among African American adults from a community-based cohort using an objective measure of physical activity and a validated quantitative imaging technique.

Background: Low physical activity and a sedentary lifestyle are contributing to overweight/obesity in children. This study aims to explore relationships between out of school physical activity, sedentary lifestyle and socioeconomic status indicators with children's weight status and adiposity.

Methods: Five hundred twenty-two children of ages 5 to 12 years were randomly selected in a school-based cross sectional study in Bamenda, Cameroon. Weight and height were measured and BMI calculated. These variables were standardized for age and gender. Socioeconomic variables and proxy measures of physical activity and sedentary lifestyle of children were reported by parents using a structured questionnaire. Bivariate and multivariable logistic regression was used to calculate odds ratios.Quantile regression was used to compare median values of triceps skinfold thickness across the different factors.

Results: In bivariate analysis, physical activity > 4 - 7 times/week was significantly (p = 0.010) associated with a lower prevalence (5.9%) of overweight/obesity. In multivariable analysis, physical activity > twice a week (OR 0.1, 95% CI 0.05 - 0.3), sedentary lifestyle > 3 h/day (OR 2.4, 95% CI 1.2 - 4.3) and being in the high occupation class (OR 4.3, 95% CI 2.2 - 8.1) independently predicted overweight/obesity. With quantile regression, physical activity > 4 - 7 times/week was significantly (p = 0.023) associated with a 1.36 mm decrease in median triceps skinfold thickness, while sedentary lifestyle (> 3 h/day) (p = 0.026) and being in the high occupation class (p = 0.007) were significantly associated with a 1.37 mm and 1.86 mm increase in median triceps skinfold thickness respectively.

Conclusion: Physical activity is inversely related to BMI-defined overweight/obesity and triceps skinfold thickness. Also, a high sedentary lifestyle and a high occupation class were associated with overweight/obesity and had the largest significant relationship with triceps skinfold thickness. There is need to objectively assess physical activity and sedentary lifestyle in our setting, in and out of school. Also longitudinal studies are warranted to understand the influence of cultural and behavioral drivers of physical activity and sedentary lifestyle.

Background: The UK rheumatology community serves an ageing and ethnically diverse population, with a growing public health concern about obesity. Overweight and obesity contribute to 2.8 million preventable deaths annually. A raised Body Mass Index (BMI) in those with Rheumatoid Arthritis (RA) can have a significant negative impact on clinical outcomes. The aim of the study was to examine patients' and providers' perceptions of obesity and potential barriers to participation in a future weight management programme to contribute to an appropriate intervention design.

Method: Qualitative semi-structured interviews were carried out with 11 patients with RA and one focus group was held with 8 members of a multi-disciplinary team working in one Rheumatology outpatient clinic. Framework analysis (FA) contributed to the inductive thematic analysis, and was employed to assist with the identification of the emergent codes and final themes.

Results: Three core themes were ascertained from the semi-structured interviews: i) The psychosocial impact of living with RA and obesity, ii) Challenges of living with RA and obesity and iii) Considerations for future weight management programmes. The Focus group analysis also identified three core themes: i) Micro-dynamics between patient and provider, ii) The relationship between the provider and the host institution in relation to the development of a future weight management programme and iii) The social and political context of obesity as a public health concern.

Conclusion: Perceptions of obesity and weight gain and associated barriers to participating in weight management programmes, differ significantly between patients and providers. Patients, require a holistic approach to weight management by clinicians and the acknowledgement of the significant psychosocial impact of a dual diagnosis of RA and being overweight or obese. In contrast, providers seem reluctant to address weight increase with patients and require education and support at an individual and institutional level to integrate weight management into routine care.

Background: Roux-en-Y gastric bypass (RYGB) improves the pathophysiology that contributes to obesity-related nonalcoholic steatohepatitis (NASH). Whether obesity-related fibrosis improves is unclear. We hypothesized that RYGB reverses NASH and fibrosis, and indocyanine green (ICG) clearance provides a sensitive measure for detecting asymptomatic fatty liver disease.

Methods: One hundred six obese adults scheduled for RYGB had preoperative liver function assessed using standard tests and ICG clearance and core liver biopsies obtained during RYGB. Once patients lost 60% of their preoperative weight or weight loss plateaued, liver function was reassessed. Repeat liver biopsies were obtained on patients with NASH at the time of RYGB.

Results: RYGB improved steatosis, lobular inflammation, hepatocyte ballooning and fibrosis. Serum albumin, AST, and ALT decreased the most in patients with NASH and NASH plus fibrosis. Twenty seven (26%) patients had normal baseline liver histology and 45 (43%) had NASH or NASH plus fibrosis. Nine of 13 patients with substantial fatty liver had normalized histology after weight loss, while severity of disease in the rest had stabilized or was reduced. Mean ICG clearance in patients with normal/mild fatty liver disease and those with histological fatty livers did not differ significantly.

Conclusions: RYGB surgery reverses NASH and liver fibrosis. Underlying mechanisms that facilitate improvement remain unclear.

Background: An understanding of the dietary behaviors linked to substantial postpartum weight retention, particularly in women diagnosed with gestational diabetes (GDM), is warranted to focus intervention efforts to prevent future type 2 diabetes. This study evaluates the relationship between dietary food intake at 6-9 weeks postpartum (baseline) and odds of substantial postpartum weight retention (≥ 5 kg) at 1-year in women with GDM.

Methods: The Study of Women, Infant Feeding and Type 2 Diabetes after GDM pregnancy (SWIFT) is a prospective multi-ethnic cohort (75% minority) of 1035 women (aged 20-45 years) with recent GDM who delivered a singleton, live birth (≥35 weeks gestation) and underwent 2-h 75 g OGTTs, anthropometric measurements and other assessments at 6-9 weeks postpartum (baseline) and annually thereafter. Eight hundred and eighty-eight women without diabetes at baseline completed the 18-item PrimeScreen to assess dietary intake and the 13-item Caffeine Survey to assess beverage intake, and completed 1-year follow-up. Average postpartum weight retention was calculated (1-year postpartum weight minus pre-pregnancy weight). Multivariable logistic regression models that estimated baseline dietary intake and odds of substantial postpartum weight retention (SPPWR ≥5 kg above pre-pregnancy weight) versus not SPPWR adjusted for numerous clinical, sociodemographic and behavioral covariates.

Results: Compared to eating no fried foods, women who reported eating fried foods ≥5 servings/wk. (n = 32) and 2-4 serv/wk. (n = 208), respectively, had a three-fold and two-fold higher odds of SPPWR (OR = 3.38, 95% CI:1.36-8.38, P = 0.009; OR = 1.99, 95% CI:1.30-3.03, P = 0.02), after adjustment for covariates and other foods and soda intake. Soda intake ≥2 serv/wk. versus none was associated with higher odds of SPPWR (OR = 1.95, 95% CI:1.22-3.11, P = 0.005) adjusted for fried foods and covariates, but was attenuated (OR = 1.61,95% CI:0.98-2.66, p = 0.06) after addition of whole eggs and processed meats.

Conclusions: These findings indicate that interventions should focus on reducing fried foods and soda intake during early postpartum periods to reduce substantial postpartum weight retention in high-risk women with GDM.

Trial registration: NCT01967030; October 2013, Eunice Kennedy Shriver National Institute of Health and Human Development (NICHD).

Background: Obesity is a global health crisis, and portion control is a key method for reducing excess body weight. Given consumers' familiarity with large portion sizes, reducing portion sizes can be difficult. Smaller plates are often recommended to reduce portion sizes and appear to reduce portion sizes. However, there are no studies evaluating dishes specifically designed to facilitate portion control. The aim of the present study was to validate the efficacy of a novel portion control plate inspired by the Ebbinghaus and Delboeuf visual illusions to promote serving smaller portions compared to a larger dinner plate.

Methods: In two studies with a total of 110 university students, we determined whether the use of the portion control plate would result in smaller food portions compared to a larger dinner plate. The portion control plate was smaller and incorporated portion size indicators. Study 1 used instructions from My Plate based on plate ratios (e.g., "the USDA recommends filling half your plate with vegetables") and study 2 used absolute portion size recommendations (e.g., "1 cup of vegetables").

Results: The portion control plate produced smaller self-selected servings in both studies. However, the servings of vegetables selected were smaller than recommended portion sizes for both the portion control plate and the regular dinner plate.

Conclusions: Portion control plates have the potential to reduce self-selected portion sizes. Future research should include studies in a broader range of ages and clinical trials of portion control dishes for weight loss.

Background: Baker's/brewer's yeast, Saccharomyces cerevisiae, has been used as an alternative to antibiotic growth promoters to improve growth performance in animals. In humans, Saccharomyces cerevisiae is among the most commonly detected fungi in fecal samples and likely originates from food. Recently, an association between anti-Saccharomyces cerevisiae antibodies (ASCA) and obesity in humans was suggested, but the cause of the elevated ASCA levels is not clear. Our aim was to study ASCA in morbidly obese subjects and explore potential associations with anthropometrics, diet, co-morbidities and biomarkers of inflammation and gut permeability.

Methods: Subjects with morbid obesity referred to a specialized hospital unit were included. Diet and clinical data were recorded with self-administered questionnaires. Main dietary sources of baker's/brewer's yeast (e.g. bread and beer) were used as a proxy for the intake of yeast. Laboratory analyses included ASCA, serum zonulin (reflecting gut permeability), C-reactive protein and a routine haematological and biochemical screening.

Results: One-hundred-and-forty subjects; 109 (78%) female, 98 with dietary records, mean age 43 years and BMI 42 kg/m² were included. The number of ASCA positive subjects was 31 (22%) for IgG, 4 (2.9%) for IgA and 3 (2.1%) for IgM. Age, body fat mass and C-reactive protein were significantly higher in IgG-positive compared to IgG-negative subjects (P < 0.05). A borderline significant association was found between elevated zonulin and ASCA IgG-positivity (P = 0.06). No association was found between yeast-containing food and ASCA IgG-positivity, or between yeast-containing food and fat mass.

Conclusions: The findings indicate that ASCA IgG-positivity may be linked to the generalized inflammation commonly seen with increased adiposity, but not to dietary yeast intake. Other potential causes for the raised ASCA IgG concentrations, such as genetic predisposition, deviations in the gut microbiota and cross-reactivity of ASCA with other antigens, were not explored.

Background: Factors influencing the increasing prevalence of overweight/obesity among children and adolescents in sub-Saharan Africa remain unclear. We assessed the prevalence and determinants of overweight and obesity and effects on cardio-metabolic profile in school learners in the Western Cape, South Africa.

Methods: Cross-sectional data were collected from 7 to 18-year-old South African school learners attending 14 schools, randomly selected from 107 government schools in the areas. The learners were selected through stratified random sampling techniques. Logistic regressions were used to assess the determinants of overweight/obesity and its association with cardio-metabolic profile.

Results: Among the 1559 participants, the overall prevalence of overweight/obesity was 22.9%. Being a girl (Odds ratio 2.51, 95% CI: 1.92-3.29), or Black African (1.35, 1.04-.75) was associated with increased odds of being overweight/obese. The identified health consequences among the overweight/obese learners differed between the ethnic groups. Overweight/obese coloured (mixed ancestry) learners were more likely to have hypertension (3.27, 1.18-9.08), hypertriglyceridemia (1.94, 0.99-3.78) and low high-density lipoprotein cholesterol (HDL-C) (3.65, 2.33-5.72), overweight/obese Black African learners had higher odds for hypertension (3.62, 1.31-10.04) and low HDL-C (1.56, 1.01-2.40) and overweight/obese White learners were prone to low HDL-C (5.04, 1.35-18.80).

Conclusions: Overweight/obesity is highly prevalent among school learners in Western Cape (South Africa), with being female or Black African increasing the odds. That overweight/obesity is also associated with adverse cardio-metabolic risk profile aggravates the problem and suggests worse cardiovascular outcomes in South African young adults in the future.

Background: Increased visceral adiposity is strongly associated with non-alcoholic fatty liver disease (NAFLD). However, little attention has been paid to the association between the change in subcutaneous adipose mass and the progression of non-alcoholic fatty liver disease (NAFLD). We aimed to investigate whether increased subcutaneous adipose tissue (gynoid fat mass) could be protective against the progression of NAFLD in Japanese patients with type 2 diabetes.

Methods: This is a retrospective observational study of 294 Japanese patients with type 2 diabetes (65 ± 10 years old, 40% female). Liver attenuation index (LAI) measured by abdominal computed tomography was used for the assessment of hepatic steatosis. Both gynoid (kg) and android (kg) fat masses were measured by the whole body dual-energy X-ray absorptiometry. One-year changes in LAI, gynoid, and android fat masses were evaluated in both male and female patients. Linear regression analysis with a stepwise procedure was used for the statistical analyses to investigate the association of the changes in gynoid and android fat masses with the change in LAI.

Results: LAI levels at baseline were 1.15 ± 0.31 and 1.10 ± 0.34 in female and male patients (p = 0.455). The change in gynoid fat mass was significantly and positively associated with the change in LAI in both univariate (standardized β 0.331, p = 0.049) and multivariate (standardized β 0.360, p = 0.016) models in the female patients. However, no significant association was observed in males. In contrast, the increase in android fat mass was significantly associated with the reduced LAI in both genders in the multivariate models (standardized β -0.651, p < 0.001 in females and standardized β -0.519, p = 0.042 in males).

Conclusions: This study provides evidence that increased gynoid fat mass may be protective against the progression of NAFLD in female Japanese patients with type 2 diabetes.

Background: The elderly are faced with health problems such as cardiovascular diseases, type II diabetes mellitus, kidney disease, arthritis and other musculoskeletal problems, which can be linked to obesity and overweight. The aim of this study was to determine the prevalence of obesity and overweight and its associated factors amongst registered pensioners in Ghana.

Methods: A cross-sectional study was conducted among members of the national pensioners association of Ghana. 4813 pensioners took part in the study. Thirteen study centers were used in the study with at least one center per regional capital. Questionnaires, physical examinations, blood and urine sample examinations were carried out.

Results: Overall, 16.3% of the pensioners were obese while 30.0% were overweight. Prevalence of obesity among males and females were 8.0% and 34.5% respectively. Pensioners who were hypertensive had 1.8 times the odds (95% CI = 1.5-2.0) of being obese/overweight. Serum triglycerides levels of 2.26 mmol/L (200 mg/dL) or more, were associated with 80% chance of obesity and overweight (OR = 1.8, 95% CI = 1.3 - 2.5). There was 30% increase in arthritis among obese/overweight pensioners compared to normal/underweight pensioners. Obesity and overweight pensioners were more likely to be using eyeglass (OR = 1.7, 95% CI = 1.3-2.2) and less likely to report hearing loss (OR = 0.7, 95% CI =0.5-1.0).

Conclusion: The prevalence of obesity among the elderly in Ghana is high. Age had an inverse linear relationship with BMI among pensioners. Hypertension, arthritis and dyslipidemia were associated with obesity among registered pensioners.