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Medical Hazards of Obesity
Abstract
The medical hazards of obesity are discussed. Risks include insulin resistance, diabetes mellitus, hypertriglyceridemia, decreased levels of high-density lipoprotein cholesterol, and increased levels of low-density lipoprotein cholesterol. Obesity is also associated with gallbladder disease and some forms of cancer as well as sleep apnea, chronic hypoxia and hypercapnia, and degenerative joint disease. Obesity is an independent risk factor for death from coronary heart disease. A central distribution of body fat enhances the risk for most of these conditions.
... It has been estimated that the proportion of diabetes mellitus among adults between the ages of 20 and 79 was 6.4% in the year 2010 and will increase to 7.7% in 2030 worldwide [2]. Weight gain is a major risk factor in the development of the disease [3,4] with a 9% relative increase in prevalence being reported for every 1kg gain in body weight [4]. Obesity and type 2 diabetes are occurring at epidemic rates in the United States and in the 8-year period from 1990 to 1998, there was a 33% increase [5]. ...
... It has been estimated that the proportion of diabetes mellitus among adults between the ages of 20 and 79 was 6.4% in the year 2010 and will increase to 7.7% in 2030 worldwide [2]. Weight gain is a major risk factor in the development of the disease [3,4] with a 9% relative increase in prevalence being reported for every 1kg gain in body weight [4]. Obesity and type 2 diabetes are occurring at epidemic rates in the United States and in the 8-year period from 1990 to 1998, there was a 33% increase [5]. ...
... Metabolic syndrome (MetSyn), affecting an estimated one third of adult Americans, has a plausible mechanistic relationship to %BF (4,10,11). On this basis, the use of %BF metrics could be more useful than body size (BMI) in guiding patients because excess fat is either a key marker or a direct cause of metabolic disease. The Adult Treatment Panel III from the National Cholesterol Education Program, classified MetSyn when 3 or more of the 5 key markers are present. ...
Objective
Thresholds for overweight and obesity are currently defined by body mass index (BMI), a poor surrogate marker of actual adiposity (percent body fat [%BF]). Practical modern technologies provide estimates of %BF but medical providers need outcome-based %BF thresholds to guide patients. This analysis determines %BF thresholds based on key obesity-related comorbidities, exhibited as metabolic syndrome (MetSyn). These limits were compared to existing BMI thresholds of overweight and obesity.
Design
Correlational analysis of data from cross sectional sampling of 16 918 adults (8734 men and 8184 women) from the US population, accessed by the National Health and Nutrition Examination Survey public use datasets.
Results
Individuals measured by BMI as overweight (BMI > 25 kg/m2) and with obesity (BMI > 30 kg/m2) included 5% and 35% of individuals with MetSyn, respectively. For men, there were no cases of MetSyn below 18%BF, %BF equivalence to “overweight” (ie, 5% of MetSyn individuals) occurred at 25%BF, and “obesity” (ie, 35% of MetSyn individuals) corresponded to 30%BF. For women, there were no cases of MetSyn below 30%BF, “overweight” occurred at 36%BF, and “obesity” corresponded to 42%BF. Comparison of BMI to %BF illustrates the wide range of variability in BMI prediction of %BF, highlighting the potential importance of using more direct measures of adiposity to manage obesity-related disease.
Conclusion
Practical methods of body composition estimation can now replace the indirect BMI assessment for obesity management, using threshold values provided from this study. Clinically relevant “overweight” can be defined as 25% and 36% BF for men and women, respectively, and “obesity” is defined as 30% and 42% BF for men and women.
... However, this study has some limitations. First, overweight and obesity are risk factors for various diseases and may co-exist with diabetes, hypertension, coronary heart disease, gout, and depression (35)(36)(37)(38) , which may mediate the association between BMI and cataracts (39)(40)(41)(42)(43) . Second, some of the studies used different cataract grading systems, which would affect the estimation of BMI and cataracts. ...
Purpose
Visual impairment and blindness caused by cataracts are major public health problems. Several factors are associated with an increased risk of age-related cataracts, such as age, smoking, alcohol consumption, and ultraviolet radiation. This meta-analysis aimed to assess the association between body mass index and age-related cataracts.
Methods
Studies on weight and age-related cataracts published from January 2011 to July 2020 were reviewed by searching PubMed, Medline, and Web of Science databases. The random-effects and fixed-effects models were used for the meta-analysis, and the results were reported as odd ratios.
Results
A total of nine studies were included in the meta-analysis. No correlation was found between underweight and nuclear cataracts (OR=1.31, 95% CI [-0.50 to 3.12], p=0.156). The results of the random-effects model showed that overweight was significantly associated with age-related cataracts and reduced the risk of age-related cataracts (OR=0.91, 95% CI [0.80-1.02], p<0.0001; I²2 Tang Y, Wang X, Wang J, Huang W, Gao Y, Luo Y, et al. Prevalence of age-related cataract and cataract surgery in a Chinese adult population: the Taizhou eye study. Invest Ophthalmol Vis Sci. 2016;57(3):1193-200.=62.3%, p<0.0001). Significant correlations were found between overweight and cortical, nuclear, and posterior subcapsular cataracts (OR=0.95, 95% CI [0.66-1.24], p<0.0001; OR=0.92, 95% CI (0.76-1.08), p<0.0001; OR=0.87, 95% CI [0.38-1.02], p<0.0001). Significant correlations were found between obesity and cortical, nuclear, and posterior subcapsular cataracts (OR=1.00, 95% CI [0.82-1.17], p<0.0001; OR=1.07, 95% CI [0.92-1.22], p<0.0001; OR=1.14, 95% CI [0.91-1.37], p<0.0001).
Conclusion
This finding suggested a significant correlation between body mass index and age-related cataracts, with overweight and obesity reducing or increasing the risk of age-related cataracts, respectively.
Keywords:
Aging; Cataracts; Body mass index; Overweight; Body weight; Obesity
... The prevalence of overweight and obesity is increasing in populations spanning the epidemiological transition and is particularly high in individuals of African origin, particularly women. [1][2][3][4] Overweight and obesity are strongly associated with the onset of non-communicable diseases such as type 2 diabetes and cardiovascular disease. [4][5][6][7] Obesity is a complex, multifaceted condition. ...
Objectives
Given the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual’s body image can inform obesity prevention and management. This study’s objective was to examine the use of silhouette showcards to measure body size perception compared with measured body mass index, and assess body size dissatisfaction, in three different African-origin populations spanning the epidemiological transition. An ancillary objective was to investigate associations between body size perception and dissatisfaction with diabetes and hypertension.
Setting
Research visits were completed in local research clinics in respective countries.
Participants
Seven hundred and fifty-one African-origin participants from the USA and the Republic of Seychelles (both high-income countries), and Ghana (low/middle-income country).
Primary and secondary outcome measures
Silhouette showcards were used to measure perceived body size and body size dissatisfaction. Objectively measured body size was measured using a scale and stadiometer. Diabetes was defined as fasting blood glucose ≥126 mg/dL and hypertension was defined as ≥130 mm Hg/80 mm Hg.
Results
Most women and men from the USA and Seychelles had ‘Perceived minus Actual weight status Discrepancy’ scores less than 0, meaning they underestimated their actual body size. Similarly, most overweight or obese men and women also underestimated their body size, while normal weight men and women were accurately able to estimate their body size. Finally, participants with diabetes were able to accurately estimate their body size and similarly desired a smaller body size.
Conclusions
This study highlights that overweight and obese women and men from countries spanning the epidemiological transition were unable to accurately perceive their actual body size. Understanding people’s perception of their body size is critical to implementing successful obesity prevention programmes across the epidemiological transition.
... Despite the increasing burden of obesity and HBP in growing countries, there was limited information about BMI contribution in BP in these populations, especially among students. BMI is independently and positively connected with mortality and morbidity due to HBP, cardiovascular disease CVD and diabetes II 5 . For all BMI categories in study 6 , age was higher with HBP and HBP in men than in women. ...
This study deals with the physiological measurements of fasting blood sugar (FBG), clinical blood pressure (CBP) and smokers and their association with risk factors (obesity, gender and age) among university students. A total of 257 students (77 females and 180 males) were registered. Including 41 healthy and 42 students who were FBG; 33 were healthy and 69 were suffering from CBP; 39 non smokers and 33 students who were smokers; aged 19-26 years. A statistically not-significant connection was found between FBG, CBP and smoking with obesity rates; but a significant difference between smoking and CBP with age and gender, respectively. These findings highlight the prevalence of FBG and CBP also smoking in students and its relation to certain risk factors such as obesity, sex and age among selected student groups.
... Obesity has risen dramatically in recent decades. Obesity in Westernized countries ranks high among public health issues because it is associated with adverse health outcomes and high economic costs (Kuczmarski et al., 1994;Pi-Sunyer et al.,1993;Burton -Freeman, 2000). Dietary fiber (DF) is classified as soluble (SDF) or insoluble (IDF). ...
Bananas are an attractive and low-cost food supply for poor countries, where bananas are consumed by the majority of the population. Typically, only the fruit of the banana tree is consumed, and before the fruit is cooked, the banana heart is chopped out and thrown. However, many people are unaware that the banana heart, also known as the banana blossom, has a high nutritional content and numerous health benefits. The blossom of a banana contains a lot of fiber and can be used to make fiber-rich foods. In addition, the flower includes a variety of bioactive substances, such as alkaloids, tannins, flavonoids, and phenolic compounds, all of which have anti-cancer, anti-microbial, and antioxidant activities. This plant is often used as a food additive in many Asian countries. On the other hand, the banana flower has received only sporadic attention. As a result, the aim of this review is to evaluate the nutritionally dense compact pack of banana blossoms and highlight the value-added product fortified with banana blossoms. So, these unique nutritional values of banana blossom should get maximum utilization, and incorporation of this banana blossom in food products can be performed for value addition.
... Obesity is a main risk factor for the onset of several chronic diseases. It has been linked to some hormonedependent cancers, such as breast, colorectal, oesophagal, kidney, gallbladder, uterine, pancreatic, and liver cancer [3][4], and it's also considered a disease by itself [5]. Many environmental factors have a role in the onset of obesity [6], including lifestyle, rising incomes, urbanizing populations, increasing urbanization and globalization of food markets and foods with high contents of saturated fats and sugars, poor diet, a lack of physical exercise [7], age trends [8], and the socio-economic factors [7]. ...
Abstract
Introduction: Yemen has a unique low-income population with several sociopolitical challenges and the association between weight disorders and sociodemographic and lifestyle factors is not clearly understood.
Aim: The aim of this study is to estimate the prevalence of obesity, overweight and underweight among Yemeni adults, and to identify their associated factors.
Methods: A cross-sectional study was conducted from 11 January to 25 March 2020, including 561 subjects of Yemen's adult population aged 18 and above, from four Yemeni governorates, who answered a questionnaire including demographic, socio-economic, and physical activity items after getting their signed consent. Height and weight were measured, and body mass index (BMI) was computed. The association between obesity or overweight (BMI ≥ 25.0kg/m2) or underweight (BMI < 18.5 kg/m2) and the other variables was analyzed using multinomial logistic regression.
Results: A total of 561 subjects aged ≥ 18 years have participated in this survey. The overall prevalence of obesity and overweight was 10.3%, 95% CI [7.7%; 12.8%] and 20.3%, 95% CI [17%; 23.5%] respectively, while the one for underweight was 21.2%, 95% CI [17.8%; 24.5%]. The risk of overweight-obesity increased with age (OR=1.02, 95% CI (1.01-1.03)), living in urban areas (OR= 1.680, 95% CI (1.105-2.552)) and average-high socioeconomic status (SES) (OR= 1.729, 95% CI (1.156-2.587)) while the risk of underweight decreased with the age (OR= 0.981, 95% CI (0.964-0.998)).
Conclusion: These findings provide a special case of high prevalence of obesity, overweight, and underweight in Yemen. Therefore, implementing awareness and prevention programs is highly recommended there.
... Available data for the past 2 decades suggest that the prevalence of hypertension has decreased in most developed countries, but has increased in several developing countries like Nigeria (Antikainen et al., 2006;Kearney, 2004). Body mass index is positively and independently associated with morbidity and mortality from hypertension, cardiovascular disease, type II diabetes mellitus, and other chronic diseases (Pi-Sunyer, 1993). In Caucasian populations, a strong association has been depicted between BMI and mortality (Stevens et al., 1998). ...
The aim of this study was to determine the relationship between BMI and BP (SBP and DBP) among university students in Maiduguri, Nigeria. A sample of convenience was used to recruit participants for this study. Data on gender, height, weight, BMI and BP were obtained using a researcher-developed data form. Blood pressure, height and weight of the participants were measured using standardised procedures. A total of 351 students participated in this study out of which 248 (70.7%) were males and 103 (29.3%) were females with mean height, weight and BMI of 1.70±0.07m, 67.01±12.78kg and 1.71±0.45kg/m 2 respectively. The mean systolic and diastolic blood pressures were 122.86±14.02mmHg and 82.17±9.69mmHg respectively. The study revealed a significant correlation between BMI and BP (SBP and DBP) among the participants (p<0.01). Significant correlation between BMI and BP (SBP and DBP) was recorded among male participants, while there was no significant correlation between BMI and BP (SBP and DBP) among female participants. In conclusion, the study found a significant relationship between BMI and BP among the participants. There is a need for Students to be enlightened on the adverse health effects associated with high BMI and high blood pressure.
... Available data for the past 2 decades suggest that the prevalence of hypertension has decreased in most developed countries, but has increased in several developing countries like Nigeria (Antikainen et al., 2006;Kearney, 2004). Body mass index is positively and independently associated with morbidity and mortality from hypertension, cardiovascular disease, type II diabetes mellitus, and other chronic diseases (Pi-Sunyer, 1993). In Caucasian populations, a strong association has been depicted between BMI and mortality (Stevens et al., 1998). ...
... When compared to the non-obese patients, Wigfield et al. observed a rise in certain morbidities after cardiac surgery in the extremely obese patient group, including prolonged ventilation (39% vs. 23.5%; p = 0.01), incidence of renal failure (14.3% vs. 5.0%; p = 0.01), and length of hospital stay (11.4 vs. 9.6; p = 0.001) [34]. Obesity has been linked to left atrial dilatation, diastolic dysfunction, and ERP shortening in the left atria, all of which increase the likelihood of AF [35]. ...
Postoperative atrial fibrillation (POAF) is a frequent and severe complication following cardiac surgery. While obesity is established as a risk factor for atrial fibrillation (AF) in non-surgical settings, its role in the postoperative period is still debated. This systematic review aims to assess the relationship between obesity and POAF in patients undergoing cardiac surgery. A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and Cochrane Library, focusing on randomized controlled trials (RCTs) published until June 2023. Data were extracted independently by two authors and assessed using the Cochrane Risk of Bias Tool (RoB2). From an initial search of 1,284 articles, 11 studies met the inclusion criteria, with a range of sample sizes between 300 and 5,000 patients. The incidence of POAF in obese patients ranged from 30% to 54%, compared to 20% to 46% in non-obese patients. Five studies concluded that obesity was a significant risk factor for POAF, whereas four found no statistically significant relationship, and two reported an "obesity paradox," where obesity appeared protective or neutral regarding POAF risk. Our review provides evidence regarding obesity developing POAF after cardiac surgery. |
... Obesity has risen dramatically in recent decades. Obesity in Westernized countries ranks high among public health issues because it is associated with adverse health outcomes and high economic costs (Kuczmarski et al., 1994;Pi-Sunyer et al.,1993;Burton -Freeman, 2000). Dietary fiber (DF) is classified as soluble (SDF) or insoluble (IDF). ...
Bananas are an attractive and low-cost food supply for poor countries, where bananas are consumed by the majority of the population. Typically, only the fruit of the banana tree is consumed, and before the fruit is cooked, the banana heart is chopped out and thrown. However, many people are unaware that the banana heart, also known as the banana blossom, has a high nutritional content and numerous health benefits. The blossom of a banana contains a lot of fiber and can be used to make fiber-rich foods. In addition, the flower includes a variety of bioactive substances, such as alkaloids, tannins, flavonoids, and phenolic compounds, all of which have anti-cancer, anti-microbial, and antioxidant activities. This plant is often used as a food additive in many Asian countries. On the other hand, the banana flower has received only sporadic attention. As a result, the aim of this review is to evaluate the nutritionally dense compact pack of banana blossoms and highlight the value-added product fortified with banana blossoms. So, these unique nutritional values of banana blossom should get maximum utilization, and incorporation of this banana blossom in food products can be performed for value addition.
... The criterion for defining obesity (i.e., BMI of 30 kg/m 2 ) was selected principally on the basis of the strong relation between BMI and mortality, shown in Figure 2. At a BMI of 30 kg/m 2 , the risk of mortality increases by approximately 30% and at a BMI Ն 40 kg/m 2 by 100% or more (Manson et al., 1995). Death is attributable primarily to obesity's association with cardiovascular disease and type 2 diabetes, as well as with several cancers (Pi-Sunyer, 1993). Other complications include sleep apnea, gallbladder disease, and the exacerbation of osteoarthritis. ...
Obesity has reached epidemic proportions in the United States and other developed nations. In the United States, 27% of adults are obese and an additional 34% are overweight. Research in the past decade has shown that genetic influences clearly predispose some individuals to obesity. The marked increase in prevalence, however, appears to be attributable to a toxic environment that implicitly discourages physical activity while explicitly encouraging the consumption of supersized portions of high-fat, high-sugar foods. Management of the obesity epidemic will require a two-pronged approach. First, better treatments, including behavioral, pharmacologic, and surgical interventions, are needed for individuals who are already obese. The second and potentially more promising approach is to prevent the development of obesity by tackling the toxic environment. This will require bold public policy initiatives such as regulating food advertising directed at children. The authors call not for the adoption of a specific policy initiative, but instead propose that policy research, based on viewing obesity as a public health problem, become a central focus of research.
... Both systolic and diastolic HTN are important predisposing factors of cardiovascular disease (CVD), chronic kidney disease and stroke [6]. BMI is directly and independently associated with morbidity and mortality in HTN and type 2 DM patients [7]. If the relationship between obesity and the risk for HTN and diabetes is not assessed early, it might lead to micro and macro vascular complications. ...
Background and objective: Obesity (Siman e Mufrat) is defined as deposition of excess adipose tissue mass and increased body weight. As per National Family Health Survey (NFHS-4) in 2015-16, India's obesity doubled in last 10 years. The prevalence of obesity is higher among the urban than rural, high socioeconomic states and in south India from 1998 to 2018. This study was designed to estimate the prevalence of obesity among patients visiting the NIUM hospital. Material and methods: Present study was a cross sectional study of 10 weeks duration conducted in the specialised OPD of musculoskeletal disease at NIUM, Bangalore. A total of 583 subjects were screened based on their typology to rule out obesity and its associated risk factors. Diagnosis was made on the basis of parameters used to determine the body weight which are Asian Indian Standard of BMI (weight in kilograms divided by height in meters squared (kg/m 2)), for adult Asians BMI (kg/m 2), underweight <18.5, normal 18.5-22.9, overweight 23-24.9, obese I 25-29.9, obese II 30-34.9, obesity III ≥35 and Waist Hip Ratio, Waist circumference ratio. Result: The present study revealed that out of 583 subjects, 241 subjects were found overweight and obese, from which 6.63% overweight, 39.00% obese I, 37.75% obese II, and 16.59% obese III. Out of these, 11.20% were found with risk of HTN, 6.22% with DM, and 2.90% with thyroid dysfunction. Conclusion: Present study reveals that obesity is a common life style disorder. Etiologically sedentary life style, lack of physical activity and exercise, consumption of energy rich diet, stress, and inadequate sleep are projected as the causes for obesity. It is a major risk factor for various diseases including type 2 DM, cardiovascular disease, hypertension, osteoarthritis, low back pain, and certain types of cancer. So, health education should be provided to the patients to adopt certain lifestyle changes that can be beneficial to limit the progress of the disease.
... Obesity as an important global health issue is associated with the risk of several chronic diseases, such as high blood pressure, cardiovascular disease (CVD)s [1], type 2 diabetes (T2D) [2], and osteoarthritis [3]. The worldwide prevalence of overweight and obesity has dramatically increased over the past decades and now approximately one-third of adults are overweight or obese throughout the world [4]. ...
Abstract Background A limited number of studies have directly examined the effect of whole eggs on body weight and composition in adults, and they have led to inconsistent results. This study aimed to summarize the evidence on the effect of whole egg consumption on body weight and body composition in adults from clinical trials. Methods Online databases were searched from inception to April 2023 for clinical trials that directly or indirectly assessed the effect of whole eggs consumption on anthropometric measures including body weight, body mass index (BMI), waist circumference (WC), and fat-free mass (FFM) in adults. A random effects model was used for meta-analysis. Results In total, 32 controlled clinical trials were included in the systematic review. The analyses revealed that whole egg consumption has no significant effect on body weight (n = 22), BMI (n = 13), WC (n = 10), and FFM (n = 4, P > 0.05). The subgroup analyses showed that whole egg consumption has an increasing effect on body weight and BMI in studies that lasted more than 12 weeks and in unhealthy participants (P
... Obesity is a metabolic condition of abnormal fat accumulation due to an energy imbalance (Spiegelman and Flier 2001). It is a significant risk factor for many serious ill-nesses such as heart disease, arthritis, and diabetes (Pi-Sunyer 1993). The critical characteristics of obesity is excessive triglycerides storage in adipose tissue, which is achieved by increase of adipocytes number and size (Hristov et al. 2019). ...
Obesity-induced inflammation is crucial in the pathogenesis of insulin resistance and type 2 diabetes. In this study, we investigated the effects of the Gracilaria chorda (GC) on lipid accumulation and obesity-induced inflammatory changes or glucose homeostasis in cell models (3T3-L1 adipocytes and RAW 264.7 macrophages). Samples of GC were extracted using solvents (water, methanol, and ethanol) and subcritical water (SW) at different temperatures (90, 150, and 210°C). The total phenolic content of GCSW extract at 210°C (GCSW210) showed the highest content compared to others, and GCSW210 highly inhibited lipid accumulation and significantly reduced gene expressions of peroxisome proliferatoractivated receptor-γ, CCAAT/enhancer-binding protein-α, sterol regulatory element-binding protein-1c, and fatty acid synthase in 3T3-L1 adipocytes. In addition, GCSW210 effectively downregulated the pro-inflammatory cytokine regulator pathways in RAW 264.7 macrophages, including mitogen-activated protein kinase, signal transducers and activators of transcription and nuclear factor-κB. In co-culture of 3T3-L1 adipocytes and RAW 264.7 macrophages, GCSW210 significantly reduced nitric oxide production and interleukin-6 levels, and improved glucose uptake with dose-dependent manner. These findings suggest that GCSW210 improves glucose metabolism by attenuating obesity-induced inflammation in adipocytes, which may be used as a possible treatment option for managing obesity and associated metabolic disorders.
... These risks include insulin resistant diabetes mellitus, and hyper triglyceridemia. Also it was reported that the obesity is associated with some forms of cancer and with sleep apnea [20]. ...
... Both these factors are considered to have negative relation with balance and functional mobility. Also, in the current study individuals who were overweight were less likely to engage into any sort of physical activity than compared to underweight and normal individuals [21]. Therefore, these individuals should be advised by their health care professionals to try and engage in more and more physical activity for the purpose of reducing the excess weight and reducing risk of disease or any impairments [20,22]. ...
Background: Overweight and obesity has been seen as a rising problem in India and around the world commonly in school and college going students at a very young age. The objective of the study is to find the relation of body mass index with balance and functional mobility and to enable the associated professionals to know better the consequences that can be caused by increase in the weight of an individual. Methods: A total of 100 subjects (65 females and 35 males) were randomly recruited based on the inclusion and exclusion criteria. They were divided into 3 groups on the basis of their MI as underweight, normal and overweight. Unilateral leg stand, tandem stand, sit to stand and timed up and go tests were assessed for each participant and the values were recorded. Results: Results show that increase in weight has a positive relation with poor balance and functional mobility in college students. Individuals falling under underweight and normal BMI showed good test results that indicated good balance and mobility than compared to overweight individuals who had poorer results. Conclusion: Increase in body mass index has a positive effect on balance and functional mobility as the population falling under overweight BMI had poorer values for balance and mobility tests as compared to the individuals who had underweight and normal BMI. KEY WORDS: BMI, Balance, Functional mobility, College students.
... The impact of obesity on surgical results in elderly patients who underwent liver resections remains a subject of vivid debate. An increased surgical risk has been expected because of comorbidities, associated to obesity and old age, underlying liver disease and technical difficulties [16][17][18][19][20]. Our multicenter study did not confirm this hypothesis and showed that LLR can be safely performed in treatment of HCC also in elderly patients with a BMI ≥ 30 kg/m 2 . ...
Background:
The impact of obesity on surgical outcomes in elderly patients candidate for liver surgery is still debated.
Aim:
To evaluate the impact of high body mass index (BMI) on perioperative and oncological outcome in elderly patients (> 70 years old) treated with laparoscopic liver resection for hepatocellular carcinoma (HCC).
Methods:
Retrospective multicenter study including 224 elderly patients (> 70 years old) operated by laparoscopy for HCC (196 with a BMI < 30 and 28 with BMI ≥ 30), observed from January 2009 to January 2019.
Results:
After propensity score matching, patients in two groups presented comparable results, in terms of operative time (median range: 200 min vs 205 min, P = 0.7 respectively in non-obese and obese patients), complications rate (22% vs 26%, P = 1.0), length of hospital stay (median range: 4.5 d vs 6.0 d, P = 0.1). There are no significant differences in terms of short- and long-term postoperative results.
Conclusion:
The present study showed that BMI did not impact perioperative and oncologic outcomes in elderly patients treated by laparoscopic resection for HCC.
... Patients who are obese are more likely to develop coronary artery disease, hypertension, hyperlipidemia, diabetes mellitus, certain malignancies, cerebrovascular accidents, osteoarthritis, restrictive pulmonary disease, and sleep apnea. 2 There has been much discussion recently about these risks because not all studies agree that being slightly overweight increases the risk of death in young people and because, even if one manages to maintain weight loss, there are no clinical studies demonstrating long-term maintenance of weight loss, so the long-term reduction of cardiovascular risk factors has not been evaluated. 3 Williamson and coworkers noted that the association between intentional weight loss and longevity in middle-aged overweight women appears to depend on their health status: in women with obesity-related health conditions, intentional weight loss of any amount was associated with a 20% reduction in all-cause mortality, primarily because a 40-50% reduction in mortality from obesity-related cancers; in women with no pre-existing illness, intentional weight loss of any amount was associated with an association with an association between intentional weight loss and longevity in middle-aged. ...
Introduction: Serotonin (5-HT) and noradrenaline (NA) reuptake inhibitor sibutramine work together. Sibutramine primarily affects food intake and energy expenditure by way of its two pharmacologically active metabolites, primary and secondary amines, which cause significant weight loss. In addition to stimulating thermogenesis and enhancing the physiological process of satiety, it can also increase the efferent sympathetic activity to brown fat that is thermochemically active. Aim: Revisiting the Most Successful United States Food and Drug Administration-approved Anti-obesity Drug Sibutramine sulfate. Methodology: For a duration of 10 years, literature is covered. Results: Clinical studies using sibutramine show a dose-related decrease in body weight, with weight loss up to 11% below the baseline that can last up to 18 months with ongoing therapy. Patients assigned to the sibutramine medication continued to lose weight throughout a 1-year period, reaching 15% below baseline, while the patients receiving the placebo treatment had some weight increase when weight loss is induced with a very low-calorie diet (VLCDL). By lowering the biochemical risk factors for obesity, such as plasma triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, glucose, and insulin, and raising HDL cholesterol, sibutramine enhances metabolic fitness. Conclusion: Sibutramine has been shown to be a beneficial treatment for obese people with moderately high blood pressure, and it has even been shown to reduce blood pressure on average as a result of weight reduction. The potential for misuse that is associated with amphetamine is not present with sibutramine, and in investigations evaluating abuse potential, it is identical to placebo.
... However, CED may not be a concern for sportsperson, particularly combat athletes. There is a positive correlation between increased BMI values and increased morbidity and mortality rates (Pi-Sunyer, 1993). Co-morbidities of obesity as listed by WHO (1998) under the 'greatly increased' category include type-2 diabetes, gallbladder diseases, dyslipidemia, metabolic syndrome, breathlessness, and sleep apnoea. ...
Naga wrestling is an indigenous wrestling style played by the menfolk of Tenyimi tribes of Nagaland and Manipur. The present study aims to find the prevalence of overweight and obesity among Naga wrestlers, and examine the influence of height, weight, and BMI on performance. For this study, we have utilized the data of Nagaland Wrestling Association (NWA) on age, height, weight, and positions achieved from 2017 to 2020. A total of 170 wrestlers aged between 18-37 years were included in the present study. The wrestlers were divided into two categories based on age: younger wrestlers (18-25 years) and older wrestlers (26-37 years). BMI was classified using Asian cut-off points given by WHO. The mean height, weight, and BMI of Naga wrestlers are 172.74 cm, 79.51 kg, and 26.57 kg/m2, respectively. Baring height, significant variation in weight (p<0.001), and BMI (p<0.001) was observed between younger wrestlers and older wrestlers. The present study showed a high prevalence of overweight (51.8%) and obesity (34.1%) among the wrestlers. The prevalence of overweight and obesity between younger and older wrestlers was also highly significant (p<0.001). Thus, there is a positive association between BMI and its categories with advancing age. Additionally, taller and heavier wrestlers were more successful in achieving positions at wrestling tournaments. The absence of weight category in this wrestling style could be the causal factor for high incidences of overweight and obesity among the wrestlers.
... Its relative technical simplicity and the good results published in medium-and long-term studies have made it the technique of choice in many cases. Nevertheless, possible long-term challenges remain, such as new weight gain and the appearance of de novo gastroesophageal reflux [1][2][3]. ...
Purpose
Advanced laparoscopic procedures are still challenging. One critical issue is the lack of stereoscopic vision. The aim of this surgical study is to evaluate whether 3D vision offers any advantages for surgical performance over 2D vision during sleeve gastrectomy for morbid obesity using a laparoscopic system that allows changing between 2D and 3D optics.
Methods
A total of 78 patients were analyzed, with 37 in the 2D group and 41 in the 3D group. Performance time, hospital stay, complications, and early outcomes were collected. To assess the quality of the 2D and 3D techniques, visual analog scales from 0 to 10 were designed, and image quality, depth of field, precision in performing tasks, and general ergonomics were measured.
Results
According to the vision system used, the mean duration of surgery was 85 ± 16.8 min for patients operated on with the 2D system and 69 ± 16.9 min for those operated on with the 3D system. There were no significant differences between the overall percentages of complications according to the type of vision used. However, postoperative complications were more severe in the 2D laparoscopy group. The average length of stay was shorter for patients in the 3D group. Regarding the differences perceived by the surgeon, the depth of field and the precision of tasks were better in the 3D vision group.
Conclusion
The 3D system provided greater depth perception and precision in more complex tasks, enabling safer surgery. This led to a reduction in the operative time and hospital stay. Moreover, the severity of complications was less.
... A study predicted that 57.8% of the world population would be overweight or obese by 2030 without effective intervention on current trends [3]. Many studies have identified obesity as a critical risk factor for all-cause mortality, metabolic diseases, cardiovascular diseases, musculoskeletal disease, Alzheimer's disease, depression, and cancers in multiple organs (e.g., breast, ovarian, prostate, liver, kidney, and colon) [4,5]. Meanwhile, obesity is associated with unemployment, social disadvantages, and reduced socio-economic productivity [1]. ...
A poor diet cannot fully explain the prevalence of obesity. Other environmental factors (e.g., heavy metals) have been reported to be associated with obesity. However, limited evidence is available for the combined effect of these factors on obesity. Therefore, we conducted a cross-sectional study and used the data from the National Health and Examination Survey (2007–2018) to explore the associations between diet quality and heavy metals and obesity. Diet quality was evaluated by the Healthy Eating Index-2015 (HEI-2015) score. Heavy metals included serum cadmium (Cd), lead (Pb), and mercury (Hg). We included 15,959 adults, with 5799 of obesity (body mass index ≥ 30 kg/m2). After adjustment for covariates, every interquartile range increase in HEI-2015 scores, Pb, Cd and Hg was associated with a 35% (odds ratios [OR] = 0.65, 95% confidence interval [CI]: 0.60, 0.70), 11% (OR = 0.89, 95%CI: 0.82, 0.98), 9% (OR = 0.91, 95%CI: 0.87, 0.96), 5% (OR = 0.85, 95%CI: 0.82, 0.89) reduction in risk of peripheral obesity, respectively. In addition, the association between the HEI-2015 scores and peripheral obesity was attenuated by higher levels of heavy metals (All p interaction < 0.05). Results remained similar for abdominal obesity. Our study reveals the distinct effects of a high-quality diet and heavy metals on obesity prevalence, and the beneficial effect of a high-quality diet could be weakened by higher levels of heavy metals.
... 13 Overweight in adolescence increases the probability of developing obesity and other chronic conditions including hypertension, type 2 diabetes, gallbladder disease and increased mortality in adulthood. [14][15][16][17] An extensive literature describing multicomponent interventions have consistently demonstrated clinically relevant weight loss for up to 12 months in typically developing children and adolescents with overweight and obesity. 18,19 In contrast, the literature relative to the impact of multicomponent interventions on long-term weight loss in youth with ID is limited to two chart reviews (n = 115, n = 74) which reported on weight change over 12 months in participants in an ongoing special needs weight management clinic at a children's hospital. ...
Background
The literature evaluating multi‐component interventions for long‐term weight loss in adolescents with intellectual disabilities (ID) is extremely limited.
Objectives
To compare the effectiveness of two delivery strategies, face‐to‐face (FTF) or remote delivery (RD), and two diets, enhanced Stop Light diet (eSLD) or conventional diet (CD) on weight change across 12 and 18 months. in response to an 18 months. weight management intervention (6 months Weight loss/12 months. Weight maintenance) in adolescents with ID.
Methods
Adolescents with ID were randomized to one of three arms: FTF /CD, RD/CD, RD/eSLD and asked to attend individual education sessions with a health educator which were delivered during FTF home visits or remotely using video conferencing. The CD followed the US dietary guidelines. The eSLD utilized the Stop Light guide and was enhanced with portion‐controlled meals. Participants were also asked to increase their physical activity (PA) and to self‐monitor diet, PA and body weight across the 18‐month. intervention.
Results
Weight was obtained from 92(84%) and 89(81%) randomized adolescents at 12 and 18 months, respectively. Weight change across 12 months. Differed significantly by diet (RD/eSLD: −7.0% vs. RD/CD: −1.1%, p = 0.002) but not by delivery strategy (FTF/CD: +1.1% vs. RD/CD: −1.1%, p = 0.21). Weight change across 18 months. Was minimal in all intervention arms and did not differ by diet (RD/eSLD: −2.6% vs. RD/CD: −0.5%; p = 0.28) or delivery strategy (FTF/CD: +1.6% vs. RD/CD: −0.5%; p = 0.47).
Conclusions
Additional research is required to identify effective strategies to improve long‐term weight loss in adolescents with ID.
... The presence of obesity has been associated with many diseases. Increased mortality due to all causes and increased risk of hypertension, dyslipidemia, type 2 diabetes, coronary artery disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, as well as endometrial, breast, prostate, and colon cancers are associated with obesity [20,21]. It is estimated that there is an estimated 75% direct relationship between the incidence of hypertension and obesity [22]. ...
Background: The study aims to investigate and evaluate the factors and treatment options for the global health problem of obesity which poses a serious risk to a healthy life
... Obesity has been associated with diabetes, hypertension, chronic heart failure (CHF), dyslipidemia, gallbladder disease, and some malignancies including kidney, breast and oesophageal, etc. [37][38][39]. Excess weight is important, but so is the pattern of fat distribution, as it determines the threat in many of these diseases. Gluteofemoral or lower-body fat distribution patterns are more common in women than in men, whereas abdominal or upper-body obesity is more common in men. ...
Obesity in recent years has become an epidemic. A high body mass index (BMI) is one of today's most crucial population health indicators. BMI does not directly quantify body fat but correlates well with easier body fat measurements. Like smoking, obesity impacts multiple organ systems and is a major modifiable risk factor for countless diseases. Despite this, reports have emerged that obesity positively impacts the prognosis of patients with chronic illnesses such as chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD), a phenomenon known as the Obesity Paradox. This article attempts to explain and summarize this phenomenon.
As it stands, two theories explain this paradox. The muscle mass hypothesis states that obese patients are better adapted to tide through acute exacerbations due to increased reserve because of greater muscle mass. The other theory focuses on brown adipose tissue and its anti-inflammatory effects on the body.
We performed a literature review on research articles published in English from 1983 to the present in the following databases - PubMed, Elsevier, and Google Scholar. The following search strings and Medical Subject Headings (MeSH) terms were used: "Obesity," "Heart Failure," "COPD," and "Cardio-Respiratory Fitness." In this review, we looked at the obesity paradox in Heart Failure and COPD. We summarized the current literature on the Obesity Paradox and reviewed its relationship with Cardio-Respiratory Fitness.
... Characteristic of non-insulin-dependent diabetes mellitus can support antibodies to self-antigens to the formation of complex antigens. So, the activity of autoimmune is associated with lymphocyte in ltration of islets and circulates serum antibodies [19,20]. The marker of autoimmune destruction includes autoantibodies to insulin (IAAs), glutamic acid decarboxylase 65 (GAD65), and tyrosine phosphates (IA2 and IA-2BETA). ...
The encoded SOX13 gene from the HMG-box genes family is testis associated with the HMG-box domain bound with DNA. The HMG-box associated genes play a dominant role during the growth. Precisely, SOX13 is an insulin-dependent gene located on chromosome 1. The insulin is substantial proof of the genomics variance of the SOX13 gene illustrates the statement of sensibility in type-1 diabetes (T1D). SOX13 identified in islets also exocrine pancreas and initiated as a vital auto-antigen (ICA12). The beta-cell antigens stimulate the mechanisms of peripheral tolerance. The approval of the SOX13 gene as an auto-antigen is an effective marker for autoimmunity. So, I aimed to an analysis of SOX13 gene from the family of SRY-related HMG-box genes in the mammal. Therefore, I performed bioinformatics and computational application for experimentation of particular gene and their family in two different organisms. My finding provided a genomic variability of the SOX13 gene is sensitive in T1D. Therefore, I documented the SOX13 gene and their molecular mechanism and total HMG-box domains in Homo sapiens and Mus musculus . A computational and bioinformatics analysis demonstrated that SOX13 is an insulin-dependent gene. The series of reports suggested unique aspects of SRY-related HMG-box genes during the growth of organisms. My findings justified that the HMG-box genes play essential roles during the development of mammals . In contrast, the high mobility group (HMG-box) of the SOX13 is an insulin-dependent gene.
... The prevalence of overweight and obesity is increasing in populations spanning the epidemiological transition and may be particularly high in individuals of African-origin [1][2][3][4]. In addition, elevated weight has been associated with the development of non-communicable diseases (NCDs) [5][6][7][8]. ...
The Pulvers’ silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual’s body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.e., body mass index (BMI), waist circumference (WC), waist-height-ratio (WHtR), and 2) the ability to predict with silhouette showcards anthropometric adiposity measures, i.e., overweight and obesity (BMI ≥ 25 kg/m ² ), obesity alone (BMI ≥ 30 kg/m ² ), elevated WC (men ≥ 94 cm; women ≥ 80 cm), and WHtR (> 0.5) across the epidemiological transition. 751 African-origin participants, aged 20–68 years old, from the United States (US), Seychelles, and Ghana, completed anthropometrics and selected silhouettes corresponding to their perceived body size. Silhouette performance to anthropometrics was examined using a least-squares linear regression model. A receiver operator curve (ROC) was used to investigate the showcards ability to predict anthropometric adiposity measures. The relationship between silhouette ranking and BMI were similar between sexes of the same country but differed between countries: 3.65 [95% CI: 3.34–3.97] BMI units/silhouette unit in the US, 3.23 [2.93–3.74] in Seychelles, and 1.99 [1.72–2.26] in Ghana. Different silhouette cutoffs predicted obesity differently in the three countries. For example, a silhouette ≥ five had a sensitivity/specificity of 77.3%/90.6% to predict BMI ≥ 25 kg/m ² in the US, but 77.8%/85.9% in Seychelles and 84.9%/71.4% in Ghana. Ultimately, silhouettes predicted BMI, WC, and WHtR similarly within each country and sex but not across countries. Our data suggest that Pulvers’ silhouette showcards may be a helpful tool to predict anthropometric and adiposity measures in different populations when direct measurement cannot be performed. However, no universal silhouette cutoff can be used for detecting overweight or obesity status, and population-specific differences may stress the need to calibrate silhouette showcards when using them as a survey tool in different countries.
... Obesity has been identified as one of the key drivers of increased healthcare spending and reduced life expectancy in the United States [1][2][3][4][5] and worldwide [6]. Obesity has been linked to a multitude of health conditions, including coronary heart disease [7], chronic renal failure [8], many cancers, sleep apnea, gallbladder disease [9], Type 2 Diabetes [10] and other conditions. The link between obesity and chronic illness is the reason for the link between obesity and reduced life expectancy [3,4]. ...
Background
National efforts to control US healthcare spending are potentially undermined by changes in patient characteristics, and in particular increases in rates of obesity and overweight. The objective of this study was to provide current estimates of the effect of obesity and overweight on healthcare spending overall, by service line and by payer using the National Institutes of Health classifications for BMI.
Methods
We used a quasi-experimental design and analyzed the data using generalized linear models and two-part models to estimate obesity- and overweight-attributable spending. Data was drawn from the 2006 and 2016 Medical Expenditures Panel Survey. We identified individuals in the different BMI classes based on self-reported height and weight.
Results
Total medical costs attributable to obesity rose to $126 billion per year by 2016, although the marginal cost of obesity declined for all obesity classes. The overall spending increase was due to an increase in obesity prevalence and a population shift to higher obesity classes. Obesity related spending between 2006 and 2016 was relatively constant due to decreases in inpatient spending, which were only partially offset by increases in outpatient spending.
Conclusions
While total obesity related spending between 2006 and 2016 was relatively constant, by examining the effect of different obesity classes and overweight, it provides insight into spend for each level of obesity and overweight across service line and payer mix. Obesity class 2 and 3 were the main factors driving spending increases, suggesting that persons over BMI of 35 should be the focus for policies focused on controlling spending, such as prevention.
... These findings are in agreement with other studies [19] which support a strong relationship between BMI and blood pressure across developed and developing countries [18]. Body mass index is reported to be positively and independently associated with morbidity and mortality from hypertension, cardiovascular disease, type II diabetes mellitus, and other chronic diseases [20]. In Caucasian populations, a strong association has been depicted between BMI and mortality, and positive relationship between BMI and BP has also been reported among African and Asian populations [21]. ...
Introduction: Hypertension is a long term medical condition in which the blood pressure in the arteries is persistently elevated. Over the last decade, it has been demonstrated that the prevalence of mild hypertension in youth aged from 18-30 years is more common than expected and is progressively rising. Methods: This study documented the point prevalence of high blood pressure among the student population of the University of Port Harcourt by determining the body mass index, level of physical activities and socioeconomic status. A cross sectional study was conducted among the University of Port Harcourt students within a period of two weeks. A total of 300 students were sampled and anthropometric data such as height, weight and age were collected. Participants were aged 19-30 years. 48.7% were observed to be female while 51.3% were of the male gender. Result: The point prevalence of pre-hypertension and hypertension was observed to be high among the students 11.3% and 31.7% respectively. It was observed that 36.3% of the male students had normal blood pressure while 76.6% of the female students had normal blood pressure, this accounted to be 22.3±0.14years for the mean age normotensive, 22.6±0.37years for pre-hypertensive and 23.2±0.14years for hypertensive. The body mass index (BMI) of the Original Research Article Olotu et al.; AJMPCP, 5(3): 14-22, 2022; Article no.AJMPCP.85134 15 normotensive, pre-hypertensive and hypertensive were observed to be 18.3±0.19kg/m 2 , 24.21±0.19 kg/m 2 and 32.5±0.32 kg/m 2 respectively. There was significant difference between the body mass indexes (P<0.05). Conclusion: From the survey carried out, it was observed that the physical activity of the students was low. Though not statistically evaluated for significance, a high percentage prevalence of hypertension in males was observed when compared with females. Considering the correlation between the anthropometric measurements and the hypertensive status of the participants, it was discovered that the age did not affect the condition significantly (P>0.05) but a significant correlation between hypertension and age as well as BMI of students exist. Recommendation: Regular screening is recommended to improve awareness and help mitigate the complications of this condition. Finally, routine screening should be undertaken by health care managements and the university's health service.
... Similar conclusions have been reported; for example, a major morbidity rate of 40% was observed after liver resection in obese or overweight patients [31,32]. There is evidence to explain this phenomenon, namely, hepatic steatosis associated with obesity may adversely affect the regeneration of liver remnants and thus influence morbidity [33]. During the perioperative period, obese patients should be instructed by dieticians to adjust their dietary habits and properly match their nutritional structure. ...
Background:
Postoperative morbidity after curative resection for hilar cholangiocarcinoma (HCCA) is common; however, whether it has an impact on oncological prognosis is unknown.
Aim:
To evaluate the influence of postoperative morbidity on tumor recurrence and mortality after curative resection for HCCA.
Methods:
Patients with recently diagnosed HCCA who had undergone curative resection between January 2010 and December 2017 at The First Affiliated Hospital of Army Medical University in China were enrolled. The independent risk factors for morbidity in the 30 d after surgery were investigated, and links between postoperative morbidity and patient characteristics and outcomes were assessed. Postoperative morbidities were divided into five grades based on the Clavien-Dindo classification, and major morbidities were defined as Clavien-Dindo ≥ 3. Univariate and multivariate Cox regression analyses were used to evaluate the risk factors for recurrence-free survival (RFS) and overall survival (OS).
Results:
Postoperative morbidity occurred in 146 out of 239 patients (61.1%). Multivariate logistic regression revealed that cirrhosis, intraoperative blood loss > 500 mL, diabetes mellitus, and obesity were independent risk factors. Postoperative morbidity was associated with decreased OS and RFS (OS: 18.0 mo vs 31.0 mo, respectively, P = 0.003; RFS: 16.0 mo vs 26.0 mo, respectively, P = 0.002). Multivariate Cox regression analysis indicated that postoperative morbidity was independently associated with decreased OS [hazard ratios (HR): 1.557, 95% confidence interval (CI): 1.119-2.167, P = 0.009] and RFS (HR: 1.535, 95%CI: 1.117-2.108, P = 0.008). Moreover, major morbidity was independently associated with decreased OS (HR: 2.175; 95%CI: 1.470-3.216, P < 0.001) and RFS (HR: 2.054; 95%CI: 1.400-3.014, P < 0.001) after curative resection for HCCA.
Conclusion:
Postoperative morbidity (especially major morbidity) may be an independent risk factor for unfavorable prognosis in HCCA patients following curative resection.
... The interpretation of the above results is as follows. A high BMI is well known to be closely associated with chronic liver disease, such as nonalcoholic steatohepatitis, and other comorbidities, such as diabetes and cardiovascular disease [34]. Previous studies have revealed that patients with diabetes mellitus, nonalcoholic fatty liver disease, and cardiovascular disease after pCCA resection have a signi cantly increased incidence of postoperative morbidities [23,35]. ...
Background & Objects
A comprehensive evaluation of the performance during the perioperative period is essential to provide good surgical care. To incorporate numerous characteristics into a single specified quality indicator, "Textbook outcomes (TO)" has been presented. The effect of the preoperative body mass index (BMI) on the occurrence of achieving/not achieving TO (non-TO) among patients having curative-intent resection for perihilar cholangiocarcinoma (pCCA) was studied.
Methods
This cohort study enrolled patients who underwent curative-intent resection for pCCA between 2014 and 2018 from a multicentre database. All cohort patients were classified into three groups according to the preoperative BMI: normal BMI (18.5 ~ 24.9 kg/m²), low BMI (≤ 18.4 kg/m²), and high BMI (≥ 25.0 kg/m²). The occurrences of non-TO among the above groups were compared. Univariable and multivariable logistic analyses were used to determine whether there was any significant effect of the preoperative BMI on non-TO.
Results
A total of 313 patients were enrolled in this study, and 212 (67.7%), 46 (14.7%), and 55 (17.6%) were in the normal-BMI, low-BMI, and high-BMI groups, respectively. In all patients, the occurrence of non-TO was 71.6%, and the occurrence of non-TO in both the high- and low-BMI groups was significantly higher than that in the normal-BMI group (85.5% and 82.6% vs. 65.6%, both P < 0.01). The multivariable logistic analyses indicated that both high BMI and low BMI were independently associated with a greater occurrence of non-TO (OR: 2.517, 95CI: 1.052–6.021, P = 0.038; OR: 3.379, 95CI: 1.423–8.022, P = 0.006).
Conclusions
More than two-thirds of the patients following curative-intent resection for pCCA did not achieve surgical TO. In addition, both preoperative high BMI and low BMI were independently associated with a higher risk of not achieving surgical TO following curative-intent resection for pCCA.
... The probability of acquiring traits such as dyslipidemia, impaired glucose metabolism, and hypertension is much greater than in the adult obese subject, increasing the risk of developing cardiovascular and metabolic diseases [1][2][3]. It has also been reported that there is an association between obesity and increased cancer risk also in childhood obesity [4,5]. The prevalence of childhood obesity is raised by incorrect lifestyles, suggested by the environment surrounding the individual. ...
Background and Methods: Long non-coding RNAs (LncRNAs) and microRNAs are involved in the pathogenesis of obesity, a multifactorial disease that is characterized by inflammation, cardiometabolic complications, and increased cancer risk among other co-morbidities. The up/down regulation of LncRNAs and microRNAs may play an important role in this condition to identify new diagnostic/prognostic markers. The aim of the study was to identify circulating inflammatory LncRNAs in obese adolescents (n = 54) and to evaluate whether their expression behaved differently compared to normal-weight adolescents (n = 26). To have a more complete insight, the expression of some circulating miRNAs that are linked to obesity (miR-33a, miR-223, miR-142, miR-199a, miR-181a, and miR-4454) were also analyzed. Results: LncRNAs and miRNAs were extracted simultaneously from plasma samples and amplified by Real-Time PCR. Among the 86 LncRNAs that were analyzed with custom pre-designed plates, only four (RP11-347E10.1, RP11-10K16.1, LINC00657, and SNHG12) were amplified in both normal-weight and obese adolescents and only SNHG12 showed significantly lower expression compared to the normal-weight adolescents (p = 0.026). Circulating miRNAs showed a tendency to increase in obese subjects, except for miR-181a expression. LncRNAs and miRNAs correlated with some clinical and metabolic parameters. Conclusions: Our results suggest the importance of these new biomarkers to better understand the molecular mechanisms of childhood obesity and its metabolic disorder.
... The worldwide prevalence of individuals who are overweight and/or obese has doubled since 1980 and they now constitute nearly one-third of the world's population [1]. This situation is a major public health concern because these people are at increased risk for morbidity and mortality associated with hypertension, cardiovascular disease, Type II diabetes mellitus, several types of cancer (e.g., breast, uterine or prostate) and mental health issues [2][3][4][5][6][7]. Current treatment options for overweight individuals can include lifestyle alterations (e.g., diet changes, behavior modification programs or exercise regimens), surgical intervention or pharmaceutical agents [8,9]. ...
GYKI-13380 (4-[3-(cyclopentyloxy)-4-methoxybenzyl]-2-imidazolidinone) was synthesized with the idea to incorporate a phenethylamine-like structure into a hydantoin-like (or imidazolidinone) ring to create a novel appetite suppressant. In this study, GYKI-13380 was tested in rats trained to discriminate injections of either S(+)amphetamine (0.75 mg/kg, IP) or fenfluramine (1.5 mg/kg, IP) from saline in a two-lever drug discrimination task. After stable discrimination performances were attained in each group, stimulus generalization (substitution) tests were conducted with GYKI-13380 and currently marketed CNS stimulant/anorectic drugs (phentermine, (−)ephedrine, diethylpropion and phendimetrazine). The fenfluramine stimulus generalized completely to GYKI-13380, but not to S(+)amphetamine nor to the stimulant/anorectic agents. In contrast, S(+)amphetamine-stimulus generalization did not occur to fenfluramine nor GYKI-13380, but did occur to the stimulant/anorectics. Taken together, it was concluded that GYKI-13380 could be a “masked fenfluramine-like agent” that would likely be perceived by humans in drug discrimination studies as being similar to fenfluramine, but would be viewed quite differently from S(+)amphetamine or other central nervous system stimulant/anorectic drugs.
Graphical abstract
... Although from enrolment to follow up, two of the three participants had a decrease in their lean body mass, the same two showed improvements in their lean body mass during the intervention phase of the study (2.6% and 6.6%), which may reflect increased activity, particularly as one of the participants did not exercise regularly outside of the study due to the level and severity of her injury, and the other completed all her exercise outside of the study in sitting. Improvement in lean body mass has many health benefits [46]. Previous research, using a device requiring upper limb support, demonstrated that 52 weeks of training yielded positive changes to body composition [6]. ...
Abstract Background Evidence is emerging for the use of overground lower limb robotic exoskeletons in the rehabilitation of people with spinal cord injury (SCI), with suggested benefits for gait speed, bladder and bowel function, pain management and spasticity. To date, research has focused on devices that require the user to support themselves with a walking aid. This often precludes use by those with severe trunk, postural or upper limb deficits and places the user in a suboptimal, flexed standing position. Free-standing exoskeletons enable people with higher level injuries to exercise in an upright position. This study aimed to evaluate the feasibility of therapy with a free-standing exoskeleton for those with SCI, and to determine the potential health-related benefits of this intervention. Methods This 12-week intervention study with 12-week waitlist control and 12-week follow up, provided people with SCI scoring
... BMI increases with age 55,56 and is linked with other agerelated complications such as cardiovascular problems, 29 joint pain, 65,66 diabetes, 20,67 coronary artery disease, and aberrant lipid profile. 67 Higher weight and a high risk of depression and other psychiatric disorders 14,23,68 indicate that BMI regulation might improve physical and mental health in patients with SCI. Apart from age, we examined sex as a demographic variable of interest and observed a higher positive mood in males and a higher negative mood in females (see table 1); males were approximately 3 and half times more likely to have lesser NA than females. ...
Objective: To examine the link between BMI and positive and negative affect after spinal cord injury (SCI).
Design: Cross-sectional study
Setting: In-patient and out- patient services of rehabilitation department in Delhi, India.
Participants: 142 persons with spinal cord injury participated in the study.
Interventions: None
Main outcome measures: Participants were asked to rate their affect using PANAS. BMI was assessed with SCI-specific procedure. Demographic details, and injury-related details (level, nature, chronicity) were taken.
Results: As expected, BMI negatively correlated with positive affect (r= -1.70, p=0.043). Further, the chances of younger SCI individuals having a lower BMI is 3.49 times the odds of the older ones having a low BMI (OR=3.491; 95% CI, 1.520-8.018). The chances of males having low affect was higher than females with (OR=2.55; 95% CI, 1.08-6.04).
Conclusions: Higher BMI might be associated with lower positive affect and contribute to a higher risk of depression, specifically in female SCI individuals. These results might be used to enhance the regulation of physical activity (exercises) and affect experiences through therapeutic activities and proactive counselling for the SCI individuals.
Body composition is an important component of an individual's health and fitness profile. The purpose of this study was to assess the accuracy of bioelectrical impedance analysis (BIA) in detecting percent body fat (%BF) changes throughout a physical activity intervention in previously sedentary, overweight men and women. Fourteen men (mean ± SD; 46 ± 7 yr) and 22 women (47 ± 5 yr) with a body mass index of ≥25 kg·m ⁻² participated in an intervention of 10,000 steps per day for 36 wk. %BF was measured by air displacement plethysmography (ADP; criterion measure) and BIA at baseline, 20 wk, and 36 wk. During the 36-wk intervention, the women lost 1.6 ± 4.8 kg and the men lost 3.9 ± 4.2 kg. There was a significant three-way interaction for %BF across time points, device, and sex ( P = 0.019). Among women, ADP and BIA detected %BF changes of −1.9% ± 2.0% and 0.5% ± 1.8%, respectively, from baseline to 20 wk, and −1.5% ± 2.3% and 0.3% ± 2.5%, respectively, from baseline to 36 wk. Among men, ADP and BIA detected %BF changes of −1.9% ± 1.8% and −1.5% ± 1.9%, respectively, from baseline to 20 wk, and −2.8% ± 3.7% and −2.3% ± 2.6%, respectively, from baseline to 36 wk. There was a significant difference in the accuracy of BIA in detecting %BF changes compared with ADP in women but not men on a group level. However, on an individual level, there was greater variation in BIA's accuracy in tracking %BF changes in both sexes. Compared with ADP, BIA is a suitable method for detecting %BF changes in a group of overweight men, but not women. However, caution should be exercised when using BIA to track body composition changes in either sex on an individual level.
Background:
There is little evidence regarding the association of body mass index (BMI) with postoperative mortality after craniotomy, especially in the Asian population. Our study aimed to explore the association between BMI and postoperative 30-day mortality in Chinese patients undergoing craniotomy for brain tumor resection.
Methods:
This large retrospective cohort study, Supplemental Digital Content 9, http://links.lww.com/JNA/A634 collected data from 7519 patients who underwent craniotomy for brain tumor resection. On the basis of the World Health Organization obesity criteria for Asians, included patients were categorized as underweight (<18.5 kg/m2), normal weight (18.5 to 22.9 kg/m2), overweight (23to 24.9 kg/m2), obese I (25 to 29.9 kg/m2), and obese II (≥30 kg/m2). We used a multivariable logistic regression model to explore the association between different BMI categories and 30-day postoperative mortality. In addition, we also conducted stratified analyses based on age and sex.
Results:
Overweight (adjusted odds ratio 0.63, 95% CI 0.40-0.99) and obese I (adjusted odds ratio 0.44, 95% CI 0.28-0.72) were associated with decreased 30-day postoperative mortality compared with normal-weight counterparts. Such associations were prominent among younger (age younger than 65 y) patients but not older patients, and there was an interaction between age and overweight versus normal weight on mortality (P for interaction=0.04).
Conclusions:
We found that among Chinese patients undergoing craniotomy for brain tumors, there was a J-shaped association between BMI and postoperative 30-day mortality, with lowest mortality at 27 kg/m². Moreover, in young patients, overweight and obese I were both associated with decreased risk of 30-day mortality.
Background:
Obesity is a public health issue worldwide. Conversational agents (CAs), also frequently called chatbots, are computer programs that simulate dialogue between people. Owing to better accessibility, cost-effectiveness, personalization, and compassionate patient-centered treatments, CAs are expected to have the potential to provide sustainable lifestyle counseling for weight management.
Objective:
This systematic review aimed to critically summarize and evaluate clinical studies on the effectiveness and feasibility of CAs with unconstrained natural language input for weight management.
Methods:
PubMed, Embase, the Cochrane Library (CENTRAL), PsycINFO, and ACM Digital Library were searched up to December 2022. Studies were included if CAs were used for weight management and had a capability for unconstrained natural language input. No restrictions were imposed on study design, language, or publication type. The quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool or the Critical Appraisal Skills Programme checklist. The extracted data from the included studies were tabulated and narratively summarized as substantial heterogeneity was expected.
Results:
In total, 8 studies met the eligibility criteria: 3 (38%) randomized controlled trials and 5 (62%) uncontrolled before-and-after studies. The CAs in the included studies were aimed at behavior changes through education, advice on food choices, or counseling via psychological approaches. Of the included studies, only 38% (3/8) reported a substantial weight loss outcome (1.3-2.4 kg decrease at 12-15 weeks of CA use). The overall quality of the included studies was judged as low.
Conclusions:
The findings of this systematic review suggest that CAs with unconstrained natural language input can be used as a feasible interpersonal weight management intervention by promoting engagement in psychiatric intervention-based conversations simulating treatments by health care professionals, but currently there is a paucity of evidence. Well-designed rigorous randomized controlled trials with larger sample sizes, longer treatment duration, and follow-up focusing on CAs' acceptability, efficacy, and safety are warranted.
Amaç: Bu araştırmayla genç yetişkinlerin obeziteye ve olası stigmaya ilişkin bilgi, tutum ve yaklaşımlarının derinlemesine görüşmeler ile niteliksel olarak ortaya konması amaçlanmıştır. Gereç ve Yöntem: Araştırmada yarı-yapılandırılmış soru rehberi ile derinlemesine görüşme yöntemi uygulanmıştır. Araştırmaya sağlık çalışanı olmayan genç yetişkinler (18-35 yaş) gönüllülük esasıyla dahil edilmiştir. Görüşmeler Mayıs 2021’de çevrimiçi olarak gerçekleştirilmiştir. Toplam 10 katılımcıyla görüşme yapılmıştır.Yapılan görüşmelerin transkriptlerinin tamamlanmasının ardından görüşmeleri yapan araştırmacılar tarafından Atlas.ti programı ile fenomenolojik analiz yapılarak kod listesi oluşturulmuş, elde edilen kodlara göre ana temalar ve alt temalar oluşturulmuştur. Bulgular: Araştırmaya katılanların beşi erkek beşi kadın olup yaş ortalaması 32,9’dur. Katılımcıların yarısından fazlası obezitenin tanımına ilişkin gerçeğe yakın bilgiye sahipti. Katılımcıların yarısı obez bireylerin arkadaşlık ilişkilerinin obezitesinden etkilenmediğini ancak çoğunluğu romantik ilişkilerinin etkilendiğini düşünmekteydi. Katılımcıların çoğunluğu obez bireylerde özgüven eksikliği olduğunu düşünmekteydi. Katılımcıların neredeyse tamamı obez bireylerin fiziksel güç gerektiren işlerde zorlanacağını ve neredeyse yarısı obez bireylere masabaşı bir iş vereceklerini söylemiştir. Çoğunluk obezitenin hiçbir avantajının olmadığını yalnızca bir katılımcı askere gitmemenin, bir katılımcı cinsel tacizi önlemenin ve bir katılımcı çocuklukta heybetli durmanın avantaj olabileceği görüşündeydi. Katılımcılarıda ailenin sağlıksız beslenmeye yönlendirmesinin ve toplumun yemek kültürünün obeziteye etkisi olduğunu ifade etmiştir. Katılımcıların çoğunluğu obez erkeklerin daha az stigmatize edildiğini, kadınların ise bir kalıba sokulmaya çalışıldığını belirtmiştir. Obeziteye yönelik stigmatizasyonun aşılması için katılımcıların yarısından fazlası toplumun eğitimi ve bilinçlendirilmesi gerektiğini belirtmiştir. Sonuç ve Öneriler: Obez bireylerin eğitim ve çalışma hayatında diğer herkesle eşit fırsatlara ulaşabilmesi önemlidir. Eğitim kurumlarının ve medyanın desteği ile obezite farkındalığı arttırılarak stigmanın önüne geçilebilir.
Objectives:
Despite evidence that sleep duration affects adolescent health, there remain important research gaps in the literature. Little is known about (1) whether the association between weekday sleep duration and health is confounded by unobserved individual heterogeneity and (2) the extent to which weekend catch-up sleep (WCS) duration moderates this association. This study addresses these gaps.
Study design:
Using six waves of longitudinal data from the 2011-2016 Korean Children and Youth Panel Survey (N = 6633), this study examined the relationship between weekday sleep duration, WCS duration, and two measures of adolescent health, body mass index (BMI) and self-rated health (SRH).
Methods:
We estimated fixed effects models to account for individual-level heterogeneity.
Results:
Fixed effects estimates suggest that part of the associations between short sleep duration and adolescent health are confounded by unobserved individual heterogeneity (62% for BMI and 30% for poor SRH), although the associations remain statistically significant. Sleeping less than 6 h increased BMI by 0.203 and the probability of reporting poor SRH by about 2 percentage points. Controlling for individual heterogeneity, however, changed the sign of the WCS duration coefficient, suggesting that a longer WCS duration is positively associated with BMI (b = 0.021). No such patterns were found for SRH.
Conclusions:
Short weekday sleep duration threatens adolescent health. WCS duration is protective only for those who are most sleep deprived.
The World Mental Health Surveys were established by the World Health Organization in 2000 to provide valuable information for physicians and health policy planners. These surveys have shed light on the prevalence, correlates, burden, and treatment of mental disorders in countries throughout the world. This volume focuses on the epidemiology of coexisting physical and mental illness around the world. This book includes surveys from 17 discrete countries on six continents, covering epidemiology, risk factors, consequences, and implications for research, clinical work, and policy. Many physical and mental illnesses share a relationship with one another and often occur simultaneously. Clinicians from the disciplines of both psychiatry and medicine are increasingly faced with both challenges on a daily basis, making this an ideal book for a wide range of health professionals. This is the first book devoted to this topic on such a wide-ranging scale.
Background and Objectives: Many studies have well documented that there is a positive association between body mass index and systolic blood pressure as well as body mass index and diastolic blood pressure. The present study examines body mass index and blood pressure in two Arunachal Monpa populations namely the Dirang (low altitude population) and Tawang (high altitude population) Monpa. Material and Methods: Healthy, 303 adult Dirang (Male: 146, Female: 157) and 472 Tawang (Male: 210, Female: 262) Monpa were randomly selected. The body mass index cut-off value for Asian people was considered as recommended by the WHO expert group (WHO 2000). While blood pressure values were classified according to the WHO expert committee (WHO 1996). Results: This study reveals a positive relationship between body mass index and blood pressure. Mean SBP and DBP both were considerably higher among the Dirang than that of the Tawang Monpa. Blood pressure values were correlated more with body mass index among the Tawang Monpa than their counterparts. Conclusion: Present study is indicative of altitudinal stresses on biological traits in highlander Tawang Monpas than that of the Dirang Monpas.
Re-aligning eating patterns with biological rhythm can reduce the burden of metabolic syndrome in older adults with overweight or obesity. Time-restricted eating (TRE) has been shown to result in weight loss and improved cardiometabolic health while being less challenging than counting calories. The New York Time-Restricted EATing study (NY-TREAT) is a two-arm, randomized clinical trial (RCT) that aims to examine the efficacy and sustainability of TRE (eating window ≤10 h/day) vs. a habitual prolonged eating window (HABIT, ≥14 h/day) in metabolically unhealthy midlife adults (50–75 years) with overweight or obesity and prediabetes or type 2 diabetes (T2D). Our primary hypothesis is that the TRE will result in greater weight loss compared to HABIT at 3 months. The efficacy of the TRE intervention on body weight, fat mass, energy expenditure, and glucose is tested at 3 months, and the sustainability of its effect is measured at 12 months, with ambulatory assessments of sleep and physical activity (ActiGraph), eating pattern (smartphone application), and interstitial glucose (continuous glucose monitoring). The RCT also includes state-of-the-art measurements of body fat (quantitative magnetic resonance), total energy expenditure (doubly-labelled water), insulin secretion, insulin resistance, and glucose tolerance. Adherence to self-monitoring and reduced eating window are monitored remotely in real-time. This RCT will provide further insight into the effects of TRE on cardiometabolic health in individuals with high metabolic risk. Sixty-two participants will be enrolled, and with estimated 30% attrition, 42 participants will return at 12 months. This protocol describes the design, interventions, methods, and expected outcomes.
Clinical trial registration: NCT04465721
IRB: AAAS7791.
Few studies have identified barriers to creating a home environment more supportive of healthy eating. We examined barriers faced by participants in a randomized controlled trial and an adaptation study of the Healthy Homes/Healthy Families intervention, which uses health coaches to support low-income families in creating healthier home food environments. Coaches maintained logs of participant interactions as part of a process evaluation. We thematically analyzed logs from interactions with participants, mostly lower-income African American women (n = 114), to identify barriers for each of 8 healthy actions that serve as core elements of the intervention. Difficulty of changing current habits was a barrier for 5 of the healthy actions. No time/convenience and limited family support each influenced 2 of the healthy actions, with interpersonal barriers also stemming from social situations and visitors, including grandchildren. Cost and economic challenges were barriers for 3 of the actions. Hunger, cravings, and limited access to resources (eg, transportation, fresh fruits and vegetables) were each noted as barriers for 1 healthy action. Overall, these findings provide insight for how to better support families who are trying to improve their home food environments and highlight the need for multilevel interventions.
Background
The main adverse effect is gastroesophageal reflux disease (GERD), with concern on the development of Barrett's esophagus and esophageal adenocarcinoma in the long term. However, the relationship between SG and GERD is complex. The aim of this study is to systematically evaluate all published data existing in the literature to evaluate the effect of sleeve gastrectomy on GERD, esophagitis, BE in order to clarify the long-term clinical sequelae of this procedure.
Materials and methods
This systematic review was conducted in accordance with the guidelines for Preferred Reporting Items for Systematic Review. The work has been reported in line with the PRISMA criteria [19]. We evaluated the quality and risk of bias of this Systematic Review using AMSTAR 2 checklist [20]. Published studies that contained outcome data for primary sleeve gastrectomy associated with the primary and secondary outcomes listed below were included. The UIN for ClinicalTrial.gov Protocol Registration and Results System is: NCT05178446 for the Organization UFoggia.
Results
49 articles were eligible for inclusion that met the following criteria: publications dealing with patients undergoing laparoscopic SG, publications describing pre- and postoperative GERD symptoms and/or esophageal function tests, articles in English, human studies and text complete available.
Conclusions
We have controversial data on LSG and GERD in the literature as there is a multifactorial relationship between LSG and GERD. The most recent studies have shown satisfactory control of postoperative reflux in most patients and low rates of de novo GERD. These data are leading to wider acceptance of LSG as a bariatric procedure even in obese patients with GERD.
Background
A portion of the human genome is characterized by long non-coding RNAs (lncRNAs), a class of non-coding RNA longer than 200 nucleotides. Recently, the development of new biomolecular methods, made it possible to delineate the involvement of lncRNAs in the regulation of different biological processes, both physiological and pathological, by acting within the cell with different regulatory mechanisms based on their specific target. To date, obesity is one of the most important health problems spread all over the world, including the child population: the search for new potential early biomarkers could open the doors to novel therapeutic strategies useful to fight the disease early in life and to reduce the risk of obesity-related co-morbidities.
Objective
This review highlights the lncRNAs involved in obesity, in adipogenesis, and lipid metabolism, particularly in lipogenesis.
Conclusion
LncRNAs involved in adipogenesis and lipogenesis, being at the cross-road of obesity, should be deeply analysed in this contest, allowing to understand possible causative actions in starting obesity and whether they might be helpful to treat obesity.
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