A two-year study of parental obesity status and childhood obesity in China

Background and aims

We evaluated the association between parental obesity and their children's obesity parameters [e.g., percentage of body fat (PBF)] over time.

Reward processing in obesity,substance addiction and non‐substance addiction

Similarities and differences between obesity and addiction are a prominent topic of ongoing research. We conducted an activation likelihood estimation meta‐analysis on 87 studies in order to map the functional magnetic resonance imaging (fMRI) response to reward in participants with obesity, substance addiction and non‐substance (or behavioural) addiction, and to identify commonalities and differences between them. Our study confirms the existence of alterations during reward processing in obesity, non‐substance addiction and substance addiction. Specifically, participants with obesity or with addictions differed from controls in several brain regions including prefrontal areas, subcortical structures and sensory areas. Additionally, participants with obesity and substance addictions exhibited similar blood‐oxygen‐level‐dependent fMRI hyperactivity in the amygdala and striatum when processing either general rewarding stimuli or the problematic stimuli (food and drug‐related stimuli, respectively). We propose that these similarities may be associated with an enhanced focus on reward – especially with regard to food or drug‐related stimuli – in obesity and substance addiction. Ultimately, this enhancement of reward processes may facilitate the presence of compulsive‐like behaviour in some individuals or under some specific circumstances. We hope that increasing knowledge about the neurobehavioural correlates of obesity and addictions will lead to practical strategies that target the high prevalence of these central public health challenges.     

Tri-Ponderal Mass Index vs body Mass Index in discriminating central obesity and hypertension in adolescents with overweight

Background and aimsRecently, it has been hypothesized that Tri-Ponderal Mass Index (TMI) may be a valid alternative to Body Mass Index (BMI) when measuring body fat in adolescents. We aimed to verify whether TMI has better accuracy than BMI in discriminating central obesity and hypertension in adolescents with overweight.Methods and ResultsThis monocentric and retrospective cross-sectional study included 3749 pupils, 1889 males and 1860 females, aged 12–13. BMI (kg/m²) was calculated and expressed as percentiles and as z-scores. TMI (kg/m³) was calculated, and we used pre-defined cut-off previously proposed by Peterson et al.. For central obesity we adopted the Waist-to-Height Ratio (WHtR) discriminatory value of 0.5. Hypertension was defined as blood pressure ≥95th percentile of age- sex-, and height-specific references recommended by NHBPEP Working Group. The discriminant ability of TMI, BMI and BMI z-score, with respect to central obesity and hypertension, was investigated using non-parametric receiver operating characteristic analysis.The overall misclassification rate for central obesity was 8.88% for TMI vs 14.10% for BMI percentiles and vs 14.92% for BMI z-scores (P < 0.001). The overall misclassification rate for hypertension was 7.50% for TMI vs 22.03% for BMI percentiles and vs 25.19% for BMI z-scores (P < 0.001).ConclusionTMI is a superior body fat index and it could discriminate body fat distribution more accurately than BMI. This supports the use of TMI, in association with WHtR, to characterize adolescents with overweight and high cardio-metabolic risk. Our analysis needs to be extended to other ethnic groups and replicated in a wider age range and in longitudinal studies.     

体重下降对肥胖人群血脂的影响

目的:评价控制体重和体重指数对血脂的影响。方法:55例体重超标、高血脂、愿意降低体重的自愿参加者,在26周内通过控制饮食和锻炼降低体重。结果:研究过程中所有患者通过适量的体育锻炼和节食后,其体重和体重指数,以及血脂均有下降。在男性患者中,胆固醇下降水平与体重和体重指数下降密切相关。女性患者的胆固醇降低较男性患者更多,体重和体重指数下降较男性患者少,组间有显著性差异。结论:超重者通过锻炼身体和合理节食可以明显降低体重、体重指数和血脂水平。     

The association of metabolic health obesity with incidence of carotid artery plaque in Chinese adults

Background and aimsWe aimed to evaluate the association between different obese phenotypes with carotid artery plaque (CAP) event.Method and resultsThe current retrospective cohort study was performed in 32,778 Chinese adults (19,221 men and 13,557 women, aged 41.9 ± 11.0 years). Obese phenotypes were assessed based on baseline body mass index (<24.0 vs. ≥24.0 kg/m²) and metabolic characteristics (health vs. unhealth). All the participants were further classified into four groups: metabolic health and normal weight (MHNW), metabolic unhealth and normal weight (MUHNW), metabolic health and overweight (MHO), and metabolic unhealth and overweight (MUHO). Ultrasound B-mode imaging was annually performed to evaluate CAP throughout the study. We have identified 2142 CAP cases during 5-year follow-up. Comparing with the MHNW group, the hazard ratios for the risk of incident CAP was 2.44 (95% CI:1.92 and 3.09) for the MUHNW group, 1.52 (95% CI:1.06 and 2.18) for the MHO group, and 1.8 (95% CI:1.4 and 2.33) for the MUHO group. The association was more pronounced in young adults (<65 y) than that in aged adults (≥65 y). Sensitivity analysis generated similar results with the main analysis.ConclusionMUHNW, MHO, and MUHO were associated with the risk of CAP.     

Prevalence of obesity in 6- and 9-year-old children living in Central-North Italy. Analysis of determinants and indicators of risk of overweight.

The objective of our article is to survey the prevalence of overweight and obesity among 6- and 9-year-old children in Emilia-Romagna, a region of Central-North Italy, and to study the eating habits and behaviours of these children and their families. During 2003 and 2005, we analysed a stratified sample of the general population of children attending pre-school (2681 children aged 6 years) and primary school (2955 children aged 9 years). Their height and weight were measured by healthcare workers. In the 6-year-old children, information concerning their eating habits was collected by means of a questionnaire completed by their parents. The prevalence of overweight was 16.5% in 6-year-old children and 20.6% in 9-year-old children. The increase of overweight from 6- to 9-year-old children was observed in males (13.5% in 6-year-old/21.3% in 9-year-old boys), but not in females. The prevalence of obesity was 8.9% in children aged 6 years and 9.0% in those aged 9 years, and it was higher in comparison with Italian surveys carried out in 1993 and in 2001: 7.5% in 6-year-old and 7.8% in 9-year-old children in 1993, and 6.6% in 6-year-old and 7.2% in 9-year-old children in 2001. In pre-school children, overweight and obesity were closely influenced by the education level, occupation and nutritional status of the parents.     

Prevalence of obesity among schoolchildren in Iran

The prevalence of overweight and obesity among schoolchildren aged 6.5-11.5 years in Shiraz (southern Iran) are presented in this paper. The body mass index (BMI) percentiles of these children are compared with the Center for Disease Control and Prevention (CDC) reference data and with the Iranian standard. The data are based on a random multistage sample survey of 2397 healthy school attenders (1268 boys, 1129 girls) living in Shiraz, whose heights and weights were measured in the 2002-2003 academic year. Joint height and weight measurements were obtained for 2195 schoolchildren (91.6%), consisting of 1138 boys (89.7%) and 1057 girls (93.6%). A total of 77 boys (6.8%) and 40 girls (3.8%) were overweight, and the difference between them was significant (P = 0.001). However, obesity was significantly less prevalent in boys (3.3%) than in girls (6.1%) (P = 0.001). Our children's median BMI lie almost on the 38th centile of the CDC reference data, whereas that of their counterparts born more than 10 years ago lay on the 20th centile of their American counterparts, showing the development of children's obesity in a period of less than 15 years in Iran. A positive secular trend in BMI has been seen during the past decade in Iran, suggesting policymakers and health professionals should pay special attention to children's health.     

Relationship Between Asthma Severity and Obesity

The prevalence of both obesity and asthma has risen in recent years. We sought to investigate whether obesity may be related to asthma. We undertook a retrospective medical record review of patient records at an inner‐city academic asthma center. Obesity was defined as a body mass index (BMI) greater than 30. Asthma severity was defined by using the National Heart Lung and Blood Institute 1997 guidelines. Adults with a history of cigarette smoking or other lung disease were excluded. A total of 143 individuals aged 18–88 with a mean age of 43.9 met the entry criteria. There were 113 females and 30 males. Seventy‐two percent of the sample was obese. The Spearman correlation coefficient showed a linear relationship between asthma severity and BMI (r = 0.40, p < 0.0001). Females with asthma were significantly more overweight than males, mean BMI 35.9 vs. 32.14, respectively (p = 0.01). The prevalence of obesity in the 13 patients on long‐term oral corticosteroids was 100%. Prevalence of obesity increases with increasing asthma severity in adults. The association of asthma severity with obesity suggests that obesity may be a potentially modifiable risk factor for asthma or asthma‐like symptoms.     

Obesity,intentional weight loss and physical disability in older adults

We examine obesity, intentional weight loss and physical disability in older adults. Based on prospective epidemiological studies, body mass index exhibits a curvilinear relationship with physical disability; there appears to be some protective effect associated with older adults being overweight. Whereas the greatest risk for physical disability occurs in older adults who are ≥class II obesity, the effects of obesity on physical disability appears to be moderated by both sex and race. Obesity at age 30 years constitutes a greater risk for disability later in life than when obesity develops at age 50 years or later; however, physical activity may buffer the adverse effects obesity has on late life physical disability. Data from a limited number of randomized clinical trials reinforce the important role that physical activity plays in weight loss programmes for older adults. Furthermore, short‐term studies have found that resistance training may be particularly beneficial in these programmes as this mode of exercise attenuates the loss of fat‐free mass during caloric restriction. Multi‐year randomized clinical trials are needed to examine whether weight loss can alter the course of physical disablement in aging and to determine the long‐term feasibility and effects of combining resistance exercise with weight loss in older adults.     

Validation of mid-upper-arm-circumference cut-offs for assessment of overnutrition in Indian children and adolescents with type 1 diabetes

AimsMid upper arm circumference (MUAC) measurement is an easy and low-cost method to determine nutritional status. MUAC cut-offs for screening for overnutrition in Indian children from 5 to 17 years age are recently published. We conducted this study to validate MUAC cut-offs against BMI to screen overnutrition in children with T1D in comparison with age-gender-matched healthy controls and to compare the predictive value of BMI and MUAC to assess adiposity.MethodologyThis cross sectional, observational study included 249 children and adolescents (5–17 years) with T1D attending a pediatric endocrine clinic along with same number of age and gender matched healthy controls. Demographic, anthropometric and body composition data were obtained using standardized protocols and questionnaires.ResultsThe co-relation between MUAC with BMI was significant for cases and controls and percent body fat with MUAC and BMI in T1D(r = 0.854,0.917 and 0.546,0.616). The AUC of MUAC to identify obesity based on BMI cut-offs for cases and controls and of BMI and MUAC for adiposity were similar(0.745,0.918 and 0.867,0.814). Sensitivity, specificity and PPV were significantly higher in controls than in cases.ConclusionMUAC is an accurate method to identify obesity and adiposity in T1D thereby reducing the risk of development of double diabetes.     

Impact of body mass index on survival of esophageal squamous carcinoma patients in southern China

Background

Although high body mass index (BMI) increases risk for developing esophageal adenocarcinoma (EAC), the prognostic influence of BMI is unknown in esophageal squamous carcinoma.

Methods

BMI was calculated using measured height and weight at the first diagnosis and categorized as overweight (25 to 29.9 kg/m²), normal (18.5 to 24.9 kg/m²) or underweight (<18.5 kg/m²). Survival was compared by using the log-rank test on the Kaplan-Meier life table. Multivariate Cox regression analysis was used to evaluate whether BMI was an independent prognostic factor for disease-specific survival (DSS).

Results

Among 1,176 esophageal squamous carcinoma patients, 146 (12.4%) were categorized as overweight, and 277 (23.6%) underweight. More patients in the underweight group had anemia (P=0.001), weight loss (P=0.035) and R1 resection (P<0.001). Less patients in the underweight group received adjuvant chemotherapy (P=0.01). Patients in the overweight group had a higher incidence rate of high blood pressure (P<0.001), diabetes (P<0.001) and coronary artery diseases (P<0.001). Moreover, more patients in the overweight group had a lower TNM stage (P=0.003). In the univariated analysis, high BMI was significantly associated with better DSS (P=0.013).

Conclusions

After adjusting for covariates enrolled for study, high BMI was an independent prognostic factor in weight loss esophageal squamous carcinoma patients.     

The relationship between ultraprocessed food consumption and obesity indicators in Iranian adults

Background and aimsFood processing changes the nature of foods, and it is growing globally due to its availability and affordability and its effects on the palatability of foods. Consumption of ultraprocessed foods (UPFs) may adversely affect weight gain.The purpose of the current study is to examine the association between UPFs consumption and adiposity among Iranian adults.Methods and resultsA cross-sectional study was conducted on 1459 Iranian adults (≥19 years). Dietary intakes were assessed using a validated 136-item food frequency questionnaire (FFQ), and foods were classified based on the NOVA system. Overweight, obesity, and abdominal obesity were defined as body mass index (BMI) ≥25 and < 30, ≥30, respectively, and waist circumference (WC) ≥91 for women and WC ≥ 89 for men. The odds of general and abdominal obesity across the quartiles of UPFs were assessed by binary logistic regression.UPFs consumption contributed to 20.17% of daily energy intake. After adjustment for potential confounders, UPFs consumption was not associated with general or abdominal obesity. However, in the fully adjusted model, men in the top quartile of UPFs were twice as likely to be overweight compared with those in the bottom quartile (OR = 2.06, 95% CI: 1.03, 4.10; P = 0.047). No association was found in women or stratified analysis by age.ConclusionThe present findings suggest a sex-specific association between UPFs consumption and overweight. UPFs consumption might be associated with an increased risk of overweight in men, but no such association was found in women. Future cohort studies are required to confirm these results.     

A comparative research on obesity hypertension by the comparisons and associations between waist circumference,body mass index with systolic and diastolic blood pressure,and the clinical laboratory data between four special Chinese adult groups

Background: The obesity-hypertension pathogenesis is complex. From the phenotype to molecular mechanism, there is a long way to clarify the mechanism. To explore the association between obesity and hypertension, we correlate the phenotypes such as the waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), and diastolic blood pressure (DB) with the clinical laboratory data between four specific Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group), and the results may show something. Objective: To explore the mechanisms from obesity to hypertension by analyzing the correlations and differences between WC, BMI, SB, DB, and other clinical laboratory data indices in four specific Chinese adult physical examination groups. Methods: This cross-sectional study was conducted from September 2012 to July 2014, and 153 adult subjects, 34 women and 119 men, from 21 to 69 years, were taken from four characteristic Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group). The study was approved by the ethics committee of Hangzhou Center for Disease Control and Prevention. WC, BMI, SB, DB, and other clinical laboratory data were collected and analyzed by SPSS. Results: Serum levels of albumin (ALB),alanine aminotransferase (ALT), low density lipoprotein cholesterol (LDLC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), alkaline phosphatase (ALP), uric acid (Ua), and TC/HDLC (odds ratio) were statistically significantly different between the four groups. WC statistically significantly positively correlated with BMI, ALT, Ua, and serum levels of glucose (GLU), and TC/HDLC, and negatively with ALB, HDLC, and serum levels of conjugated bilirubin (CB). BMI was statistically significantly positively related to ALT, Ua, LDLC, WC, and TC/HDLC, and negatively to ALB, HDLC, and CB. DB statistically significantly positively correlated with ALP, BMI, and WC. SB was statistically significantly positively related to LDLC, GLU, serum levels of fructosamine (FA), serum levels of the total protein (TC), BMI, and WC. Conclusion: The negative body effects of obesity are comprehensive. Obesity may lead to hypertension through multiple ways by different percents.

GGT, serum levels of gamma glutamyltransferase; ALB, serum levels of albumin; ALT, serum levels of alanine aminotransferase; LDLC, serum levels of low density lipoprotein cholesterol; TG, serum levels of triglyceride; HDLC, serum levels of high density lipoprotein cholesterol; FA, serum levels of fructosamine; S.C.R, serum levels of creatinine; IB, serum levels of indirect bilirubin; ALP, serum levels of alkaline phosphatase; CB, serum levels of conjugated bilirubin; UREA, Urea; Ua, serum levels of uric acid; GLU, serum levels of glucose; TC, serum levels of the total cholesterol; TB, serum levels of the total bilirubin; TP, serum levels of the total protein; TC/HDLC, TC/HDLC ratio.     

Study of serum insulin levels in patients of euglycemic essential hypertension: A cross sectional study in North Indian population

ObjectiveEssential hypertension is associated with multiple metabolic abnormalities, among them one of the most important is hyperinsulinemia. Hyperinsulinemia has been suggested as being responsible for the increased arterial pressure in patients with essential hypertension. But this is contradicted by the finding that all patients of essential hypertension are not hyperinsulinemic.The present study was conducted to explore the hypothesis that hyperinsulinemia plays a pathogenic role in hypertension in euglycemic North Indian population.Methods and materials120 subjects were studied (60 hypertensive and 60 normotensive). Blood pressure, fasting insulin levels, lipid profile and BMI were calculated for both the groups. Statistical analysis was done using online statistical software freely at www.openepi.com.ResultsHypertensive subjects were characterized by increased fasting insulin levels (16.77 ± 7.62 vs. 8.84 ± 2.04 μIU/ml, p < 0.01), increased BMI (p < 0.01) and dyslipidemia, i.e. increased total cholesterol, high serum triglycerides, high LDL-C and low HDL-C with p < 0.01. There was a positive correlation of fasting insulin levels with BMI, total cholesterol and LDL-C (p < 0.01) and a negative correlation with HDL-C (p < 0.05). However, serum insulin levels showed a non significant correlation with mean systolic and mean diastolic blood pressure (p > 0.05).ConclusionsOur study showed a significant increase in serum insulin levels in hypertensive patients thereby supporting a possible pathogenic role of insulin resistance in onset of hypertension even when the fasting blood sugar is within normal limits.     

城市居民体重指数与糖尿病和糖耐量低减关系的研究

目的 分析南宁市城市居民体重指数（BMI）与糖尿病（DM）发病的关系。方法 对南宁市样本区随机抽取5个街道社区（居委会）810户，每户抽取年龄在35-74岁的居民1人，共810人。分别检测体重、体重指数（BMI）、餐后12h空腹血糖（FPC）；按DM糖耐量低减（IGT）诊断标准分别计算各组的患病率并对照比较。结果 DM患病率以65-74岁组最高，达14．56％；IGT患病率以55-64岁组最高，达16．28％；BMI肥胖组DM、IGT患病率均比正常体重组高，分别高出8．49％及14．48％；不同性别DM、IGT患病率无明显差异。结论 南宁市城市居民DM与IGT的患病情况与年龄呈正比关系，提示超重和肥胖是DM的重要危险因素之一；DM及IGT在南宁市城市居民中已占有相当大的比例。     

Prevalence of obesity in Canada

Excess weight represents a critical and common health problem in Canada. The last survey of a national representative sample based on measured anthropometrics has been conducted in 1992. According to surveys using measured data, the prevalence of obesity (body mass index, BMI = 30.0 kg m(-2)) between 1970 and 1992 for those aged 20-69 years increased from 8% to 13% in men and 13% to 15% in women. The proportion of Canadians displaying a BMI > or =25.0 kg m(-2) increased from 47% to 58% in men and from 34% to 41% in women in the same period. The most recent prevalence estimates from self-reported data in a national representative sample indicated that 15% of the adult population (> or =18 years) was affected by obesity, while an additional 33% was classified in the overweight category (BMI 25.0-29.9 kg m(-2)) in 2003. However, it has been suggested that self-reported height and weight underestimate the prevalence of obesity by approximately 10%. Canadian children, aboriginal populations, and immigrants are some of the vulnerable groups particularly at risk of excess weight or for which the increase in the recent decades has been greater than the national increase. The increases in overweight and obesity over the past 30 years among Canadians have been dramatic. It will be possible to precisely analyse the current situation and its evolution in the last 10 years when data based on measured height and weight will be released, that is, in 2005 and after.     

Depressive symptom clusters are differentially associated with general and visceral obesity

OBJECTIVES: To examine the relationship between obesity and depressive symptoms taking into account different measures for obesity (body mass index (BMI), waist circumference (WC), and waist‐to‐hip ratio (WHR)) and different depressive symptom clusters. DESIGN: Cross‐sectional population‐based survey. SETTING: Baseline data of the Nijmegen Biomedical Study. PARTICIPANTS: One thousand two hundred eighty‐four persons aged 50 to 70. MEASUREMENTS: Obesity (BMI, WC, and WHR) and depressive symptoms were measured, the latter using the Beck Depression Inventory (BDI). Principal components analysis of the BDI items yielded two factors, one representing a cognitive‐affective symptom cluster and the other a somatic‐affective symptom cluster. Multiple regression analyses corrected for confounders were conducted for each measure of obesity, with separate models testing the BDI sum score and the depression symptom clusters. RESULTS: BMI was significantly associated with BDI sum score (β=0.12, P<.001) and the cognitive‐ (β=0.08, P=.008) and somatic‐affective symptom clusters (β=0.10, P=.001). WC (β=0.11, P<.001) and WHR (β=0.07, P=.004) were specifically associated with the somatic‐affective symptom cluster. CONCLUSION: Visceral obesity, which is more indicative of vascular risk than BMI, is specifically associated with somatic‐affective depressive symptom cluster, which might suggest that these symptoms are primarily due to a (subclinical) somatic condition.     

Body mass index,waist circumference,body fat mass,and risk of developing hypertension in normal-weight children and adolescents

Background and aims

We prospectively examined the association between three adiposity indices, including body mass index (BMI), waist circumference (WC), and percentage of body fat (PBF), and risk of hypertension in normal-weight Chinese children.

Identification of U-shaped curve relation between proneurotensin and risk of coronary artery disease (CAD) in patients with premature CAD

Background and aimsNeurotensin (NT) is a gut hormone with broad effects on the cardiovascular system. Recent data suggested that circulating proneurotensin (pro-NT)—the stable precursor fragment of NT—could independently predict cardiovascular artery disease (CAD) development. However, serum pro-NT levels in patients with premature cardiovascular artery disease (PCAD) are still unknown. This study aims to determine serum pro-NT levels in patients with PCAD and investigate its relationship with PCAD risk.Methods and resultsA total of 490 subjects, including 364 with PCAD and 126 without PCAD (NPCAD), and 182 controls were enrolled in the study. Data of baseline clinical parameters and biochemical variables were collected. Serum pro-NT levels were measured by ELISA.Serum pro-NT levels were higher in patients with PCAD than in controls (59.42 ± 66.66 vs. 38.07 ± 48.48 pg/mL, P < 0.05), especially in patients with BMI<25 kg/m². Serum pro-NT levels were independently related to PCAD (β = 0.349, P < 0.001), and the association revealed a U-shaped curve characteristic between pro-NT tertiles and CAD risk in patients with premature CAD and controls. Subjects with low and high tertiles of pro-NT levels had 1.79-fold and 2.23-fold higher risks of PCAD, respectively, than subjects with median pro-NT levels (P < 0.05). After adjusting for age, gender, and BMI in Model 1 and other confounders in Model 2 and Model 3, the U-shaped relationship remained significant.ConclusionSerum pro-NT levels were significantly increased in patients with PCAD. The association between pro-NT levels and PCAD risk presents a U-shaped curve characteristic, which demonstrated that subjects with lower and higher pro-NT levels both were more likely to have PCAD.     

The effects of body mass index on surface electrocardiograms in young adults

Introduction

While BMI is known to affect ECG measurements, these effects have not been well characterized in young adults.

Methods

We retrospectively reviewed all ECGs performed in adults 18 to 35 years old at a single institution over a 30 year period. ECG measurements were derived electronically and stratified by WHO BMI category.

Results

A total of 55,218 ECGs were included. Increasing BMI led to increased P wave duration and decreasing P, R, and T wave axes. Additionally, while increasing BMI led to less R wave voltage, J point elevation, and T wave amplitude in patients with a BMI ≥ 18.5 kg/m², there was also a decrease in the measured parameters in patients with a BMI < 18.5 kg/m².

Discussion

BMI had significant effects on ECG measurements. For accurate assessment of ECGs, these data should be incorporated into established nomograms. Further investigation into the effects of BMI on the ECG is warranted.