Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis

ObjectiveIn recent years, many original studies have shown that skipping breakfast has been associated with overweight and obesity; however, the results of different studies are inconsistent. Therefore, we conducted a systematic review and meta-analysis of observational studies to synthesize the associations between skipping breakfast and the risk of overweight/ obesity.MethodsWe did a systematic search using Pubmed, and Ovid searched up to August 2019. Observational studies (cohort studies and cross-sectional studies) reporting adjusted Odds Ratio or Risk Ratio estimates for the association between breakfast skipping and overweight/obesity (including abdominal obesity). Summary odds ratio (or Risk Ratio) and 95% confidence intervals calculated with a random-effects model.Results45 observational studies (36 cross-sectional studies and 9 cohort studies) were included in this meta-analysis. In cross-sectional studies, The ORs of low frequency breakfast intake per week versus high frequency were 1.48 (95% CI 1.40–1.57; I² = 54.0%; P = 0.002) for overweight/obesity, 1.31 (95% CI 1.17–1.47; I² = 43.0%; P = 0.15) for abdominal obesity. In cohort studies, The RR of low-frequency breakfast intake per week versus high frequency was 1.44 (95% CI 1.25–1.66; I² = 61%; P = 0.009) for overweight/obesity.ConclusionsThis meta-analysis confirmed that skipping breakfast is associated with overweight/obesity, and skipping breakfast increases the risk of overweight/obesity. The results of cohort studies and cross-sectional studies are consistent. There is no significant difference in these results among different ages, gender, regions, and economic conditions.     

Trend in the prevalence of obesity and overweight among Iranian children and adolescents: A systematic review and meta-analysis

ObjectiveChildhood obesity is an important predisposing factor for most non-communicable diseases. The aim of this review was to provide evidence on the prevalence and trends of childhood obesity and overweight in Iran.MethodsMultiple international and Iranian scientific databases were searched for relevant literatures. Two independent reviewers identified relevant papers in several steps. Separate meta-analyses (using fixed- or random-effect models) were performed to estimate the overall, age, sex, and age–sex specific prevalence of obesity and overweight. Stratified analysis based on Centers for Disease Control and Prevention, International Obesity Task Force, and World Health Organization definition criteria and study year also were performed.ResultsWe included 107 studies in the meta-analysis (49 English and 58 Persian). Based on Centers for Disease Control and Prevention definition criteria, the overall prevalence of obesity and overweight remained relatively constant in the 2000s and are estimated to be about 5.1% (95% confidence interval [CI], 4.4–5.8) and 10.8% (95% CI, 10.2–11.4), respectively. The meta-regression analysis showed that the prevalence of obesity and overweight did not vary significantly with respect to sex and age of study participants. Girls had a lower prevalence of obesity and higher prevalence of overweight than boys.ConclusionThis review, which is the first of its kind in the Middle East and North Africa, suggests that although the trend in the prevalence of childhood obesity in Iranian children is not considerably high, but the escalating trend of excess weight among young children is alarming and should be considered by providers of interventional preventive programs at national and regional levels.     

Home-based exercise for adults with overweight or obesity: A rapid review

The COVID-19 pandemic has impacted the ability of people globally to consistently engage in their typical physical activity and exercise behaviour, contributing to the rising number of people living with overweight and obesity. The imposed government lockdowns and quarantine periods saw an increase in social media influencers delivering their own home-based exercise programmes, but these are unlikely to be an evidence-based, efficacious, long-term solution to tackle sedentary behaviour and increase physical activity.This rapid review aims to conceptualise home-based exercise and physical activity programmes, by extracting relevant programme characteristics regarding the availability of evidence and effectiveness of home-based exercise programmes. Fifteen studies met the inclusion criteria, of which there were varied reports of significant positive effects of the exercise programme on weight management and related outcomes. The two most common measures were Body Mass Index and body mass, as of which almost all reported a trend of post intervention reduction. Some programmes reported qualitative data, identifying barriers to physical activity and preferred programme components, highlighting a need to consider factors outside of physiological measures.The findings provide guidance and direction for the development of future home-based physical activity and exercise programmes for adults living with overweight and obesity.     

Effect of zinc supplementation on blood sugar control in the overweight and obese population: A systematic review and meta-analysis of randomized controlled trials

BackgroundAlthough overweight and obese people have a higher risk of type 2 diabetes incidence than normal-weight individuals, the efficacy of zinc supplementation in blood sugar control in overweight and obese people remained unknown. This meta-analysis attempted to address this issue.MethodsDatabases including PubMed, Embase, and the Cochrane Library were searched from inception until May 2022 to identify randomized controlled trials (RCTs) investigating the effects of zinc supplementation among participants who were overweight or obese without language restriction. It is a random-effect meta-analysis that analyzed the impact of zinc supplementation on fasting glucose (FG) (i.e., primary outcome) and other variables including fasting insulin (FI), homeostasis model assessment-insulin resistance index (HOMA-IR), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), and 2-hour postprandial glucose (2 h- PG).ResultsAnalysis of 12 eligible RCTs involving 651 overweight/obese participants demonstrated that zinc supplementation significantly improves FG (weighted mean difference [WMD]: −8.57 mg/dL; 95% confidence interval [CI]: −14.04 to −3.09 mg/dL, p = 0.002), HOMA-IR (WMD: −0.54; 95% CI: −0.78 to −0.30, p < 0.001), HbA1c (WMD: −0.25%; 95% CI: −0.43% to −0.07%, p = 0.006), and 2 h-PG (WMD: −18.42 mg/dL; 95% CI: −25.04 to −11.79 mg/dL, p < 0.001) compared to those in the control group. After conducting subgroup analyses, we found that the primary outcome, FG, showed more significant results in the subgroups with Asia, Zinc supplementation alone, higher dose (≥30 mg) and patients with diabetes.ConclusionOur meta-analysis indicated that zinc supplementation benefits blood sugar control in overweight and obese populations, with an especially significant reduction in FG.     

2013年中国18岁及以上超重肥胖患者采取体重控制措施情况及影响因素分析

目的 了解2013年我国≥18岁超重肥胖患者采取体重控制措施情况,分析其影响因素。方法 2013年在中国慢性病及其危险因素监测的302个监测点,采用多阶段分层整群随机抽样方法调查≥18岁成年人179 570人。问卷调查获取人口学特征、采取体重控制措施情况等信息;通过体格检查获取个体的BMI、腰围和血压;采集调查对象静脉血,检测FPG、餐后2 h血糖、TC、TG、LDL-C和HDL-C。剔除关键信息缺失者152人,最终对87 545名调查对象资料进行分析。经复杂加权后分析不同特征超重肥胖患者采取体重控制措施情况及其影响因素。结果 我国≥18岁超重肥胖患者采取体重控制措施率为16.3%（95% CI：14.9%～17.7%）。在所有采取体重控制措施的12 133名患者中,采取体重控制措施的构成比例由高到低依次为：饮食（40.9%,95% CI：38.4%～43.3%）、饮食运动组合（31.5%,95% CI：28.9%～34.0%）、运动（22.8%,95% CI：21.0%～24.6%）和药物（1.3%,95% CI：1.0%～1.7%）。有利于采取体重控制措施的因素有女性（OR=1.26,95% CI：1.15～1.38）、低年龄（18～44岁,OR=1.51,95% CI：1.31～1.74）、高文化程度（大专及以上,OR=4.52,95% CI：3.76～5.43）、高年收入（2.4～万元,OR=1.94,95% CI：1.63～2.30）等;不利因素有农村（OR=0.63,95% CI：0.55～0.72）等。结论 我国超重肥胖患者采取体重控制措施率较低,且受性别、年龄、文化程度、收入水平等因素影响,应针对不同特征群体,开展针对性干预措施。     

Behavioral factors influencing childhood obesity: a systematic review and meta-analysis

BackgroundThis report provides information on 14 behavioral and nutritional factors that can be addressed in childhood overweight/obesity prevention programs.MethodsWeb of Science, PubMed, and Scopus were searched through November 2018. Reference lists were also screened for additional references. Observational studies addressing the associations between overweight/obesity in children/adolescents aged between 5 to 19 years and associated risk factors were analyzed. Between-studies heterogeneity was assessed by χ², τ², and I² statistics. The likelihood of publication bias was evaluated using the Begg and Egger tests and trim & fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.ResultsOf 34,537 retrieved studies, 199 including 1,636,049 participants were eligible. The ORs (95% CI) of factors associated with childhood overweight/obesity were as follows: sufficient physical activity 0.70 (0.66, 0.75); eating breakfast every day 0.66 (0.59, 0.74); sufficient consumption of fruits/vegetables 0.92 (0.84, 1.01); breastfeeding <4 months 1.24 (1.16, 1.33); inadequate sleep 1.26 (1.13, 1.40); watching TV >1–2 h/day 1.42 (1.35, 1.49); playing computer games >2 h/day 1.08 (0.95, 1.23); eating sweets ≥3 times/week 0.78 (0.71, 0.85); eating snack ≥4 times/week 0.84 (0.71, 1.00); drinking sugar-sweetened beverages ≥4 times/week 1.24 (1.07, 1.43); eating fast-food ≥3 times/week 1.03 (0.89, 1.18); eating fried-food ≥3 times/week 1.09 (0.90, 1.33); smoking 1.17 (1.07, 1.29); and drinking alcohol 1.05 (0.95, 1.16).ConclusionsThis meta-analysis provided a clear picture of the behavioral and nutritional factors associated with weight gain in children.     

2013年中国18岁及以上超重/肥胖人群体重测量行为分析

目的 了解2013年我国≥ 18岁超重/肥胖人群体重测量情况及其影响因素。方法 2013年在中国慢性病及其危险因素监测的302个监测点,采用多阶段分层整群随机抽样方法调查≥ 18岁常住居民共计177 099名,选取87 670名超重/肥胖者作为研究对象。问卷调查获取人口学特征、体重测量情况、主要慢性病患病情况等信息;通过身体测量获取个体的身高、体重、腰围和血压;采集调查对象空腹静脉血,检测FPG、TC、TG、LDL-C和HDL-C,采集服75 g无水葡萄糖后静脉血检测服糖后2 h血糖。经复杂加权后分析超重/肥胖者体重测量情况及其影响因素。结果 我国超重/肥胖成年人在1周内、1个月内、1年内测量过体重的比例分别为18.9%、23.0%和30.2%。1周内的体重测量率男性高于女性,60~岁组最低（P<0.05）。超重/肥胖成年人从未测量过体重的比例为20.5%,女性高于男性,60~岁组最高（P<0.05）。较高年龄（60~岁组OR=0.73,95%CI：0.64~0.82）是体重测量的危险因素;女性（OR=1.11,95%CI：1.03~1.19）、较高文化程度（大专及以上OR=3.79,95%CI：2.89~4.97）、较高家庭年收入（2.1~万元OR=1.61,95%CI：1.31~1.98）、糖尿病（OR=1.15,95%CI：1.03~1.30）、血脂异常（OR=1.13,95%CI：1.04~1.23）是体重测量的保护因素。结论 我国超重/肥胖成年人自主体重测量行为有待提高,应对不同特征人群开展针对性健康教育,促进重点人群规律监测体重、维持健康体重。     

Mechanistic insights into the effects of Astaxanthin on lipid profile and glucose homeostasis parameters: A systematic review of animal and clinical trial studies

Background and aimsThe antioxidant Astaxanthin (ASTX) may have potential to improve cardiometabolic risk factors. This study aimed to systematically review the impact of ASTX supplementation on lipid profile and glycemic indices in animal and clinical trial studies.MethodElectronic databases, including PubMed, Scopus, Web of Science, and Google Scholar were searched from inception up to June 2021. All clinical trials and animal studies published in English that investigated the effects of ASTX on lipid profile and glycemic parameters were considered in the study.ResultsA total of 3258 studies were retrieved from the search strategy from which 20 animal and five human studies were included in this systematic review. Twenty animal studies evaluated the effect of ASTX on lipid profile, of which 17 studies reported significant beneficial impact on one or more lipids. In addition, of 20 animal studies assessing the effect of ASTX on glucose homeostasis parameters, only 11 detected significant improvements. Five clinical trials evaluated the effect of ASTX on lipid profile; from these, three reported significant beneficial effect on at least one lipid. Moreover, of five human studies in which glucose homeostasis parameters were measured, only two observed significant improvement.ConclusionEvidence supports positive effects of ASTX on lipid profile. Nevertheless, the results on glycemic parameters are controversial and more studies are needed to draw a definite conclusion. ASTX could have great potential for reducing the risk of CVD and prevent T2DM and obesity-associated metabolic disturbances.     

The food environment in schools and their immediate vicinities associated with excess weight in adolescence: A systematic review and meta-analysis

AimThe present study systematically reviewed the characteristics of the food environment in schools and their immediate vicinities associated with excess weight in adolescents.MethodsWe searched for relevant articles in seven databases. No restrictions were applied on language, publication date, and status of publication. The study selection process and data extraction were conducted by two authors independently. For meta-analyses, the random-effects model and the maximum-likelihood method were applied.ResultsA total of 9327 publications were identified from the initial search. Of these, 20 studies met the inclusion criteria and were included in the systematic review. The sale of food in school or immediate vicinity was associated with high BMI [Odds ratio (OR)= 1.14, 95% confidence interval (CI) 1.01, 2.06]. The availability of healthy food provided by school significantly decreased the odds of obesity [OR= 0.89, 95%CI 0.82, 0.96]. However, the presence of nutrition policies or programs at school was not associated with obesity (OR= 0.81, 95%CI 0.57, 1.16).ConclusionsThis study highlights the need for improvement in school food environment, including restricting students' exposure to unhealthy foods. The quality of food (healthy vs unhealthy) provided or made available to adolescents in the school food environment influences their weight status. Therefore, promotion of healthy food programs and availability of healthy food at school would limit the prevalence of excess weight in adolescents.     

2013年中国超重肥胖成人体重水平低估情况

目的  了解2013年我国超重肥胖成人体重水平低估情况,分析其影响因素。 方法  2013年中国慢性病及其危险因素监测采用多阶段分层整群抽样的方法调查≥ 18岁成人共计179 570人。问卷调查获取人口学特征、体重水平自我评价、慢性病患病知晓情况等信息;体格测量获取个体的身高、体重和血压;采集调查对象静脉血,检测空腹血糖、服糖后2 h血糖和血脂四项。选取收集到的87 552名超重肥胖成人作为研究对象,复杂加权后分析不同特征人群体重水平低估情况及其影响因素。 结果  我国有74.7%（95%CI：73.3%~76.1%）的超重肥胖成人低估自我体重水平,其中轻度低估率为60.7%（59.6%~61.7%）,严重低估率为14.0%（13.1%~14.9%）。较高年龄、低文化程度、低收入水平、农村地区和肥胖是低估和严重低估体重水平的危险因素（均有P < 0.05）;高血压患者知晓和血脂异常患者知晓是低估和严重低估体重水平的保护因素（均有P < 0.05）。 结论  中国大部分超重肥胖成人低估自身的体重水平,低估受年龄、文化程度、收入水平和慢性病知晓等因素影响,应对不同特征人群开展针对性干预。