Improving reproductive performance in overweight/obese women with effective weight management

Obesity and overweight are common conditions in the developed countries and they carry many health consequences, including some reproductive disorders. There is a very high prevalence of obese women in the infertile population and many studies have highlighted the link between obesity and infertility. A large proportion of infertile women have polycystic ovary syndrome (PCOS) which is also linked with increased risk of obesity and other metabolic anomalies. The association between obesity and/or PCOS and hyperinsulinaemia, hyper androgenism and abnormal secretion of other hormones, such as leptin, underlies many reproductive disorders observed in this population. It has been demonstrated that weight loss can improve the fertility of obese women through the recovery of spontaneous ovulation, whereas others will have improved response to ovarian stimulation in infertility treatment. Therefore, it is proposed that following the initial assessment of infertility and body mass index or other measurement of obesity, various weight management interventions, including diet, exercise or pharmacotherapeutic approaches, should be considered for overweight and obese infertile women.     

Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children

OBJECTIVES: To evaluate the relationship between changes in physical activity (PA), sedentary behavior, and physical self-perceptions and global self-worth in 30, 8-12 years old, overweight/obese children (13 boys, 17 girls). METHODS: Secondary analyses from a randomized controlled trial designed to increase PA and reduce sedentary behavior. PA was measured by accelerometers worn by participants every day for 8 weeks. Sedentary behavior, defined as minutes per day spent in television viewing, was assessed by self-report. RESULTS: Increases in PA were associated with increases in perceived physical conditioning (r = .54, p < .01), body satisfaction (r = .55, p < .01), and overall physical self-worth (r = .44, p < .05) independent of changes in body mass index (BMI). Reductions in TV viewing were also related to increased physical and global self-worth. CONCLUSIONS: Increases in PA are associated with improvements in physical self-perceptions but not global self-worth, while reductions in TV viewing are associated with increased physical and global self-worth, and these psychosocial benefits appear to be independent of changes in adiposity.     

肥胖及超重小学生的自尊水平及相关因素

目的:探讨肥胖及超重小学生的自尊状况及相关因素。方法:通过两阶段抽样,在长沙市抽取4~6年级小学生1410人,按WHO公布的儿童体质量指数(body mass index,BMI)筛查参考值,将受试分为正常(n=1084)、超重组(n=211)和肥胖组(n=115),用自尊量表(the self-Esteem scale,SES)进行调查,并对小学生低自尊的相关因素进行回归分析。结果:(1)超重和肥胖小学生SES得分低于正常学生,肥胖男生SES得分低于正常和超重男生,超重和肥胖女生SES得分低于正常女生;(2)肥胖学生中低自尊者比例高于正常和超重学生,但高自尊比例在3组间差异无统计学意义;(3)肥胖、超重、祖辈认为太胖、对身高不满意、对体质量不满意为小学生低自尊的危险因素(OR=1.45~3.74),对成绩满意为小学生低自尊的保护因素(OR=0.22)。结论:超重和肥胖小学生自尊水平低于正常体质量小学生;除肥胖和超重外,对自己身高和体质量不满意也是小学生低自尊的相关因素。     

Genetic approach identifies distinct asthma pathways in overweight vs normal weight children

The pathogenesis of asthma in the context of excess body weight may be distinct from asthma that develops in normal weight children. The study's objective was to explore the biology of asthma in the context of obesity and normal weight status using genetic methodologies. Associations between asthma and SNPs in 49 genes were assessed, as well as, interactions between SNPs and overweight status in child participants of the Greater Cincinnati Pediatric Clinic Repository. Asthma was significantly associated with weight (OR = 1.38; P = 0.037). The number of genes and the magnitude of their associations with asthma were notably greater when considering overweight children alone vs normal weight and overweight children together. When considering weight, distinct sets of asthma‐associated genes were observed, many times with opposing effects. We demonstrated that the underlying heterogeneity of asthma is likely due in part to distinct pathogenetic pathways that depend on preceding/comorbid overweight and/or allergy. It is therefore important to consider both obesity and asthma when conducting studies of asthma.     

Effects of a cognitive-behavioural weight loss programme on overweight obstructive sleep apnoea patients

SUMMARY  Thirty-two obese patients (Body Mass Index (BMI) = 38.5 ± 3.7) with obstructive sleep apnoea (the average number of oxygen desaturations per hour of sleep exceeding 4% from the baseline (OD14) = 38.6 ± 23.9) underwent a one-year cognitive-behavioural weight reduction programme with a one year follow-up period.
The criteria for successful treatment were (i) a decrease in OD14 to less than 10 and (ii) a decrease in OD14 that was greater than 50%. Fourteen (44%) patients were considered to be treated successfully at six months. When the patients were grouped according to weight loss 23 patients had lost more than 5 kg; 12 (52%) of them belonged to the group treated successfully. At 24 months, however, only three (9%) patients could be regarded as treated successfully and six patients had been transferred to other treatment modes (Nasal Continuous Positive Airway Pressure (nCPAP) and uvulopalatopharyngoplasty (UPPP)). The changes in weight correlated with the changes in OD14 (r = 0.47 and 0.63 at the 6-month and the 24-month evaluation, respectively).     

超重和正常体质量儿童对不同种类食物的内隐态度

目的:考察超重和体质量正常的儿童对不同种类食物的内隐态度。方法:从重庆市某中学初一年级学生中筛选出超重(含肥胖)儿童33名(男26名,女7名),按相应班级、年龄、性别选出匹配的正常体质量儿童33名(男26名,女7名)。所有儿童均完成外部情感西蒙任务。分别对男性和女性儿童完成外部情感西蒙任务的反应时间和错误率进行2(组别:超重组、正常体质量组)×2(食物种类:健康食物、不健康食物)×2(外在反应效价:积极、消极)的重复测量方差分析。结果:超重男性儿童对所有食物的反应时均短于正常体质量男性儿童[(686.7±32.6)ms vs.(760.8±32.6)ms,P0.05];超重男性儿童可能对所有食物按消极反应效价键的反应时长于按积极键的反应时[(702.4±32.9)ms vs.(670.9±34.5)ms,P0.01],正常体质量男性儿童对所有食物按积极键和消极键的反应时差异无统计学意义(P0.05)。女性儿童反应时的组别主效应及外在反应效价与组别的交互作用均无统计学意义(均P0.05)。对男性和女性儿童错误率的重复测量方差分析结果发现:组别的主效应、外在反应效价的主效应、外在反应效价与组别的交互作用及外在反应效价与组别、食物种类间的交互作用均无统计学意义(均P0.05)。结论:超重儿童和正常体质量儿童对食物的内隐态度的差异可能存在着性别上的不同。超重男性儿童可能对所有种类的食物(健康和不健康食物)均持积极态度,而正常体质量男性儿童对所有食物均持中立态度;女性儿童体质量与对食物的态度之间无关系。     

Abdominal obesity has the highest impact on metabolic profile in an overweight African population

Aim: The aim of this study was to determine the association between different anthropometric parameters and metabolic profile in an overweight, adult, black Kenyan population.

Methods: An opportunity sample of 245 overweight adult Kenyans (body mass index (BMI) ≥ 25 kg/m²) was analysed. A score of metabolic profile (metabolic Z-score) was constructed on the basis of levels of plasma lipids, blood pressure, blood glucose and serum insulin. Linear regressions using metabolic Z-score as outcome and six anthropometric variables (waist circumference (WC), hip circumference, visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue, arm fat area and arm muscle area) separately as independent variables were carried out.

Results: Mean age of study participants was 42.1 years (SD = 9.6) and 26.5% of the participants were men. The median BMI was 28.6 kg/m² (Q1 = 26.3; Q3 = 31.3). Of the six anthropometric variables tested, WC and VAT thickness had the strongest negative association with the metabolic profile (β = 0.17 (0.09; 0.24) and 0.15 (0.08; 0.23), respectively).

Conclusions: WC and VAT thickness were the strongest anthropometric predictors for the metabolic profile in overweight adult Kenyans. WC is useful in clinical practice for the diagnosis of metabolically unhealthy fat accumulation in an African setting.     

The effects of socioeconomic status and short stature on overweight,obesity and the risk of metabolic complications in adults

Objective:

to observe the relationship between socioeconomic status, height and nutritional problems related to obesity, overweight and risk of metabolic complications in men and women of Medellin (Colombia).

Methods:

cross-sectional study with a sample of 5556 adults between 18 and 69 years of age. We assessed weight, height and waist circumference. Socioeconomic variables were evaluated by family income, socioeconomic stratum and academic level achieved.

Results:

we found that in men and women the height reached in adulthood is associated with socioeconomic conditions as measured by the socioeconomic strata and family income. In women, height, age, and socioeconomic strata are associated with obesity, overweight and risk of obesity, and risk of metabolic complications.

Conclusion:

These results are not only from individual unhealthy habits, such as eating patterns based on high density foods combined with low energy expenditure, but also from the cumulative effect of food deprivation throughout life. Therefore, policies intended to prevent them should take a preventive approach that begins before birth and continues during childhood and adulthood.     

Obesity,appearance, and psychosocial adaptation in young African American children

OBJECTIVE: To evaluate the contributions of weight status, skin tone, peer teasing, and parental appraisals of child's size to self-esteem and psychosocial adjustment in overweight African American children. METHOD: Overweight to very obese 5- to 10-year-old African American children (N = 117) completed measures of self-esteem, skin tone satisfaction, peer teasing, and body size perception. Caregivers completed the Child Behavior Checklist and rated their child's body size. RESULTS: Overweight was associated with low appearance self-esteem, and body size dissatisfaction with low global self-worth and low appearance self-esteem in children 8 and older. Appearance self-esteem but not global self-worth was lower in girls than boys. Parental perception of child's size as heavier than average was associated with low child appearance self-esteem. Heavier children also had more parental report of behavior and psychosocial problems, but their scores were in the nonclinical range. Child skin tone dissatisfaction was associated with low global self-worth. Weight-related peer teasing was associated with low self-esteem. CONCLUSIONS: The relationship between obesity and self-esteem in African American children depends upon age, gender, and children's experiences with teasing and parental evaluation of their size. Other factors, like skin tone satisfaction, contribute to a child's sense of self-worth.     

The influence of father-daughter relationship and girls' sex-roles on girls' self-esteem

Summary The aim of this study was to explain how a father-daughter relationship and a girl's femininity has an influence on a girl's self-esteem by examining the relationship among paternal rearing, a girl's self-esteem, and a girl's femininity. Subjects were 319 girls attending junior high school and high school. Paternal rearing, girls' self-esteem, and their femininity were measured on the Parental Bonding Instrument, the Coopersmith Self-Esteem Inventory, and the Bem Sex-Role Inventory, respectively. Fathers' overprotection had significant negative correlation with daughters' self-esteem in the junior high school students (r = −0.32, p < 0.01), but not in the high school students. While, daughters' femininity significantly correlated with their self-esteem both in the junior high school students (r = 0.32, p < 0.01) and in the high school students (r = 0.48, p < 0.01).     

The incidence of acute myocardial infarction in relation to overweight and obesity: a meta-analysis

Introduction

Epidemiological evidence suggests that overweight and obesity have been associated with acute myocardial infarction (AMI). However, data on this issue are controversial. This study aims to use meta-analysis to determine whether overweight and obesity are related to AMI.

Material and methods

We searched PubMed and Embase databases up to October 23^rd, 2013 for related literature. The association of overweight and obesity with AMI was assessed by odd ratio (OR) with 95% confidence interval (CI) as the effect size. Then subgroup analysis was performed according to gender, area and study type.

Results

Five primary studies (one cohort study and four case-control studies) were included in this meta-analysis involving 36 803 participants, 14 883 of whom had an AMI. There was a significant association between overweight and AMI (OR = 1.27, 95% CI: 1.21–1.33, p < 0.001). Similar results revealed a relation between obesity and AMI (OR = 1.22, 95% CI: 1.07–1.40, p = 0.003). Subgroup analysis showed that overweight and obesity were positively associated with AMI risk except for obese subjects in Europe. There was no publication bias (Begg''s test p = 0.972, Egger''s test p = 0.858).

Conclusions

Both overweight and obesity increased the incidence of AMI, and it is necessary to control weight to prevent AMI. A large number of studies is needed to explore the mechanisms that link overweight and obesity with AMI.     

Inpatient treatment for children with obesity: weight loss, psychological well-being, and eating behavior

OBJECTIVE: Evaluated the effects of a 10-month inpatient treatment program and implemented as a nondiet healthy lifestyle approach. In addition, the effects of two extended treatment programs were compared to a standard cognitive-behavioral treatment program for maintenance of the treatment gains. METHODS: A within-subjects design was employed to evaluate treatment outcome, including a 14-month follow-up. Children (N = 122) ranged in age from 7 to 17 years (M = 12.7 years) with a mean Body Mass Index (BMI) of 32.5, expressed as a percentage of overweight (M = 77.4%). RESULTS: The children lost 49.0% of their weight during the course of treatment. Comparing baseline with the 14-month follow-up, a weight loss of 31.7% was maintained. The children continued to show healthy eating behavior at follow-up, and their psychological well-being had improved. No significant interaction effects were found for the extended coping programs. CONCLUSION: An inpatient cognitive-behavioral nondiet approach is a promising treatment option for childhood obesity, with lasting effects throughout the 14-month posttreatment.     

Observation of family functioning at mealtime: a comparison between families of children with and without overweight

OBJECTIVE: To examine differences between families of children with and without overweight on parental control and support. METHODS: Twenty-eight families with an overweight child and a control group of 28 families with a normal weight child (age range 7-13 years) participated in the study. Observations and self-reports of mealtime family functioning were administered and analyzed. RESULTS: Parents of children with overweight reported to exert more control on their children's feeding behavior and an equal amount of parental support in comparison with parents of children without overweight. However, observations at mealtime indicated that in families with an overweight child, maladaptive control strategies were twice as prevalent, and less parental support was displayed. CONCLUSIONS: Self-reports and observations provide complementary information on how parents interact with their overweight children. Family-based treatment programs should include discussions on the adequate amount of parental control and support.     

Relations among multiple peer influences, body dissatisfaction, eating disturbance, and self-esteem: a comparison of average weight, at risk of overweight, and overweight adolescent girls

OBJECTIVE: The goal of this study was to evaluate peer-related influences on appearance, body dissatisfaction, eating disturbance, and self-esteem in average weight, at risk of overweight, and overweight adolescent girls. METHODS: Three hundred twenty-five adolescent girls from high schools in Florida were assessed. Ninety met criteria for being at risk of overweight or overweight. Logistic and multiple regression analyses were used to evaluate group differences on all variables and to assess the amount of variance accounted for by peer-influence variables in the prediction of body dissatisfaction, eating disturbance, and self-esteem. RESULTS: Overweight and at risk of overweight girls scored higher than average weight girls on body dissatisfaction, dieting, and a peer measure that assessed negative comments and attributions about appearance. They also scored lower than average weight girls on self-report measures that assessed conversations about appearance and anti-dieting advice. How influential friends were in determining one's body image was a unique predictor of body dissatisfaction but only for the overweight and at risk of overweight group. CONCLUSIONS: Possible implications for clinical intervention programs are discussed along with directions for future research.     

Treatment of pediatric overweight: an examination of feasibility and effectiveness in an applied clinical setting

OBJECTIVE: To examine the effectiveness and feasibility of an evidence-based treatment for weight loss in children. METHODS: A total of 41 children who were overweight and their families were provided a modified version of the Traffic Light Diet (TLD) in an applied setting. Children who received treatment as usual (TAU) constituted a comparison sample. RESULTS: Children receiving the modified TLD demonstrated a significantly greater reduction in standardized body mass index (z-BMI) than children receiving TAU. CONCLUSIONS: The TLD is a feasible treatment that can be implemented in applied settings that include samples often excluded from treatment efficacy studies. Results are discussed in the context of bridging the gap between science and service.