Obesity Prevalence in Gaziantep, Turkey

Background:

Obesity is associated with reduced quality of life, development of serious chronic conditions such as heart disease and diabetes, increased medical care costs, and premature death. Environmental effects, especially feeding habits may cause hyperinsulinemia and obesity. A Healthy People 2010 objective is to reduce the proportion of adults who are obese to 15%.

Materials and Methods:

This cross-sectional study was conducted on 1647 persons in a sample representing Gaziantep, Turkey. Over the selected 329 houses, 310 houses were reached (94.2%) and data about 1315 related persons was collected. The body mass index (BMI) shows the relationship between the weight and the height of people, calculated by the ratio of mass by kg over the square value of height measure. In statistical analyses chi-square, student''s t-test and logistic regression analysis were used.

Results:

The mean BMI increased with time for both sex, whereas decreased for 60+ age group. The fastest increase for both sex was seen while transition from 18 year to 19-29 age groups occurred. Another increase in women was in 30-39 age group; BMI=25.08±4.39 in 19-29 ages whilst BMI=29.02±5.79 in 30-39 ages. The increases in both sex in other age groups were not as much as in this group.

Conclusion:

Obesity is not only a problem in the Gaziantep but is also a major health concern in Europe and other regions of the world. As an accepted method against obesity, life-style changes should be put into use from childhood supported in school and family life.     

北纬53°地区人群体质指数、腰臀比与高血压关系的调查

目的：解高寒地区人群超重肥胖、中心性肥胖发生率及其与高血压的关系。以期为肥胖和高血压的防治措施制定提供研究依据。方法对北极村1064例体检者进行身高、体重、腰围、臀围、血压等检测,并按照腰臀比值、体质指数进行分层分析各组与高血压相关性。结果受检者肥胖患病率为19.55%,超重的患病率为35.81%,中心性肥胖患病率为69.64%,高血压患病率为27.16%。正常人群随着BMI的增加,高血压的患病率呈明显上升趋势;中心性肥胖人群随着BMI的增加高血压的患病率显著上升(P<0.0001)。将WHR和BMI作为自变量对高血压的患病率进行相关性分析,结果显示,肥胖组和超重组高血压的患病率明显高于正常体重组(P<0.0001);中心性肥胖组的高血压率明显高于正常体型组(P<0.0001)。经多因素相关分析,WHR和BMI与高血压都有极显著性意义(P<0.0001)。结论该研究结果显示,超重,肥胖和中心性肥胖都是高血压的独立危险因素。即使BMI仍在标准范围的人,若是任由腰围一直变大,对健康而言,仍是一种非常不良的信号。因此,如果只注意体重,而忽视腹部脂肪过多,仍有发生慢性疾病的危险。     

Trends of Overweight and Obesity Among Children in Tijuana,Mexico

The objectives of this study were to compare the trends of obesity from 2001–02 to 2006–07 in school children of Tijuana, Mexico and to investigate the relationship with the child's gender and type of school attended. Bietapic random sample was selected by cluster of schools and groups. Results of the 1684 children from 6–14 years of age assessed showed an overall prevalence of obesity (> 95^th) of 28%. An overall increase of overweight and obesity of 7-percentage points (p = 0.0003), from 41 to 48%, being higher among boys and younger girls. Prevalence of obesity was higher among boys and children from private schools.     

The Harrow Slimming Club: report on 1090 enrollments in 50 courses, 1977–1986

The Harrow Slimming Club is a non-profit making group run by Harrow Health Authority using Health Service premises, and with trained dietitians as counsellors. The administration structure, recruitment procedure and nutrition advice are described.
Data is presented on 1090 enrollments in 50 courses. The club members were typically women about 13 kg overweight, and 30–50 years old, although there was a wide range in both age and degree of obesity. Men (114) attended either mixed courses or men only courses.
During the first initial 10-week course the average attendance was 8.4 with a 5.4 kg weight loss for members who later attended another course or courses. Members who attended only one course lost 3.82 kg during 6.8 attendances. Men who attended men-only courses attended more frequently and lost more weight than men on mixed courses.
The results presented are similar to those obtained from the first 14 courses (Seddon et al ., 1981)     

Barriers and facilitators to childhood obesity prevention among culturally and linguistically diverse (CALD) communities in Victoria,Australia

Objective: Childhood obesity is rising among culturally and linguistically diverse (CALD) groups who show poor engagement in obesity prevention initiatives. We examined the barriers and facilitators to the engagement of CALD communities in obesity prevention initiatives. Methods: We used the nominal group technique to collect data from 39 participants from Vietnamese, Burmese, African, Afghani and Indian origins living in disadvantaged areas of Victoria, Australia. Data analysis revealed ranked priorities for barriers and facilitators for CALD community engagement in obesity prevention initiatives. Results: CALD parents identified key barriers as being: competing priorities in the post‐migration settlement phase; language, cultural and program accessibility barriers; low levels of food and health literacy; junk food advertisement targeting children; and lack of mandatory weight checks for schoolchildren. Key facilitators emerged as: bicultural playgroup leaders; ethnic community groups; and school‐based healthy lunch box initiatives. Conclusion: This study has identified several policy recommendations including: the implementation of robust food taxation policies; consistent control of food advertising targeting children; improving CALD health literacy using bicultural workers; and matching health promotional materials with CALD community literacy levels. Implications for Public Health: These recommendations can directly influence public health policy to improve the engagement of CALD communities in obesity prevention services and ultimately reduce the widening obesity disparities in Australia.     

Zinc,Iron and Vitamins A,C and E Are Associated with Obesity,Inflammation, Lipid Profile and Insulin Resistance in Mexican School-Aged Children

The objective of this cross-sectional study was to evaluate the relationship between micronutrient status and obesity, lipids, insulin resistance and chronic inflammation in children. Weight, height, waist circumference and body composition (dual-energy X-ray absorptiometry (DEXA)) were determined in 197 school-aged children. Lipids, glucose, insulin, C-reactive protein (CRP), zinc, iron and vitamins A, C and E were analyzed in blood. Vitamin C and vitamin E:lipids were negatively associated with Body Mass Index (BMI), waist-to-height ratio (WHR) and body and abdominal fat (p < 0.05). Vitamin A was positively associated with BMI, BMI-for-age, WHR and abdominal fat (p < 0.05). Iron and vitamin E:lipids were negatively associated with insulin (p < 0.05). Vitamins A, C and E and iron were negatively associated with CRP (p < 0.05). Interaction analysis showed that children who were overweight and obese who also had low concentrations of vitamin A had higher CRP and lower triglycerides (p < 0.1), children with low vitamin E had significantly lower glucose and triglycerides (p < 0.1) and higher low-density lipoprotein (LDL) concentrations (p < 0.05), and children with low zinc concentrations had higher insulin resistance compared with children with adequate weight (p < 0.05). In conclusion, low vitamin C concentration and vitamin E:lipids were associated with obesity. Furthermore, low concentrations of zinc, vitamins A and E in children who were overweight and obese were associated with lipids, inflammation and insulin resistance.     

单纯性肥胖儿血脂及载脂蛋白AⅠ,B100,CⅡ和CⅢ的研究

本文测定了32例肥胖儿和年龄及性别配对的正常健康儿血脂和载脂蛋白水平,使用相对体重,Kaup指数,上臂围,体脂含量和皮褶厚度总和作为肥胖的评价指标,肩胛下与三头肌皮褶厚度比值(STR)评价脂肪分布情况。采用Sclaro法测定TG,TC和HDL-C。免疫圆周扩散法测定APO-AI,B100,CⅡ和CⅢ。结果表明:肥胖儿血HDL-C,HDL-C/TC,APO-AI和APO-CⅡ/CⅢ比显著降低,TG,VLDL-C,APO-B100,APO-CⅢ,动脉硬化指数和APO-BlOO/AⅠ显著升高,并与肥胖程度显著相关。多元分析表明:TSFT与HDL-C显著相关,STR主要影响VLDL-C和APO-CⅡ/CⅢ。结果提示:肥胖可影响血脂和载脂蛋白水平;载脂蛋白和脂肪异常分布是血脂变化的主要原因之一;肥胖儿的确有发生动脉粥样硬化的危险。     

Global Obesity: Nestle Initiatives in Nutrition, Health, and Wellness

This paper addresses some of the ways that Nestle is making a long-term commitment to the health and well-being of consumers. In particular, Nestle, like other food companies, has a role to play in improving people's health and wellness by improving the nutritional profile of foods, by ensuring sound communication on nutrition and consumer education, and by collaborating with other stakeholders in order to improve consumer health.     

Preserved Skeletal Muscle Mitochondrial Function,Redox State,Inflammation and Mass in Obese Mice with Chronic Heart Failure

Background: Skeletal muscle (SM) mitochondrial dysfunction, oxidative stress, inflammation and muscle mass loss may worsen prognosis in chronic heart failure (CHF). Diet-induced obesity may also cause SM mitochondrial dysfunction as well as oxidative stress and inflammation, but obesity per se may be paradoxically associated with high SM mass and mitochondrial adenosine triphosphate (ATP) production, as well as with enhanced survival in CHF. Methods: We investigated interactions between myocardial infarction(MI)-induced CHF and diet-induced obesity (12-wk 60% vs. standard 10% fat) in modulating gastrocnemius muscle (GM) mitochondrial ATP and tissue superoxide generation, oxidized glutathione (GSSG), cytokines and insulin signalling activation in 10-wk-old mice in the following groups: lean sham-operated, lean CHF (LCHF), obese CHF (ObCHF; all n = 8). The metabolic impact of obesity per se was investigated by pair-feeding ObCHF to standard diet with stabilized excess body weight until sacrifice at wk 8 post-MI. Results: Compared to sham, LCHF had low GM mass, paralleled by low mitochondrial ATP production and high mitochondrial reative oxygen species (ROS) production, pro-oxidative redox state, pro-inflammatory cytokine changes and low insulin signaling (p < 0.05). In contrast, excess body weight in pair-fed ObCHF was associated with high GM mass, preserved mitochondrial ATP and mitochondrial ROS production, unaltered redox state, tissue cytokines and insulin signaling (p = non significant vs. Sham, p < 0.05 vs. LCHF) despite higher superoxide generation from non-mitochondrial sources. Conclusions: CHF disrupts skeletal muscle mitochondrial function in lean rodents with low ATP and high mitochondrial ROS production, associated with tissue pro-inflammatory cytokine profile, low insulin signaling and muscle mass loss. Following CHF onset, obesity per se is associated with high skeletal muscle mass and preserved tissue ATP production, mitochondrial ROS production, redox state, cytokines and insulin signaling. These paradoxical and potentially favorable obesity-associated metabolic patterns could contribute to reported obesity-induced survival advantage in CHF.     

Human vulnerabilities,transgression and pleasure

In the face of the ‘obesity epidemic’ public health has largely failed to engage with the human pleasures that surround eating. Pleasures are often linked to vulnerabilities and frailties that are part of being human. We argue in this paper that leaving human vulnerabilities and the pleasures that haunt them under-acknowledged and under-examined within public health contributes to the problems that public health tries to solve. While in some quarters debates revolve around the best ways of encouraging people to become responsible for and modify their own behaviour, the well-documented centuries of struggle with managing human vulnerabilities and pleasures helps to explain why this is no easy task. The mantra of restraint, reason, and rationality is very limited in the face of the importance of some pleasures, even small ones, in human lives. In unequal societies, people have unequal access to pleasures. People are presented with a landscape of temptation, encouraged to consume, and then unequally admonished for indulging according to their means. Understanding and democratising pleasures will involve public health grappling with pleasures, and all those concerned with health inequity asking hard questions about ethics, morality, and intervention.     

瘦素、肥胖与青春期发育

瘦素是由肥胖基因编码的一种分泌型的蛋白质,其作用主要在于调节体重、脂肪和能量代谢。青春期的发动需要一定量的体重或是体脂的贮存,瘦素可能是脂肪组织发出的给生殖系统一种特殊的代谢信号。现就瘦素与肥胖及青春期发育关系的研究进展作以综述。     

个体化健康管理对单纯性肥胖儿童身体形态、糖脂代谢及C-反应蛋白的影响

目的 比较个体化健康管理与常规干预1年对单纯性肥胖儿童的效果,探究更为有效的肥胖儿童干预模式。方法 共入组3~8岁单纯性肥胖儿童130例,随机接受个体化的饮食、运动、行为干预(个体化组)与常规干预(常规组)。比较两组在干预1年后体质量指数(BMI)、腰围、体脂百分比等身体形态指标及糖脂代谢、C反应蛋白(CRP)等生化指标有无差异,比较个体化组中不同性别、不同学习地点肥胖儿童干预前后身体形态指标有无差异。结果 干预1年后,个体化组BMI、腰围、体重、体脂百分比的减少比常规组更明显(P值均＜0.001),身高增长高于常规组(P＜0.001);个体化组空腹血糖、空腹胰岛素、LDL、TG、TC、CRP均较常规组降低(P值均＜0.01),HDL较常规组升高(P＜0.01)。结论 个体化健康管理可有效改善3~8岁单纯性肥胖儿童的身体形态,改善糖脂代谢及CRP水平,是对肥胖儿童的一种有效干预模式。     

White Rice Consumption,Body Mass Index,and Waist Circumference among Iranian Female Adolescents

Objective: Refined grains consumption is positively associated with obesity. White rice is the most usual refined grain in Iran. However, few studies have assessed the association between rice intake and anthropometric measures among adolescents. Therefore, we aimed to compare anthropometric measures as well as the diet quality indices across the tertiles of white rice consumption among Iranian adolescents.

Methods: This cross-sectional study was conducted on 415 female adolescents who were chosen by using a systematic cluster random sampling. Dietary intake assessment was done using a validated semiquantitative food frequency questionnaire. Anthropometric measures were done according to the standard protocols. Diet quality indices (including dietary energy density [DED], nutrient adequacy ratio [NAR], and mean adequacy ratio [MAR]) were calculated using standard definitions.

Results: The prevalence of overweight across the tertiles of rice consumption was 11.6, 17.8, and 24.6%, respectively (p = 0.03). Corresponding values for obesity were 2.1, 5.7, and 8.6%, respectively (p = 0.04). A significant positive association was observed for the prevalence of central obesity across the tertile of rice intake (13.1, 21.4, and 28.1%; p = 0.02). Dietary fiber and energy intake and diet quality indices were significantly different among different tertiles of white rice intake. Those in the highest tertiles of white rice intake had the lowest scores for MAR and NAR and highest scores for DED.

Conclusion: There was significant association between rice consumption and obesity as well as diet quality indices among Iranian adolescents.     

Sarcopenia,Obesity, Sarcopenic Obesity and Risk of Poor Nutritional Status in Polish Community-Dwelling Older People Aged 60 Years and Over

Poor nutritional status (PNS) is a modifiable factor determining abnormalities in body composition-sarcopenia, obesity, and sarcopenic obesity (SO). We aimed to assess the prevalence of these conditions and their association with PNS in 211 community-dwelling older adults. Sarcopenia was diagnosed based on the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) recommendations. Obesity was diagnosed with the Percent Body Fat (>42% in women and >30% in men). Subjects fulfilling the criteria for obesity and concomitantly with reduced lower and/or upper limbs muscle strength and muscle mass (ALM/BMI < 0.512 in women and <0.789 in men) were classified as SO phenotype. Participants without obesity and sarcopenia were categorized as ‘normal’ phenotype. Nutritional status was estimated with the Mini Nutritional Assessment, and a score of <24 indicated PNS. In total, 49.8% participants had abnormal body composition (60.7% men and 42.5% women; p = 0.001). Sarcopenia, obesity, and SO were diagnosed in 10%, 32.7%, and 7.1% of subjects. PNS was found in 31.3% of the study sample. Its prevalence differed between phenotypes: 81% in sarcopenia, 60% in SO, 14.5% in obesity, and 28.3% in the ‘normal’ phenotype group (p = 0.000). Based on the results, abnormal body composition is prevalent in elderly subjects. Sarcopenia and SO are often associated with PNS.     

Links between body mass index,total body fat,cholesterol, high-density lipoprotein,and insulin sensitivity in patients with obesity related to depression,anger, and anxiety

OBJECTIVE: Define links between psychosocial parameters and metabolic variables in obese females before and after a low-calorie diet. METHOD: Nine female obese patients (age 36.1 +/- 7.1 years, body mass index [BMI] > 30 kg/m2) were investigated before and after a 6-week low-calorie diet accompanied by behavior therapy. Blood lipids, insulin sensitivity (Bergman protocol), fat distribution (by dual-energy X-ray absorptiometry [DEXA]), as well as psychological parameters such as depression, anger, anxiety, symptom load, and well-being, were assessed before and after the dieting period. RESULTS: The females lost 9.6 +/- 2.8 kg (p < .0001) of body weight, their BMI was reduced by 3.5 +/- 0.3 kg/m2 (p < .0001), and insulin sensitivity increased from 3.0 +/- 1.8 to 4.3 +/- 1.5 mg/kg (p = .05). Their abdominal fat content decreased from 22.3 +/- 5.5 to 18.9 +/- 4.5 kg (p < .0001). In parallel, psychological parameters such as irritability (p < .05) and cognitive control (p < .0001) increased, whereas feelings of hunger (p < .05), externality (p < .05), interpersonal sensitivity (p < .01), paranoid ideation (p < .05), psychoticism (p < .01), and global severity index (p < .01) decreased. Prospectively, differences in body fat (percent) were correlated to nervousness (p < .05). Waist-to-hip ratio (WHR) differences were significantly correlated to sociability (p < .05) and inversely to emotional instability (p < .05), whereas emotional instability was inversely correlated to differences in insulin sensitivity (p < .01). DISCUSSION: Weight reduction may lead to better somatic risk factor control. Women with more nervousness and better sociability at the beginning of a diet period may lose more weight than others.     

Obesity and Dyslipidemia in Chinese Adults: A Cross-Sectional Study in Shanghai,China

This study examined the association of obesity and dyslipidemia according to body measurements among Chinese adults in Shanghai, a place in the process of rapid urbanization. Using the baseline data of the Shanghai Suburban Adult Cohort and Biobank study (SSACB), the subjects completed questionnaires and physical examinations, and fasting blood was collected for biochemical assays. We estimated the odds ratios (OR) and 95% confidence interval (CI) by multivariable logistic regression. The prevalence was 12.9% and 28.8% in both general and central obesity, respectively. Compared with the non-obese, the general or central obesity participants had a higher level of TC, TG, LDL-C and lower level of HDL-C. The OR (95%CI) for dyslipidemia was 1.79 (1.69–1.91) and 1.91 (1.83–2.00) in general or central obesity, respectively. Positive associations were also observed between obesity and high TC, high LDL-C, low HDL-C and high TG, with the adjusted OR ranging from 1.11 to 2.00. Significant modifying effect of gender, age, hypertension, and diabetes were found in the association of obesity and different forms of dyslipidemia. The findings of our study indicated that participants with obesity, including general or central obesity, have a higher prevalence of dyslipidemia and gender, age, hypertension, and diabetes might be potential modifiers of the association. More effective attention and interventions should be directed to managing body weight to reduce the prevalence of dyslipidemia.     

博山地区4780名成年人身高、体重调查及体重指数、肥胖发生率的统计分析(人群肥胖症研究之一)

作者采用较准确的方法,对博山地区20岁以上不同职业的4780人(男3216,女1564),进行了年龄、身高和体重的调查,并对调查结果作了性别、年龄、身高与体重之问关系的相关、回归分析,得出推算标准体重的回归方程式、“正常成年男女身高与体重表”。按公式计算出体重指数,并拟定了20岁以上男女体重指数的正常范围(男0.1933～0.2525,女0.1951～0.2563)和体重超重、肥胖的体重指数界限值。按这个体重指数标准,本次调查结果男性属超重者占7.71％,肥胖占5.22％;女性超重占6.96％,肥胖占4.73％。本调查资料所载博山地区20岁以上人群年龄、身高与体重之间的关系及推算标准体重的方法,对国内其它地区也会有一定参考价值。