The Association Among Overweight,Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey

Objective

The purpose of this study was to explore the association between obesity (via body mass index [BMI]) and presence of low back pain (LBP) in a representative sample of US adults, aged ≥18 years.

短期补充鱼油对超重高血压患者大动脉弹性的改善作用

目的:探讨超重的原发性高血压(高血压)患者短期摄入富含n-3脂肪酸的鱼油对其动脉弹性的影响。方法:社区高血压患者52例(男41例,女11例)经洗脱期去除6例后,随机分为鱼油组(n=23,补充3 g／d鱼油胶囊)和安慰剂组(n=20,试验过程中有3例被去除,补充3粒/d安慰剂)共8周。桡动脉脉搏波测定法测量大、小动脉弹性指数(C1和C2),测定空腹血清游离脂肪酸组成、血脂、血糖、胰岛素等。结果:鱼油对高血压患者空腹血清游离脂肪酸组成的影响:鱼油组干预前后即基线与8周后比较,n-3多不饱和脂肪酸水平、多不饱和脂肪酸／饱和脂肪酸比值均显著性增加。RM-ANOVA分析显示两组之间n-3多不饱和脂肪酸水平、多不饱和脂肪酸／饱和脂肪酸比值在基线与8周后的变化趋势存在显著性差异(P=0．027和P=0．008),协方差分析显示两组之间它们的变化趋势存在显著性差异(P=0．013和P=0．007)。鱼油对高血压患者动脉弹性指数、心率和血压水平的影响:安慰剂组大动脉弹性指数在基线和8周后之间保持不变,而鱼油组大动脉弹性指数则显著性增高,RM- ANOVA分析显示两组大动脉弹性指数的变化趋势有显著性差异(P=0．027)。多元线性回归分析显示,在调整了年龄、性别、体重指数改变、收缩压改变、舒张压改变和心率改变之后,全部参与者基线与8周后大动脉弹性指数的改变、空腹血清游离多不饱和脂肪酸／饱和脂肪酸比值的改变呈独立正相关(标准回归系数为0．415,P=0．004)。结论:超重高血压患者短期鱼油补充改善其大动脉弹性,与其改变的空腹血清游离脂肪酸组成独立相关。     

超重人群血清网膜素-1水平的变化及其影响因素

目的 探讨超重人群血清网膜素-1水平的变化及其影响因素.方法 选择超重组29例,正常体重组21例,检测腰围（WC）、血糖、血脂、血清网膜素-1、脂联素及瘦素水平,计算腰臀比（WHR）、体重指数（BMI）、脂联素与瘦素的比值,并分析网膜素-1与各指标之间的关系.结果 与正常体重组相比,超重组血清网膜素-1、脂联素水平及脂联素/瘦素的比值明显降低,而瘦素水平升高（P均〈0.05）.相关性分析显示,血清网膜素-1水平与WC（r=-0.27,P〈0.05）、BMI（r=-0.36,P〈0.05）呈显著负相关,与脂联素呈显著正相关（r=0.29,P〈0.05）.结论 超重人群血清网膜素-1水平降低,血清网膜素-1可能在肥胖的发生发展中起一定的作用.     

Prevalencia e incidencia de sobrepeso y obesidad en 2,5 millones de niños y adolescentes en España

Introduction and objectivesChildhood obesity trends are plateauing in Spain, but limited information is available about how they differ by region. This study assessed childhood and adolescent the prevalence and incidence of overweight and obesity from 2005 to 2017 across 8 Spanish regions.MethodsThis longitudinal study used height and weight measurements from 2.5 million children aged 2 to 17 years to calculate overweight and obesity, according to the World Health Organization (WHO) guidelines. Data were obtained from The Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria, and the Information System for Research in Primary Care. Prevalence and incidence rates and trends from 2005 to 2017 were calculated and stratified by age, sex, and region.ResultsThe overall obesity prevalence increased in boys and girls from age 2 (0.8%; 95%CI, 0.8-0.9 in both sexes) until peaking at age 7 in girls (17.3%; 95%CI, 17.1-17.5) and age 9 in boys (24.1%; 95%CI 23.9-24.3). The highest and lowest obesity prevalences were observed in Murcia and Navarre. Overall obesity prevalence trends decreased from 2005 to 2017 in all age-sex groups and in most regions. Highest obesity incidence rates were found in children aged 6 to 7 years, (4.5 [4.5-4.5] and 3.5 [3.5-3.5] new obesity cases per 100 person-years in boys and girls, respectively). Boys had higher prevalence and incidence rates than girls across all regions. Overweight/obesity prevalence and incidence rates and their trends were consistently higher than the obesity results, although a similar pattern was observed across sex and age.ConclusionsOverweight and obesity prevalence slightly decreased in Spain from 2005 to 2017, but regional, sex, and age differences persisted. Because incidence peaked around the age of 6 years, it may be important to begin health promotion programs at an early age.     

Weight-adjusted resting energy expenditure is not constant in critically ill patients

Objective In critically ill patients, energy requirements are frequently calculated as a multiple of total body weight presuming a linear relationship between total body weight and resting energy expenditure (REE); however, it is doubtful if this estimation of energy needs should be applied to all patients, particularly to overweight patients, since adipose tissue has a low contribution to REE. This study was undertaken to test the hypothesis that REE adjusted for total body weight decreases with increasing body mass index in critically ill patients. Additionally, measured REE was compared with three predictive equations. Design and Setting Clinical study in a university hospital intensive care unit. Patients One hundred critically ill patients admitted to the intensive care unit. Measurements and results Patients were included into four groups according to their body mass index (normal weight, pre-obese, obese, and morbidly obese). Measured REE was assessed using indirect calorimetry. Energy needs were calculated using the basal metabolic rate, the Consensus Statement of the American College of Chest Physicians (REEacs), and 25 kcal/kg of ideal body weight (REEibw). Adjusted REE was 24.8 ± 5.5 kcal/kg in normal weight, 22.0 ± 3.7 kcal/kg in pre-obese, 20.4 ± 2.6 kcal/kg in obese, and 16.3 ± 2.3 kcal/kg in morbidly obese patients (p < 0.01). Basal metabolic rate underestimated measured REE in normal weight and pre-obese patients. REEacs and REEibw over- and underestimated measured REE in overweight patients, respectively. Conclusions Predictive equations were not able to estimate measured REE adequately in all the patients. Adjusted REE decreased with increasing body mass index; thus, a body mass index group-specific adaptation for the estimation of energy needs should be applied.     

Effectiveness and safety of interventions to manage childhood overweight and obesity: An Overview of Cochrane systematic reviews

BackgroundChildhood overweight and obesity are associated with adverse physical, social, and psychological outcomes.ObjectivesWe conducted an overview of Cochrane systematic reviews on the effectiveness and risks of interventions to treat overweight and obesity in children and adolescents.MethodsIn June 2019, we searched the Cochrane Database of Systematic Reviews for eligible reviews. The primary outcomes were change in adiposity (body mass and body mass index [BMI] z-score) and adverse events. Two reviewers screened studies and one reviewer extracted and another verified data. Two reviewers assessed methodological quality and reached consensus. Data were synthesized narratively.ResultsWe included seven Cochrane reviews published between 2011 and 2017 containing evidence from 167 randomized controlled trials with 21,050 participants. Lifestyle and behavioural interventions more effectively reduced weight compared with no intervention, usual care, or another behavioural treatment (three reviews, low-to-moderate certainty). Parent–child lifestyle and behavioural interventions more effectively reduced BMI z-score compared with no intervention (one review, low certainty). Decision support tools for healthcare providers more effectively limited increases in BMI z-score compared with usual care (one review, moderate certainty). Pharmacologic treatments combined with behavioural modification more effectively reduced adiposity compared with placebo or usual care (one review, low certainty), but the risk of adverse events was greater than non-pharmacologic therapy. Surgical interventions (e.g., LAP-BAND) combined with behavioural modification more effectively reduced adiposity compared with behavioural modification alone (one review, low certainty). Those who underwent surgery reported a higher number of adverse events compared with those treated with lifestyle modification.ConclusionsThere is low-certainty evidence that lifestyle and behavioural interventions, pharmacologic interventions, and surgical interventions are effective in weight management for children with overweight and obesity. Safety data remain lacking across all intervention modalities. Future research should focus on implementation strategies. Further, a focus on overall well-being may be more beneficial than weight management specifically.     

内江市中区超重及肥胖人群相关因素调查

目的 探讨内江市企事业及机关单位从业人员20~60岁人群中超重、肥胖者及其相关因素.方法 2009年6月-2010年9月采用整体随机分层方法,对内江市企事业及机关单位从业人员共5 832例进行调查.用问卷了解吸烟、饮酒、运动、家族史、文化程度,并测定身高、体重、空腹血糖、甘油三脂、胆固醇等.采用SPSS 17.0软件进...     

Childhood obesity: a transtheoretical case management approach

Childhood obesity is an increasing health problem because of its strong associations with chronic health problems in children and adults. Obesity during childhood commonly persists into adulthood and is resistant to interventions that involve only recommendations to decrease caloric intake and to increase caloric expenditure through increased physical activity. The challenge with this approach to childhood obesity is that it is not theoretically based, nor does it consider the child's or the parent's perceptions of the health problem or their transition along the stages of behavioral change. Case management has been proven to be successful in managing various chronic health problems in both adults and children. This article will introduce a new intervention model based on the transtheoretical framework by utilizing case management in a primary care setting to treat childhood obesity.     

二维斑点追踪技术评估超重及肥胖女性妊娠期胎儿心室收缩功能的研究

目的应用二维斑点追踪技术评价超重及肥胖女性妊娠期胎儿心室收缩功能。 方法选取空军军医大学唐都医院2019年6月至2020年3月单胎妊娠的孕妇80例,所有孕妇均于孕24周行常规胎儿超声心动图及二维斑点追踪成像检查。依据孕前体质量指数（BMI）将研究对象分为正常对照组30例、超重组27例和肥胖组23例。采用常规超声心动图及二维斑点追踪技术,对各组胎儿心脏结构、常规心室舒张及收缩功能指标、全心整体球形指数（GSI）以及左、右心室心内膜整体纵向应变（GLS）和右心室游离壁应变（FWSt）进行评价及比较分析。 结果肥胖组、超重组与正常对照组的胎儿左、右房室横径,心脏面积,心胸面积比及四腔心横径、长径,GSI比较,差异均无统计学意义（P均＞0.05）。各组胎儿二、三尖瓣口血流E/A值及瓣环运动速度e/a值差异均无统计学意义,肥胖组二、三尖瓣瓣环收缩期运动速度s较正常对照组及超重组均降低,差异均有统计学意义（P均＜0.05）。各组胎儿左心室射血分数,左、右心室面积变化率,二尖瓣环收缩期位移及三尖瓣环收缩期位移比较,差异均无统计学意义（P均＞0.05）。左、右心室GLS,及右心室FWSt在正常对照组、超重组、肥胖组均依次逐渐减低,组间差异均有统计学意义（P均＜0.05）。 结论超重女性妊娠可能会使胎儿心肌功能发生改变,左、右心室纵向应变各参数指标可以较好地反映超重及肥胖女性妊娠所引起的胎儿心肌收缩功能改变,有利于孕期随访观察及指导孕妇体重管理。     

Evaluation of the effect of caloric restriction on serum BDNF in overweight and obese subjects: preliminary evidences

Brain-derived neurotrophic factor (BDNF) has emerged as a new element related with insulin resistance and obesity. Objective To evaluate the effect of a 3-month reduced-calorie diet (RCD) on serum BDNF concentrations in overweight and obese subjects. Subjects Seventeen healthy overweight and obese subjects of both sexes (24–48 years, BMI 34.6 ± 1.1 kg/m²). Methods Anthropometry, oral glucose tolerance test (OGTT), lipid levels, and serum BDNF were measured at baseline and at the end of the third month. Reduced-calorie diet was defined as a 25% reduction in energy intake composed of: 55% carbohydrates, 20% proteins, and 25% fat (less than 10% saturated fat and over 10% nonsaturated fat). Refined sugar was not allowed. Results There was a significant decrease in BMI, waist circumference, body fat percentage, fasting glucose, post-OGTT glucose levels, area under the curve of glucose, and HOMA2-IR after 3 months of RCD. Serum BDNF showed a significant increase (3.97 ± 0.87 to 6.75 ± 1.62 ng/ml, P = 0.02). Final serum BDNF correlated negatively with weight (r = −0.51, P = 0.03), and basal post-OGTT insulin correlated positively with final serum BDNF (r = 0.48, P = 0.04). Conclusions Serum BDNF increases in insulin-resistant overweight and obese subjects after three months on a RCD. This observation could indicate that BDNF may be modulated in humans through diet composition.