Associations Between Nonnutritive Sweetener Intake and Metabolic Syndrome in Adults

Objective: Individuals looking to improve their health or weight status often use nonnutritive sweeteners (NNS), yet NNS consumption has been associated with increased risk factors for metabolic syndrome (MetS). Most studies examining NNS only assess total intake using diet soda as a proxy for NNS consumption, without distinguishing potential risks associated with individual sweeteners. The objective of this cross-sectional investigation was to identify whether there were associations between NNS consumption (total or individual) and risk factors for MetS in adults (n = 125) from Southwest Virginia.

Methods: Participants provided three 24-hour dietary recalls and blood pressure, waist circumference, fasting glucose, triglycerides, and high-density lipoprotein cholesterol were assessed. Linear regression models, adjusted for age, sex, caloric intake, dietary quality, and physical activity, examined associations between total and individual types of NNS with MetS and MetS risk factors.

Results: Sixty-three participants were classified as NNS consumers and eighteen met the criteria for MetS. While no significant associations between MetS and NNS consumption were found, waist circumference was positively associated with total NNS, saccharin, sucralose, and acesulfame potassium, and both fasting glucose and triglyceride values were positively associated with total NNS and aspartame consumption.

Conclusion: While these cross-sectional data are consistent with previous work implicating NNS in development of MetS, additional research using randomized controlled trials is needed to clarify whether and how NNS in general or specific NNS might contribute to risk factors for MetS. This trial was registered at clinicaltrials.gov (NCT03364452).     

Obesity and its association with generalised epilepsy,idiopathic syndrome,and family history of epilepsy

Aim. Previous studies support the concept that obesity is a common comorbid condition in patients with epilepsy (PWE). In this study, we present the body mass index (BMI) and data from a survey to assess physical activity in a sample of PWE from an epilepsy clinic. Methods. Between June of 2011 and January of 2013, 100 PWE from an adult epilepsy clinic were included. We obtained BMI, waist circumference, and information regarding physical activity using a standardised questionnaire. Clinical, demographic, electrographic, and imaging parameters were collected from charts. Results. Mean age of patients was 40±14 (18–77) years. The BMI distribution was as follows: 2 patients (2%) underweight, 26 (26%) normal weight, 34 (34%) overweight, 25 (25%) obese, and 13 (13%) with morbid obesity. In our study, obesity was defined as having a BMI ≥30. We found 38 (38%) patients in this range. There was no difference in the rate of drug‐resistant epilepsy between obese and non‐obese patients (55 vs. 55%; p=0.05). Leisure time habit was reported in 82% of obese patients and 79% of patients without obesity. Overall, the most frequent activity was walking (70%). Factors associated with obesity were generalised epilepsy (OR: 2.7, 1.1–6.6; p=0.012), idiopathic syndrome (OR: 2.7, 1.04–7; p=0.018), and family history of epilepsy (OR: 6.1, 1.5–24.2; p=0.002). Conclusion. Our study suggests an association between obesity, idiopathic generalised epilepsy, and family history of epilepsy. Our study shows that PWE are physically active and there is no clear relation between exercise and obesity. We could not identify any association between drug‐resistant epilepsy and obesity. Absence of direct comparison with a control non‐epileptic population; a cross‐sectional design not allowing evaluation of a causal association among variables; and reliance on self‐reported physical activity are to be considered as limitations of the present study.     

Periodontal Status and High‐Sensitivity C‐Reactive Protein Levels in Polycystic Ovary Syndrome With and Without Medical Treatment

Background: Recently, some studies have revealed the effect of polycystic ovary syndrome (PCOS) on gingival inflammation. This cross‐sectional study attempts to assess the periodontal status and systemic inflammation of women receiving medical treatment for PCOS and women newly diagnosed with PCOS. Methods: A total of 126 participants comprising 41 newly diagnosed patients with PCOS (PCOS‐N), 45 patients with PCOS on medical treatment (PCOS‐MT), and 40 systemically healthy controls (control group [CG]) were examined. Periodontal parameters, anthropometric parameters, and serum levels of high‐sensitivity C‐reactive protein (hsCRP) were recorded. Results: Women with newly diagnosed PCOS had increased sites with bleeding on probing (BOP), probing depth, clinical attachment level (CAL), waist circumference (WC), hsCRP, and prevalence of periodontitis compared with control and PCOS‐MT groups (P ≤0.05). On partial correlation analysis after controlling for confounders, BOP and CAL correlated positively and significantly with hsCRP (P = 0.01 and P = 0.005). Multivariate linear regression analysis revealed that BOP and CAL (dependent variable) (P = 0.009/R² = 0.05 and P = 0.005/R² = 0.07, respectively) had significant association with hsCRP. Furthermore, hsCRP, when considered as outcome, also exhibited association with CAL and WC (P = 0.002/R² = 0.07 and P = 0.04/R² = 0.106). Logistic regression analysis demonstrated that the PCOS‐N group had 2.88 times increased likelihood of having moderate periodontitis (adjusted odds ratio 2.88, 95% confidence interval 1.18 to 6.98). Conclusions: Women with newly diagnosed PCOS may have increased prevalence and likelihood for periodontitis, with higher measures of periodontal inflammation and breakdown than those on medical treatment for PCOS and systemically healthy females. Furthermore, periodontal breakdown might depend on systemic inflammation and vice versa.     

Heterogeneous effects of obesity on mental health: Evidence from Mexico

Obesity can spread more easily if it is not perceived negatively. This issue may be more pronounced among the poor, a conjecture that we test in this paper. We start with general evidence on the concave relationship between income and obesity, both across countries and within Mexico, a country characterized by very unequal development levels and the highest obesity rate in the world. We suggest a general model that explains this stylized fact from a simple necessary condition, namely, the complementarity between nonfood consumption and health concerns. Then, we test the direct effect of overweight on mental health among Mexican women. We find a positive effect of obesity in the low consumption group and a depressing effect among the rich. This result is robust to the inclusion of a range of confounders (childhood conditions, lifestyle variables, food expenditure, and household shocks) and after instrumenting individual fatness by the variation in genetic predisposition. The complementarity between living standards and weight concerns may reflect different norms, different labor market penalties, or simply different returns to healthy time across the social spectrum.     

Association of weight-adjusted-waist index with incident hypertension: The Rural Chinese Cohort Study

AimsTo explore the association between WWI and the incidence of HTN in the Rural Chinese Cohort Study.Methods and ResultsWe examined data for 10,338 non-hypertensive participants (39.49% men) aged ≥ 18 years from the Rural Chinese Cohort Study who completed a baseline examination during 2007–2008 and follow-up during 2013–2014. WWI was calculated as waist circumference (cm) divided by the square root of weight (kg). Multiple logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the probability of HTN across four WWI categories. Restricted cubic splines analysis was used to model the dose–response association of WWI and HTN. A total of 2078 participants had HTN during a median follow-up of 6 years. After adjusting for potential confounders, as compared with the lowest WWI category (<9.94 cm/√kg), with WWI 9.94 to 10.42, 10.42 to 10.91 and ≥ 10.91 cm/√kg, the ORs (95% CIs) for HTN were 1.12 (0.93–1.35), 1.40 (1.17–1.69) and 1.50 (1.24–1.82), respectively. Results of the sensitivity analyses were robust. The ORs were generally consistent on subgroup analysis by sex, smoking status, systolic blood pressure and diastolic blood pressure. Multiple logistic regression models with restricted cubic splines showed a non-linear positive association between WWI and HTN (P_nonlinearity < 0.001).ConclusionThe highest WWI category was significantly associated with increased risk of HTN. Our findings may facilitate the development and promotion of obesity prevention strategies aimed at reducing the risk of HTN and provide evidence for healthcare policy in rural China.     

Predictive performance of traditional and novel lipid combined anthropometric indices to identify prediabetes

Background and aimsDiabetes mellitus is one of the critical public health challenges in the Indian healthcare scenario. Novel anthropometric indices are promising surrogate markers to detect prediabetes compared to the traditional anthropometric indices that only reflect gross obesity. Thus, the authors aim to analyse the potential of three novel lipid combined anthropometric indices in predicting prediabetes in the Asian Indian population.MethodsWe conducted an age and gender-matched case-control study to identify the predictors of prediabetes. Prediabetes was diagnosed as per the American Diabetes Association (ADA) guidelines 2010. The traditional anthropometric measurements including waist circumference (WC), waist to hip ratio (WHR) and body mass index (BMI) were executed using standardised methods. Fasting lipid profile was obtained and using standardised formulas, the novel lipid combined anthropometric indices such as lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride glucose index (TyG index) were derived. TyG related indices such as triglyceride glucose-waist circumference (TyG-WC) and triglyceride glucose-body mass index (TyG-BMI) were also calculated.ResultsThe novel lipid combined anthropometric indices LAP, VAI, TyG index, TyG-WC and TyG-BMI were significantly higher in subjects with prediabetes of both the genders (p < 0.05). During receiver operating characteristic (ROC) curve evaluation, TyG index (AUC = 0.802) was the superior predictive measure in males, while in females, TyG-WC (AUC = 0.767) was the best among all the markers.ConclusionTyG index and TyG-WC seem to be a superior indicator of prediabetes in the Asian Indian population in comparison with other anthropometric indices to screen prediabetes.     

Obesity as a Causal Risk Factor for Aortic Valve Stenosis

BackgroundCausal risk factors for aortic valve stenosis are poorly understood, limiting the possibility of preventing the most common heart valve disease.ObjectivesThe hypothesis was tested that genetically based obesity measured by body mass index is causally associated with risk of aortic valve stenosis and replacement.MethodsThe authors included 108,211 individuals from the Copenhagen General Population Study. Participants had measurements of body mass index, waist-hip ratio, and waist circumference, and information on 5 genetic variants associated with obesity. A Mendelian randomization design was used to investigate genetic and observational associations of obesity with incident aortic valve stenosis (n = 1,215) and replacement (n = 467) for a median follow-up time of 8.7 years.ResultsGenetically increased body mass index was causally associated with increased risk of aortic valve stenosis. Compared with an unweighted allele score of 0 to 3, individuals with an allele score 7 to 10 had a mean increase in body mass index of 0.87 kg/m², and the age and sex–adjusted hazard ratio for aortic valve stenosis was 1.3 (95% confidence interval [CI]: 1.0 to 1.7) for allele score 4, 1.4 (95% CI: 1.1 to 1.8) for allele score 5 to 6, and 1.6 (95% CI: 1.3 to 2.1) for allele score 7 to 10 (p for trend: 9 × 10⁻⁵). A 1-kg/m² increase in body mass index was associated with causal risk ratios for aortic valve stenosis and replacement, respectively, of 1.52 (95% CI: 1.23 to 1.87) and 1.49 (95% CI: 1.07 to 2.08) genetically, and with corresponding hazard ratios of 1.06 (95% CI: 1.05 to 1.08) and 1.06 (95% CI: 1.03 to 1.08) observationally.ConclusionsObesity from human genetics was causally associated with higher risk of aortic valve stenosis and replacement.