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The Global Epidemic of Obesity: An Overview
Abstract
For centuries, the human race struggled to overcome food scarcity, disease, and a hostile environment. With the onset of the industrial revolution, the great powers understood that increasing the average body size of the population was an important social and political factor. The military and economic might of countries was critically dependent on the body size and strength of their young generations, from which soldiers and workers were drawn. Moving the body mass index (BMI) distribution of the population from the underweight range toward normality had an important impact on survival and productivity, playing a central role in the economic development of industrialized societies (1).
Historical records from developed countries indicate that height and weight increased progressively, particularly during the 19th century. During the 20th century, as populations from better-off countries began to approach their genetic potential for longitudinal growth, they began to gain proportionally more weight than height, with the resulting increase in average BMI. By the year 2000, the human race reached a sort of historical landmark, when for the first time in human evolution the number of adults with excess weight surpassed the number of those who were underweight (2). Excess adiposity/body weight is now widely recognized as one of today's leading health threats in most countries around the world and as a major risk factor for type 2 diabetes, cardiovascular disease, and hypertension (3).
This overview provides an introduction to this issue of Epidemiologic Reviews, highlighting, in historical perspective, key scientific aspects of obesity that are addressed by the 11 articles that follow. This compilation of reviews underscores the multidisciplinary nature of obesity research and the need to expand even further our scope to fully understand and confront the obesity epidemic.
... Obesity has become a major global epidemic with substantial health implications for children and adolescents worldwide [1,2]. Weight problems and obesity are increasing in most of the EU Member States [3]. ...
... It is well known that eating habits and dietary patterns acquired during childhood are likely to be maintained into adulthood [5]. Obesity is considered as a risk factor in the development of Metabolic Syndrome (MetS) [2,4,5]. MetS is a complex disorder affecting individuals across all age groups, including children and adolescents [1,2]. ...
... Obesity is considered as a risk factor in the development of Metabolic Syndrome (MetS) [2,4,5]. MetS is a complex disorder affecting individuals across all age groups, including children and adolescents [1,2]. Having MetS increases the risk of developing type 2 diabetes mellitus and cardiovascular disease [6]. ...
Purpose of Review
We aimed to examine the relationship between various diet quality scores and obesity and Metabolic Syndrome (MetS) in children and adolescents.
Recent Findings
Obesity and MetS, which increase the risk of type 2 diabetes and cardiovascular disease from childhood through adolescence, have been associated with adherence to various diet quality scores.
Summary
A systematic search was performed in PubMed/Medline, Scopus, SciELO, Embase, and Cochrane, covering the period until March 2024. Two researchers evaluated 3,519 studies according to the inclusion criteria. Finally, 73 articles that analysed the relationship between diet quality scores and obesity and MetS were included, and 6 of them were included in a meta-analysis. Children younger than 12 years old showed statistically significant differences indicating a higher Mediterranean diet (MD) score adherence compared to those with a low score adherence for BMI (MD = 0.33 kg/m², 95% CI: 0.01, 0.64) and WC values (MD = 1.21 cm, 95% CI: 0.50, 1.93). Additionally, in the meta-regression analysis, boys showed stronger associations for BMI, z-score BMI and WC (β = 19.82, 95% CI: 17.62, 22.03, β = 0.64, 95% CI: 0.33, 0.96 and β = 67.03, 95% CI: 57.29, 76.77, respectively). Studies in this review suggest an association between high adherence to different diet quality scores and low BMI. Meta-analysis assessing the association between adherence to the MD and BMI, and WC, showed a protective effect of the MD pattern against obesity outcomes. This systematic review and meta-analyses provided evidence on the effect of the diet quality on obesity and MetS in children and adolescents.
... Obesity has a pronounced impact on morbidity and mortality, as it contributes to the global incidence of chronic diseases, including cardiovascular disease, type 2 diabetes and cancer [1]. The rise in the global incidence of obesity over the last several decades is attributed to an increased availability of highly palatable and energy-dense foods, including high-fat foods [2,3]. The hedonic value of energy-dense foods promotes preferential consumption, leading to increased caloric intake and obesity [4]. ...
... We utilized whole striatum and olfactory bulb; future studies could examine single-cell RNA-sequencing to determine whether DEGs are cell-type specific. Lastly, obesity has a multifactorial etiology, and its complex pathogenesis cannot entirely be explained by dietary differences alone [2,55]. Genetic predisposition, environmental exposures, and social factors, also play a role in the pathogenesis of obesity [2,55]. ...
... Lastly, obesity has a multifactorial etiology, and its complex pathogenesis cannot entirely be explained by dietary differences alone [2,55]. Genetic predisposition, environmental exposures, and social factors, also play a role in the pathogenesis of obesity [2,55]. The results and interpretation of the effect of the genes discussed in this study should also be considered in the context of the multidimensionality of obesity. ...
The incidence of obesity has markedly increased globally over the last several decades and is believed to be associated with the easier availability of energy-dense foods, including high-fat foods. The reinforcing hedonic properties of high-fat foods, including olfactory cues, activate reward centers in the brain, motivating eating behavior. Thus, there is a growing interest in the understanding of the genetic changes that occur in the brain that are associated with obesity and eating behavior. This growing interest has paralleled advances in genomic methods that enable transcriptomic-wide analyses. Here, we examined the transcriptomic-level differences in the olfactory bulb and striatum, regions of the brain associated with olfaction and hedonic food-seeking, respectively, in high-fat-diet (HFD)-fed obese mice. To isolate the dietary effects from obesity, we also examined transcriptomic changes in normal-chow-fed and limited-HFD-fed groups, with the latter being pair-fed with an HFD isocaloric to the consumption of the normal-chow-fed mice. Using RNA sequencing, we identified 274 differentially expressed genes (DEGs) in the striatum and 11 in the olfactory bulb of ad libitum HFD-fed mice compared to the chow-fed group, and thirty-eight DEGs in the striatum between the ad libitum HFD and limited-HFD-fed groups. The DEGs in both tissues were associated with inflammation and immune-related pathways, including oxidative stress and immune function, and with mitochondrial dysfunction and reward pathways in the striatum. These results shed light on potential obesity-associated genes in these regions of the brain.
... Obesity is emerging as a global challenge, as its burden is rising alarmingly in both high and low-income countries [1][2][3][4][5][6][7][8]. It is associated with adverse health consequences, including but not limited to the increased burden of non-communicable diseases (NCDs) and chronic diseases, poor morbidity outcomes, and a decreased life expectancy of up to 20 years [1][2][3][4]6,7,[9][10][11][12]. ...
... Obesity is emerging as a global challenge, as its burden is rising alarmingly in both high and low-income countries [1][2][3][4][5][6][7][8]. It is associated with adverse health consequences, including but not limited to the increased burden of non-communicable diseases (NCDs) and chronic diseases, poor morbidity outcomes, and a decreased life expectancy of up to 20 years [1][2][3][4]6,7,[9][10][11][12]. These adverse effects not only impact children's current health but also their adolescence and adulthood [1][2][3]10], making early obesity prevention efforts a crucial priority [1]. ...
... The restructuring of the built environment to create a physical activity-promoting environment aims to achieve a beneficial impact on health outcomes, particularly on obesity outcomes in children. Since children spend a substantial amount of time within their home neighbourhood, it is believed that this approach may support efforts to address the obesity epidemic, although evidence to date has been inconsistent [3,4,10]. ...
The burden of obesity is rising globally and is studied widely, yet the evidence for the association of environmental factors (both built and natural) with childhood obesity remains inconsistent. A relation with temperature as a proxy for natural environmental factors for obesity has not been reviewed previously. The purpose of this review was to assimilate updated evidence on environmental factors of childhood obesity. Three databases, MEDLINE (Medical Literature Analysis and Retrieval System Online), Web of Science, and Cochrane, were searched for articles related to the effect of built environment and temperature on childhood obesity in 6-12-year-olds published in the last five years. Twelve studies were identified: four longitudinal and eight cross-sectional. The studies were appraised using the National Institute of Health Quality (NIH) Assessment Tool. A review of included studies showed that built environmental features like higher residential and population density, higher intersection density, more playgrounds, and all park features like the presence or availability of parks, high number of parks, proximity to parks, and an increased park land area, showed a protective association against childhood obesity while land use mix showed a promoting association for the development of childhood obesity. Inconclusive evidence was observed for other built environmental features. The search strategy did not retrieve any literature published in the past five years studying the association between temperature and the development of childhood obesity. Standardization of definitions of exposure and outcome measures is recommended. Further research studying the relationship between environmental temperature and the development of childhood obesity is recommended.
... Chai (a tea beverage made by boiling black tea in milk and water with a mixture of aromatic herbs and spices); most of the South Asian people including Pakistanis drink it with sugar. According to Food and Agriculture Organization, currently the black tea consumption in Pakistan has been estimated at 1,72,911 tonnes which is expected to increase to 2,50,755 tonnes in 2027. Research has shown that the use of excessive white sugar can result in overweight and obesity which can ultimately lead to the development of cardiovascular diseases 35 . ...
... The epidemic of obesity is marked by alarming proportions globally 72 . It highly contributes to the burden of non-communicable diseases in general and cardiovascular disease (CVD) in particular 73,74 . ...
South Asians including Pakistanis have higher risk of developing diabetes, hypertension and heart diseases even at the same body weight as compared to other ethnicities. Both genetics and lifestyle factors are at play in determining the risk of diseases among this population. Diet is one of these lifestyle factors. Historically, Pakistani households consume a variety of fruits and vegetables, grains, pulses, meat and dairy products. In the modern era, with the advent of processed foods there has been increase in the use of fast food, beverages containing sugars, fruit juices, bakery products and use of processed oil for cooking. These modern changes which are the result of cultural shifts are increasing the diseases among this population. In addition, migration from one country to another country also brings the shift in dietary patterns which can be a predictor of diseases. This book explores the old school dietary habits of Pakistanis and unravels its nutritional benefits and downsides; alongside the book also looks at the cultural shift in dietary habits of Pakistanis living inside and outside Pakistan. It is pertinent to mention that dietary habits have a big role to play in determining the risk of diseases like overweight, obesity, diabetes, hypertension and heart diseases.
... Obesity is commonly considered a form of malnutrition that primarily emerged in the twientieth century, in association with lifestyles promoting high-energy intake or low physical activity [1,2]. The influential 'energy balance equation' encourages us to consider the aetiology of obesity through the lens of 'calorie counting', and failure to regulate the balance between energy intake and expenditure [3]. ...
... The further we look back into the human past, however, the more the literature highlights food scarcity and undernutrition as the primary nutritional stresses [1,8,9], even though the emergence of agriculture appears to have worsened the risk of famine [10] and was associated with an increase in skeletal markers of malnutrition in early European farmers [11]. Accordingly, it is rare for obesity to be presented as a pre-agricultural phenomenon. ...
Evolutionary perspectives on obesity have been dominated by genetic frameworks, but plastic responses are also central to its aetiology. While often considered a relatively modern phenomenon, obesity was recorded during the Palaeolithic through small statuettes of the female form (Venus figurines). Even if the phenotype was rare, these statuettes indicate that some women achieved large body size during the last glacial maximum, a period of nutritional stress. To explore this paradox, we develop an eco-life-course conceptual framework that integrates the effects of dietary transitions with intergenerational biological mechanisms. We assume that Palaeolithic populations exposed to glaciations had high lean mass and high dietary protein requirements. We draw on the protein-leverage hypothesis, which posits that low-protein diets drive over-consumption of energy to satisfy protein needs. We review evidence for an increasing contribution of plant foods to diets as the last glacial maximum occurred, assumed to reduce dietary protein content. We consider physiological mechanisms through which maternal overweight impacts obesity susceptibility of the offspring during pregnancy. Integrating this evidence, we suggest that the last glacial maximum decreased dietary protein content and drove protein-leverage, increasing body weight in a process that amplified across generations. Through the interaction of these mechanisms with environmental change, obesity could have developed among women with susceptible genotypes, reflecting broader trade-offs between linear growth and adiposity and shifts in the population distribution of weight. Our approach may stimulate bioarchaeologists and paleoanthropologists to examine paleo-obesity in greater detail, and to draw upon the tenets of human biology to interpret evidence.
... Caballero (2007) defined obesity as an excess of body adiposity. In the 1980s, the ideal body weight approach was replaced by BMI, and the commonly used cutoffs for overweight and obesity (BMI >30), for both male and female, were adopted to define obesity in adults (Caballero, 2007). World Health Organization (WHO) (1995) stated that, at individual level, anthropometry is use either to identify a person as being in need of special consideration, or to assess that person's response to some intervention. ...
... This was because it is common, easy to use, non-expensive and appropriate for measuring a large population of schoolchildren. However, there are other anthropometric methods to assess weight status for individuals (Caballero, 2007), but these measurements may not applicable to be used in a large number of children in schools. ...
Background: The purpose of this cross-sectional study was to find out the prevalence rates of underweight, overweight and obesity among schoolchildren in Selangor. Methods: The study comprised a multistage stratified random sample that included 918 schoolchildren aged 13 to 16 from three secondary schools in Selangor. Heights and weights were measured, from which the BMI was calculated. CDC growth chart 2000, was used to identify children's who are at risk for weight-related problems. Results: About 24 % of the overall children were overweight/obese, and the Malays showed the highest prevalence of overweight/obese 25.9% compare to other ethnic groups. A higher prevalence of overweight/obese was found among boys and girls Malays children 30% and 21.5% respectively. The overall prevalence of underweight between children was 13.6%, and the Chinese had the highest rates of underweight 16.5% compare to other ethnic groups. Children with high living standards were more likely to be overweight/obese (32% boys and 25.5% girls) compare with lower living standards children. Conclusion: The results suggested that Selangor children are facing the risks of overweight/obesity problems. Primary and secondary prevention plans are needed in order to reduce the proportion of overweight in school-aged children in Selangor.
... A World Health Organization (WHO) report from 2021 states that in 2016, more than 650 million adults were obese and over 1.9 billion individuals were overweight, with the proportion of obese people having nearly quadrupled between 1975 and 2016 [1]. Obesity is a global public health concern not only because it lowers people's quality of life, but also because it acts as a proxy for many comorbidities, making it the leading cause of preventable death globally [2,3]. It is the second biggest risk factor after smoking, accounting for up to 3.4 million deaths annually [1]. ...
... In the wake of the COVID-19 pandemic, obesity has been found to be a major risk factor for hospitalization and subpar clinical outcomes for SARS-CoV2 patients [8]. Although its pathophysiology is very complicated, it is influenced by both congenital (inherited) and acquired (environmental) variables [3]. ...
Obesity has been associated with the occurrence and prevalence of various chronic metabolic diseases. The management of obesity has evolved to focus not only on reducing weight, but also on preventing obesity-related complications. Studies have shown that bioactive components in natural products like white kidney bean extract (WKBE), propolis ethanolic extract (PEE), and chromium picolinate (CrPi 3) showed anti-obesity properties. However, no studies have examined the outcomes of combining any of these nutraceutical supplements. We compared the effects of HFD supplemented with WKBE, WKBE+PEE, or WKBE+PEE+CrPi 3 against control and obese groups using Sprague-Dawley rats fed a 45% high-fat diet as an in vivo model. Nutritional parameters, biochemical parameters, and biomarkers of cardiovascular disease, liver function, kidney function, and gut health were among the comparable effects. Our findings showed that combining the three nutraceutical supplements had a synergetic effect on reducing weight gain, food utilization rate, abdominal fat, serum lipids, arterial and hepatic lipids, risk of cardiovascular disease, and blood glucose level, in addition to improving renal function and gut microbiota. We attributed these effects to the α-amylase inhibitor action of WKBE, flavonoids, and polyphenol content of PEE, which were potentiated with CrPi 3 resulting in a further reduction or normalization of certain parameters.
... 123 Obesity is a global health issue that is associated with chronic conditions such as cardiovascular disease and diabetes, impacting overall quality of life and life expectancy. 124 Probiotic extracellular vesicles containing proteins and nucleic acids can influence the host's energy metabolism, fat synthesis, and decomposition processes, thus affecting body weight. Research suggests that extracellular vesicles from Akkermansia muciniphila contain biomolecules that can positively impact obesity by influencing the expression of relevant genes. ...
Probiotics have been established to exert a positive impact on the treatment of various diseases. Indeed, these active microorganisms have garnered significant attention in recent years for their potential to prevent and treat illnesses. Their beneficial effects have been hypothesized to be linked to their released extracellular vesicles. These nanoscale structures, secreted during the growth and metabolism of probiotics, possess favorable biocompatibility and targeting properties, thereby promoting intercellular material transport and signaling. This article aimed to review the bioactive components and functions of these probiotics vesicles, highlighting their role in the treatment of various diseases and discussing their potential future applications. By exploring the mechanisms of probiotic extracellular vesicles in disease development, this review aimed to provide a theoretical reference for further research on their therapeutic potential. © 2025 Society of Chemical Industry.
... Very recently, obesity significantly spanned in developing countries (4)(5)(6) . In the 2000s, the World health Organization (WHO) recognized obesity as a global epidemic (7) because of its interlinkages with non-communicable diseases (NCD). Recent estimates indicated that 1.5 billion of adults aged 20 years and above were overweight; among them, over 200 million of men and 300 million of women were obese (5) . ...
Objective
To investigate the relationship between maternal age and nutritional status, and test associations between maternal nutritional status and child mortality with a focus on maternal obesity.
Design
Secondary analysis of data from nationally representative cross-sectional sample of women of reproductive ages (15—49 years) and their children under five years. The outcome variable for maternal nutritional status was Body Mass Index (BMI), classified into underweight (BMI < 18.50 kg/m ² ), normal weight (18.50—24.99 kg/m ² ), overweight (25.0—29.9 kg/m ² ) and obesity (>=30.0 kg/m ² ). Child mortality was captured with five binary variables measuring the risk of dying in specific age intervals (neonatal, post-neonatal, infant, childhood, and under-five mortality).
Setting
The most recent Demographic and Health Surveys from Democratic Republic of Congo (DRC).
Participants
The final samples consisted of 7,892 women of reproductive ages (15—49 years) and 19,003 children aged 0—59 months.
Results
The prevalence of obesity was estimated at 3.4%; it increased with maternal age. Furthermore, obesity unevenly affected provinces in the Democratic Republic of the Congo: Kinshasa, South Kivu, North Kivu and Maniema were most affected. Finally, maternal obesity showed mixed effects on child mortality.
Conclusion
The prevalence of obesity is still low; however, provinces are unevenly affected. Therefore, interventions and programs to improve nutrition should incorporate geographical disparities to tackle adverse child outcomes associated with maternal obesity, to limit negative consequences of maternal obesity, including non-communicable diseases (NCD) which might be a strong impediment to reach Sustainable Development Goals (SDG) 2 and 3.
... What is even more important is that, as obesity in children and adolescents has become a major global epidemic [28,29], the effect of a nutritional intervention with the MeDi in obese children exhibiting at least one MetS component showed improvements in BMI and the glucose and lipid profile in comparison to the standard diet in a study from Velázquez-López et al. [30]. In addition, a recent systematic review and meta-analysis by Larruy-García et al. further supports these claims as it highlights the protective effect of MeDi adherence on unwanted obesity outcomes in children and adolescents [31]. ...
Metabolic syndrome (MetS) is a major health issue defined by central obesity and at least two more of the following factors: high triglycerides, low high-density lipoprotein (HDL) cholesterol, high blood pressure, and high fasting glucose. Managing MetS involves lifestyle changes, with the adherence to a Mediterranean diet (MeDi) playing a crucial role. MeDi, emphasizing the consumption of whole grains, fruits, vegetables, legumes, nuts, and olive oil, has been linked to a reduced risk of type 2 diabetes and improved glucoregulation. A randomized controlled trial showed that a low-carb MeDi resulted in a 30% lower relative risk of developing type 2 diabetes compared to a low-fat diet. Additionally, meta-analytic data highlighted a strong inverse relationship between adherence to the MeDi and the incidence of diabetes. Furthermore, the MeDi’s anti-inflammatory properties help manage obesity-related low-grade chronic inflammation, crucial for weight management and the improvement of quality of life. The improvement of lipid profiles, reductions in low-density lipoprotein and total cholesterol, and an increase in HDL cholesterol were also found to be linked to MeDi adherence. However, despite its benefits, adherence to the MeDi varies widely, often being low to moderate in many Mediterranean populations. Improving adherence through physician advice and patient education is crucial for maximizing the MeDi’s potential to prevent and manage diabetes and diabetes-related complications.
... Prior studies have demonstrated the importance of establishing healthy eating patterns from childhood (Macias et al., 2012), as they can influence long-term food preferences and eating habits (Nascimento-Ferreira et al., 2016). Obesity is one of the leading public health problems globally, being a risk factor for numerous comorbidities, and Chile is not exempt from the consequences of this pandemic (Caballero, 2007;Upadhyay et al., 2018). However, it is the consequence of many dimensions, thus it can be explained from a bio-socioecological framework in which biological predisposition, socioeconomic, and environmental factors promote adipose tissue deposition and proliferation and resistance to efforts to control it (Jebeile et al., 2022). ...
This study aimed to characterize the physical activity levels and their association with healthy and unhealthy behaviors in adolescent students in Chile. It was a non-experimental, cross-sectional, and descriptive study. The non-probabilistic sample consisted of 175 high school students from public schools (n=103 females, age: 14.4±1.48 years; n=72 males, age: 14.2±1.56 years) who completed the World Health Organization's Global School-based Student Health Survey during the second semester of the year 2023. The main findings revealed a 32.5% prevalence of overweight and obesity and an 8.6% compliance with the World Health Organization physical activity recommendation. Those who engage in at least 60 minutes of physical activity per day show higher consumption of fruits and vegetables and fewer absences from classes, while those who use active transportation also demonstrate higher consumption of fruits and vegetables. Adolescent students are mostly physically inactive, with a higher level of inactivity among females, and those who met the physical activity recommendations consumed more fruits and vegetables than those who did not. From a gender perspective, females exhibited higher drug and marijuana consumption, increased feelings of loneliness, worry, suicidal ideation, and higher rates of absenteeism compared to males. These results highlight the necessity of developing intervention strategies targeting the adolescent school population with a gender perspective, focusing on promoting physical activity, active transportation, as well as healthy habits in both physical and mental domains.
... También han afectado la alimentación, y han generado efectos negativos en la nutrición y la salud de personas y ecosistemas (Colás et al. 2018). No sorprende que el incremento en la morbilidad y mortalidad, relacionado con el sobrepeso y la obesidad, sea uno de los grandes desafíos en la salud pública en el siglo XXI (Caballero 2007;Ng et al. 2014). El problema se asocia con cambios acelerados, relativamente homogéneos entre geografías y culturas, entre hábitos alimentarios y estilos de vida (Popkin 2004), pero en especial con el consumo de productos ultraprocesados (Carrera-Bastos et al. 2011;Monteiro 2010). ...
Con base en el modelo de transición nutricional, se atribuye la prevalencia del sobrepeso y la obesidad, padecimientos ligados a mayores tasas de morbilidad y mortalidad, a un proceso uniforme e inexorable en el que sociedades rurales abandonan sus dietas y prácticas agrícolas tradicionales. Sin embargo, un encuentro impensado durante una intervención nutricional ofreció pistas para cuestionar dicho modelo. Mediante análisis de investigación cualitativa desarrollada entre 2008 y 2015 en la Sierra central de Ecuador, y entrevistas a líderes comunitarios en 2016, encontramos información que sugiere que las transformaciones agroalimentarias son heterogéneas y están moldeadas por circunstancias históricas, geográficas y socioculturales. Varias familias indígenas andinas fusionan prácticas precolombinas, coloniales y actuales con una identidad revalorada, lo cual revitaliza agroecosistemas y dietas tradicionales. Este enfoque refleja resiliencia, resistencia y circularidad en la preservación de los sistemas agroalimentarios indígenas; una movilización comunitaria enraizada en estructuras socioculturales andinas, y surgida de transformaciones que reconocen el pasado como medio simbólico para caminar hacia el futuro.
... Prior studies have demonstrated the importance of establishing healthy eating patterns from childhood (Macias et al., 2012), as they can influence long-term food preferences and eating habits (Nascimento-Ferreira et al., 2016). Obesity is one of the leading public health problems globally, being a risk factor for numerous comorbidities, and Chile is not exempt from the consequences of this pandemic (Caballero, 2007;Upadhyay et al., 2018). However, it is the consequence of many dimensions, thus it can be explained from a bio-socioecological framework in which biological predisposition, socioeconomic, and environmental factors promote adipose tissue deposition and proliferation and resistance to efforts to control it (Jebeile et al., 2022). ...
Introduction: Healthy lifestyle habits in school-aged children are crucial for their physical, emotional, and cognitive health and development. Objective: to characterize physical activity levels and their association with healthy and unhealthy behaviors in adolescent students in Chile. Methodology: It was a non-experimental, cross-sectional, and descriptive study. The non-probabilistic sample consisted of 175 high school students from public schools (n=103 females, age: 14.4±1.48 years; n=72 males, age: 14.2±1.56 years) who completed the World Health Organization's Global School-based Student Health Survey during the second semester of the year 2023. Results: The main findings revealed a 32.5% prevalence of overweight and obesity and an 8.6% compliance with the World Health Organization's physical activity recommendation. Those who engage in at least 60 minutes of physical activity per day show higher consumption of fruits and vegetables and fewer absences from classes, while those who use active transportation also demonstrate higher consumption of fruits and vegetables. Discussion: Adolescent students are mostly physically inactive, with a higher level of inactivity among females, and those who met the physical activity recommendations consumed more fruits and vegetables than those who did not. From a gender perspective, females exhibited higher drug and marijuana consumption, increased feelings of loneliness, worry, suicidal ideation, and higher rates of absenteeism compared to males. Conclusions: These results highlight the necessity of developing intervention strategies targeting the adolescent school population with a gender perspective, focusing on promoting physical activity, active transportation, as well as healthy habits in both physical and mental domains.
... For thousands of years obesity was rarely seen [9]. It was not until the 20th century that it became common; in 1997 WHO formally recognized obesity as a global epidemic feature [10]. As for 2005 the WHO estimated that at least 400 million adults (9.8%) were obese, with higher rates among women than men [11]. ...
Background: Overweight and obesity are among the most frequently encountered multi-factorial disorders in most populations of the world. In addition, to its health impacts, overweight/obesity leads to many health problems which reflect on the university students' physical, psychological, social and environmental aspects of their quality of life. The study aimed to evaluate the effect of an educational program on improving the quality of life of overweight/obese university students in the Gaza Strip. Materials and Methods: quasi-experimental nonequivalent pretest-posttest control group design utilized in this study 74 and 69 students in the intervention and control group respectively. The study was conducted at the Islamic University of Gaza and data were collected in two stages before and after five months from the application of the educational program, using an interviewing questionnaire and World Health Organization Quality of life-BREF instrument; pre-post test and body mass index were calculated. Results: The study results revealed that overall students' knowledge for the posttest was significantly higher than pretest (p-value ≤ 0.05). Overall, the mean score of quality of life after the program was significantly (p-value = 0.001) greater than before and greater than the control group for all domains. Conclusion: The study concluded that the health educational intervention program had positive effects on knowledge, practices and attitudes regarding overweight/obesity by improving university students' mean score of quality of life.
... Obesity is a global phenomenon that has reached epidemic proportions, affecting both developed and developing countries (1). The worldwide prevalence of obesity is escalating swiftly, with a substantial surge in the past years (2). ...
Background
The effects of exercise training combined with plant-based diets (PBD) on leptin and adiponectin levels have been studied. However, little is known regarding the impact of exercise training combined with PBD on leptin and adiponectin levels in adults with or without chronic diseases.
Methods
PubMed, Web of Science, and Scopus were searched to identify original articles, published until May 2024, to assess the effects of exercise training combined with PBD on leptin and adiponectin levels in adults with or without chronic diseases. Standardized mean differences (SMD) and 95% confidence intervals were calculated using random models.
Results
Nine studies comprising 960 participants with overweight and obesity were included in the current meta-analysis. Exercise training combined with PBD reduced leptin [SMD = -0.33 (95% CI: −0.62 to −0.04); p = 0.025] while increasing adiponectin [SMD = 0.93 (95% CI: 0.12 to 1.74); p = 0.024] levels.
Conclusion
Exercise training combined with PBD is suggested as a non-invasive intervention for reducing leptin while increasing adiponectin levels to control body mass and other disorders related to obesity in adults.
... Tal abordagem não apenas contribui significativamente para a prevenção de patologias, mas também intervém de maneira eficaz quando necessário, reduzindo os riscos de morbimortalidade e promovendo um substancial melhoria na qualidade de vida e bem-estar do indivíduo. De acordo com Caballero (2007) as estatísticas demonstram que, a obesidade se configura como uma epidemia global de magnitude alarmante. Além de ser um fator de risco primordial para uma série de condições mórbidas, tais como hipertensão arterial sistêmica, resistência à insulina, dislipidemia e síndrome metabólica, a obesidade também está associada à esteatose hepática gordurosa não alcoólica. ...
O presente artigo apresenta uma revisão narrativa sobre epidemiologia, fisiopatologia, diagnóstico e tratamento da DHGNA. A prevalência pode acometer até 25% da população em alguns estudos, sendo homens e hispânicos os grupos mais acometidos. A fisiopatologia é complexa e multifatorial, com bases na obesidade, na resistência à insulina e na herança genética. Após diagnóstico, o manejo consiste principalmente em mudanças de estilo de vida, tratamento da síndrome metabólica, farmacoterapia e manejo das complicações da cirrose hepática. Diante do aumento na prevalência, é de grande interesse para a medicina a busca por melhores formas de obter sua detecção precoce, tratamento e controle de complicações. Essas questões são complexas e exigem uma abordagem multidisciplinar. O presente artigo é classificado como revisão sistemática, com abordagem qualitativa, método indutivo e descritivo, com foco na temática, publicados nas bases de dados da Scientific Electronic Library Online (SciELO) e United States National Library of Medicine (PUBMED) no período de 2018 a 2024, utilizando os descritores: esteatose hepática e doença hepática gordurosa não alcoólica. Resultados: foram revisados 20 artigos, onde abordou que a redução do peso corporal, mediante alterações do comportamento alimentar diminui a gordura hepática, porém é necessário um controle rígido e contínuo, visto que o excesso de triacilgliceróis pode voltar a se acumular nos hepatócitos caso os hábitos saudáveis de vida tenham ação descontinuada ou reduzida. Conclusão: a melhor conduta terapêutica para o tratamento e a reversão da patologia baseia-se no consumo alimentar adequado e, na prática, regular de atividade física de forma contínua. This article presents a narrative review of NAFLD's epidemiology, pathophysiology, diagnosis, and treatment. The prevalence can affect up to 25% of the population in some studies, with men and Hispanics being the most affected groups. The pathophysiology is complex and multifactorial, based on obesity, insulin resistance, and genetic inheritance. After diagnosis, management consists mainly of lifestyle changes, treatment of metabolic syndrome, pharmacotherapy, and management of liver cirrhosis complications. Given the increase in prevalence, the search for better ways to achieve early detection, treatment, and control of complications is of great interest to medicine. These issues are complex and require a multidisciplinary approach. This article is classified as a systematic review, with a qualitative approach, inductive and descriptive method, focusing on the theme, published in the Scientific Electronic Library Online (SciELO) and National Library of Medicine (PUBMED) databases from 2018 to 2024, using the descriptors: hepatic steatosis and non-alcoholic fatty liver disease. Results: 20 articles were reviewed, which found that reducing body weight through changes in eating behavior reduces liver fat. However, strict continuous control is necessary since excess triacylglycerols can accumulate in hepatocytes again if healthy lifestyle habits are not reduced.
... 3 Moreover, contemporary dietary shifts have significantly altered nutritional patterns, consequently exacerbating the prevalent issue of overweight and obesity. 8 This has been reported due to the natural and artificial sweeteners used in foods and beverages though artificial sweeteners are considered to be less cariogenic and safe. 9 Giacaman et al. reported free fatty acids, dietary proteins, and polyphenols to have anticariogenic potentials. ...
Background Nutrition is associated with oral health and any changes in dietary habits have impacted nutritional profiles which in turn influences oral health status. Objective To assess the oral health and nutritional status among school teachers in Dharamshala city, Himachal Pradesh. Method A descriptive cross-sectional study was undertaken with interviews and documented using a structured and adapted WHO proforma. The oral health was assessed by using WHO oral assessment form 2013 (by tooth surfaces) and the nutritional status by using five day dietary recall and scored according to dental health dietary score. The dental health dietary scores included food group scores (FGS), nutritional evaluation score (NES), decay promoting potential scores (DPPS) for all five days. Result Almost, two third of the school teachers in both types of schools had an excellent Food Group Score (FGS) on all five days of dietary recalls. The mean total Decay Promoting Potential Score (DPPS) was 23.33±3.20 (minute). Approximately onethird of the teachers in both types of schools had DPPS scores within the “watch out” zone of dietary recall, ranging 15 or more on each day. The mean DMFT was 3.79±2.52 with mean total decayed teeth as 1.35±2.03. Similarly, the mean DMFS was 9.68±7.95 with the mean total decayed surfaces as 1.81±2.94. Conclusion The frequency of essential food groups remained consistent throughout the fiveday dietary recall period. Carbohydrates formed the primary component whereas proteins were frequently missing from the diets. Frequent absence of protein intake in diet increased loss of attachment.
... 3 Moreover, contemporary dietary shifts have significantly altered nutritional patterns, consequently exacerbating the prevalent issue of overweight and obesity. 8 This has been reported due to the natural and artificial sweeteners used in foods and beverages though artificial sweeteners are considered to be less cariogenic and safe. 9 Giacaman et al. reported free fatty acids, dietary proteins, and polyphenols to have anticariogenic potentials. ...
... The World Health Organization estimated that, in 2022, 43% of adults aged 18 years and over (43% of men and 44% of women) were overweight or obese, an increase from 25% in 1990. Being overweight and obese are considered to be serious health problems worldwide [1][2][3]. Over the years, an increasing trend of obesity and being overweight has been observed in both men and women in Thailand as well, resulting in an increasing rate of pregnant women who are overweight or obese [4]. ...
Objective
To determine the incidence of excessive gestational weight gain (GWG) among overweight and obese pregnant
women, its associated factors, and pregnancy outcomes.
Methods
A total of 355 overweight or obese singleton pregnant women who were included. Obstetric characteristics, weight
gain, and pregnancy outcomes, were extracted from medical records. GWG was categorized according to the Institute
of Medicine recommendation. Comparisons were made between individuals with inadequate, normal, and excessive
GWG. Logistic regression analysis was performed to determine independent associated factors for excessive GWG.
Results
Majority of the women were overweight (68.7%), 38.9% were nulliparous, and mean pre-pregnancy body mass index
was 28.9 kg/m2. Excessive GWG was observed in 53% of the women. Women with excessive GWG had significantly
higher weight gain in every trimester. Risk of excessive GWG increased in women ≤30 years, while gestational diabetes
(GDM) significantly decreased the risk. Women with excessive GWG had a significantly higher primary cesarean
section rate. Both women with normal and excessive GWG showed higher rate of having large for gestational age (LGA)
infants (P=0.003). Maternal age of ≤30 years significantly increased the risk of excessive GWG (adjusted odds ratio [aOR],
1.91; 95% confidence interval [CI], 1.11-3.27) and GDM significantly decreased this risk (aOR, 0.40; 95% CI, 0.24-0.67).
Conclusion
The incidence of excessive GWG among overweight and obese women was 53%. Maternal age of ≤30 years
significantly increased this risk while women with GDM were significantly decreased risk. Primary cesarean section
and fetal LGA significantly increased in women with excessive GWG.
... However, over the same period, a shift toward an increase in body mass over height can be observed. Due to environmental and behavioural changes (Caballero 2007;Temple 2023), the global epidemic of overweight and obesity began in the 1980s in developed countries (Ng et al. 2014;Cole 2003;Garrido-Miguel et al. 2019;Afshin et al. 2017). The main mechanism for the development of obesity is energy imbalance, in which excessive caloric intake exceeds the energy expenditure (e.g., through physical activity). ...
Objectives: To determine secular trends in body height, fat-mass, fat-free mass, and external skeletal robustness in young adults and examine possible relationship between them. Methods: Anthropometric data (body height, body mass; skinfold thickness (SFT) – triceps, abdominal, thigh; circumferences (C) – waist, upper arm, thigh; width – elbow, knee) of young adults aged 20-25 years (N = 5303; males 1985, females 3318) were used from the Slovenian (data)Base of Anthropometric Measurements from 1960 to 2023. Multiple linear regressions were performed. Results: The most significant positive secular trends (p < 0.000) were observed in males for abdominal SFT (B = 0.151, R2 = 0.169) and thigh SFT (B = 0.131, R2 = 0.142). In females, similar trend was observed in waist C (B = 0.151; R2 = 0.169). The most significant negative secular trend (p < 0.001) was observed in muscle area of lower limbs in both sexes (males: B = - 0.427, R2 = 0.000; females: B = - 0.875, R2 = 0.300). Body height and overall body mass were the most important factors influencing the observed decline in external skeletal robustness assessed with frame index according to elbow and knee width according to multiple linear regression. Conclusion: Over the last 60 years, a positive secular trend was observed in body height and body fat, while a negative trend was noted in muscle mass. Increases in body height and overall body mass had the most significant impact on the observed decrease in assessed external skeletal robustness over time.
... L'augmentation de la prévalence d'obésité depuis le milieu des années 1970 est corrélée à un accroissement de l'apport calorique dans les pays industrialisés [5,6]. L'apport en lipides a augmenté, mais par exemple aux États-Unis, la contribution de ces derniers à l'apport calorique total a plutôt diminué en faveur d'une contribution accrue des glucides, notamment des glucides simples ou rapides [7]. ...
As a result of its expansion during obesity, white adipose tissue undergoes structural and functional changes that contribute to an increased risk of developing diabetes or cardiovascular disease, and premature death. Compelling evidence suggests that the quality of some energy nutrients can modulate the physiological response to a positive energy balance. Indeed, the quality of dietary fatty acids can modulate numerous biological functions and slow down or prevent some pathologies. Studies have highlighted the health benefits of omega-3 polyunsaturated fatty acids, particularly regarding adipose tissue functions during obesity and against related co-morbidities. In connection with changes in the fatty acid profile of diets that may have contributed to the rise in obesity prevalence in Western countries, this article describes how omega-3s can modulate the accumulation and function of the adipose tissue. It was prepared based on human observational data, preclinical and clinical intervention data, and cellular models
... Managing chronic diseases like obesity and averting its chronic consequences using nutraceuticals and dietary supplements have emerged as a cutting-edge and all-inclusive dietary strategy [4]. In addition to lowering people's quality of life, obesity is the leading cause of preventable deaths globally and is linked to several comorbidities, making it a global public health concern [5,6]. With up to 3.4 million deaths per year, it is the second most dangerous risk factor after smoking [7]. ...
Objective: This study aimed to formulate and evaluate the stability profile of an anti-obesity nutraceutical combination in different dosage forms. Methods: Active and inactive ingredients were formulated into pharmaceutical dosage forms. The quality parameters of the dosage forms were determined, followed by accelerated stability testing (40±2 °C and 75±5% Relative Humidity (RH)) for 180 d was completed to evaluate their physical, chemical and microbiological attributes throughout the storage period. Results: Pre-formulation parameters of the powder blend of active and inactive ingredients for each dosage form showed a satisfactory flowability with Hausner's ratio falling between 1.16 and 1.18, average angle of repose between 22.29° and 22.90° and acceptable compressibility with Carr’s index below 25%. Tablets assessments were acceptable with a mean friability value of 0.21±0.03%, hardness of 4.12±0.09 kg/cm2. The average disintegration time of 5 min 10 sec for tablets and 4 min and 30 sec for capsules. The accelerated stability study revealed that tablet dosage forms are stable for longer period that can reach up to 180 d (24 mo real-time), while sachets and capsules are stable for a period of 135 d (18 mo real-time). Conclusion: The anti-obesity blend of White Kidney Bean Extract (WKBE), Propolis Ethanolic Extract (PEE) and CrPic3 can be successfully formulated in acceptable and convenient dosage forms that can be stable for 18-24 mo.
... Obesity is a known complex disease with multifaceted etiology stemming from interactions between genetic, behavioral, physiological, socioeconomic, and environmental factors [1][2][3]. While many factors have been recognized, the consumption of the Western (American) diet or energy-dense foods high in fat, sodium, and sugar, is considered as one of the major contributing factors to the global epidemic [4][5][6][7]. 2 The endogenous opioid system has been linked to regulate feeding behavior, however, the role of each opioid peptide has not been fully characterized. More specifically, previous studies have shown that the expression of β-END increases after consumption of a highly palatable food, suggesting its role in the natural reward pathway [8][9][10]. ...
The rates of obesity and obesity-related diseases continue to increase worldwide, classifying obesity as a global epidemic. Endogenous opioids have been implicated in influencing feeding behavior; however, the role of each opioid peptide is still only partially characterized. Therefore, we assessed the role of the proopiomelanocortin (POMC)-derived peptide beta-endorphin (β-END) in long-term high-fat diet (HFD) feeding and glucose homeostasis and assessed if sex-related differences exist in these processes. Male and female mice lacking the ability to produce β-END and their respective controls were subjected to a 12-week HFD consumption to determine the role of the opioid peptide in food intake and glucose homeostasis. Body weight and food intake were measured weekly for twelve weeks. At weeks 6 and 12, plasma glucose levels were measured using an oral glucose tolerance test. Here, we report that male β-END deficient mice gained more weight and consumed more calories than their wildtype controls; however, this difference was not observed in the female mice. Regardless of genotype, female mice consumed more calories per body weight when compared to male mice despite their smaller body weights. Moreover, our findings suggest differences in glucose homeostasis between the wildtype and knockout mice and that these were only observed at week six but not at week 12. Overall, our study suggests that endogenous β-END may play a role in controlling body weight, feeding behavior, and glucose homeostasis and that sex-related differences may exist in this regard.
... Methods This study was a retrospective cohort study. The inclusion criteria were (1) male patients with obesity who met the surgical indications of the "Chinese Guidelines for Surgical Treatment of Obesity and Type 2 Diabetes" (2019 Edition); (2) patients with a body mass index (BMI) of ≥27.5 kg/m2 and obesity-related metabolic diseases, or patients with severe obesity and a BMI of ≥35 kg/m2; and (3) sex hormone levels checked 1 year after surgery. The exclusion criteria included (1) patients with endocrine diseases (thyrotoxicosis, hyperprolactinemia) and hypothalamicpituitary lesions and (2) those with severe major organ dysfunction who could not tolerate anesthesia or surgery. ...
Objective: To analyze and evaluate the differences in sex hormones after laparoscopic Roux-en-Y Gastric Bypass Surgery (LRYGB) and laparoscopic sleeve gastrectomy (LSG) in male patients with obesity. Methods: This study was a retrospective cohort study. The inclusion criteria were (1) male patients with obesity who met the surgical indications of the "Chinese Guidelines for Surgical Treatment of Obesity and Type 2 Diabetes" (2019 Edition); (2) patients with a body mass index (BMI) of ≥27.5 kg/m2 and obesity-related metabolic diseases, or patients with severe obesity and a BMI of ≥35 kg/m2; and (3) sex hormone levels checked 1 year after surgery. The exclusion criteria included (1) patients with endocrine diseases (thyrotoxicosis, hyperprolactinemia) and hypothalamic-pituitary lesions and (2) those with severe major organ dysfunction who could not tolerate anesthesia or surgery. According to the above criteria, the clinical data of male patients with obesity admitted to the Gastrointestinal Surgery/Bariatric Center of the First Affiliated Hospital of Jinan University from October 2017 to January 2020 were included. A total of 52 male patients with obesity were included in this study. The mean age, body weight, BMI, and total testosterone level were (29.3±10.2) years, (123.6±35.4) kg, (40.1±11.1) kg/m2, and 7.6 (5.5, 9.1) nmol/L, respectively. Forty-five patients (86.5%) exhibited testosterone deficiency. Among all the patients, 29 underwent LSG (LSG group) and 23 underwent LRYGB surgery (LRYGB group). The main outcome measure was the change in sex hormone levels before and after bariatric surgery in all the patients. The secondary outcome measures were the comparison of changes in sex hormone levels before and after LSG and LRYGB. Results: Pearson correlation analysis showed that preoperative estradiol was positively correlated with waist circumference (R=0.299, P<0.05), hip circumference (R=0.326, P<0.05), and chest circumference (R=0.388, P<0.05). Testosterone was negatively correlated with BMI (R=-0.563, P<0.01), waist circumference (R=-0.521, P<0.01), hip circumference (R=-0.456, P<0.01), chest circumference (R=-0.600, P<0.01), and neck circumference (R=-0.547, P<0.01). One year following bariatric surgery, the serum testosterone (7.6 [5.5, 9.1] nmol/L vs. 13.6 [10.5, 15.4] nmol/L, Z=-5.910, P<0.001), follicle-stimulating hormone (4.7 [2.7, 5.3] IU/L vs. 6.5 [3.6, 7.8] IU/L, Z=-4.658, P<0.001), and progesterone (1.2 [0.4, 1.5] nmol/L vs. 1.9 [0.8, 1.3] nmol/L, Z=-2.542, P=0.011) levels were significantly higher in all the patients. Both estradiol (172.8 [115.6, 217.5] pmol/L vs. 138.3 [88.4, 168.1] pmol/L, Z=-2.828, P=0.005) and prolactin (11.4 [6.4, 14.6] mIU/L vs. 8.6 [4.8, 7.3] mIU/L, Z=-2.887, P=0.004) levels were decreased. In addition to prolactin levels in the LRYGB group, there were statistically significant differences in the levels of estradiol (P=0.030), follicle-stimulating hormone (P < 0.001), luteinizing hormone (P=0.033), progesterone (P=0.034), and testosterone (P<0.001) compared with their preoperative levels. In the LSG group, there were statistically significant differences in the levels of follicle-stimulating hormone (P=0.011), prolactin (P=0.023), and testosterone (P<0.001) compared with their preoperative levels. Conclusion: The degree of obesity in men was negatively correlated with testosterone levels. Both LRYGB and LSG can significantly improve sex hormone levels in male patients with obesity, and testosterone levels show a significant increase after surgery.
... Camallero defined 'Global Epidemic of Obesity' as a condition influenced by environmental, social, and economic factors that have shaped eating habits and lifestyles, primarily since the 2000s. 10 The term 'obesogenic environment' encompasses the various factors contributing to obesity such as urbanization, automation, reliance on cars, sedentary lifestyle due to limited public spaces for physical activity, and unhealthy diets. 2 A correlation between time spent watching television and Obesity has been demonstrated.2 Such a lifestyle leads to less physical activity, resulting in lower energy expenditure, effects on diet and sleep. ...
Obesity is a health condition caused by the accumulation of excess body weight in the form of adipose tissue. This condition has negative effects on a person's overall health. Obesity has a multifactorial etiology involving environmental, genetic, hormonal, and epigenetic factors. The percentage of obese people in childhood is constantly increasing. It is therefore important to implement preventive strategies. This is because Obesity is a systemic condition with major consequences on the endocrine-metabolic, psychosocial, musculoskeletal, respiratory, neurological, gastrointestinal, and especially vascular spheres. Obesity is, in fact, an independent cardiovascular risk factor. Appropriate educational therapy aimed at the child/adolescent and their family is essential. Modifying behaviors that contribute to increased food intake and decreased energy expenditure is essential in promoting healthy lifestyles for individuals and their families.
... En España, la prevalencia de la obesidad infantil se encuentra entre las más altas de Europa, junto con Malta, Italia, Grecia y el Reino Unido (Caballero, 2007;Wang y Lobstein, 2006). En 2010 la SESPAS (Sociedad Española de Salud Pública y Administración Sanitaria) informó que el 35% de los niños tenían exceso de peso (20% tenían sobrepeso y 15 % obesidad) (Sánchez-Cruz et al., 2013). ...
La obesidad es una enfermedad especialmente cara y costosa en términos económicos y sociales tanto para las personas que la padecen como para las instituciones públicas sanitarias. Por ello, en las últimas décadas distintas organizaciones internacionales y nacionales han mostrado una enorme preocupación por sus implicaciones, pasando a ser tratado como un verdadero problema social. Según la Organización Mundial de la Salud, España es uno de los países de la Unión Europea con mayor prevalencia de sobrepeso infantil, ya que registra un 33% en la población entre 5 y 17 años, mientras que en Europa uno de cada cuatro niños tiene sobrepeso o es obeso. Además, España es uno de los países donde más ha crecido esta enfermedad (en la década de los ochenta la prevalencia era de un 15%). Diversas revisiones sistemáticas que evalúan la efectividad de los programas de intervención basados en el aumento de la actividad física y el control dietético sobre el sobrepeso y/u obesidad en población infantil y adolescente resaltan la necesidad de diseñar programas específicos para los escolares, así como valorar objetivamente la eficacia de dichos programas a largo plazo en niños y adolescentes con sobrepeso u obesidad. El objetivo del presente trabajo es describir el diseño y metodología utilizada en el Programa SALUD 5-10, un programa que ha sido diseñado con el objetivo de abordar el sobrepeso y la obesidad en escolares de una franja de edad entre 5 a 10 años.
... IIH typically presents with several symptoms, including highfrequency headaches, transient visual obscuration, pulsatile tinnitus, and blurred or double vision. IIH is usually observed in young women of childbearing age [3,4], and its frequency reflects the increased prevalence of obesity [5]. Magnetic resonance venography (MRV) usually depicts bilateral cerebral transverse venous sinus stenosis [6,7]. ...
Background: We aimed to assess the status of the optic nerve and retina by optical coherence tomography (OCT) in a group of patients with idiopathic intracranial hypertension (IIH) on the basis of dynamic changes in intracranial pressure. Methods: This observational and cross-sectional study included patients affected by idiopathic intracranial hypertension with papilledema (IIHWP) and patients with idiopathic intracranial hypertension without papilledema (IIHWOP). All participants underwent an OCT examination of the macula and optic nerve head. Parameters related to intracranial pressure, including cerebrospinal fluid (CSF) opening pressure (oCSFp), CSF mean pressure (mCSFp), and pulse wave amplitude (PWA), were included in the analysis. Results: Out of the 22 subjects enlisted for the study, a total of 16 patients suggestive of IIH were finally enrolled. Papilledema was detected in nine subjects (56.2%) and seven patients were affected by IIHWOP (43.7%). The OCT examination showed a higher mean RNFL thickness in IIHWP patients in comparison to IIHWOP in both eyes (p < 0.05 and p < 0.01, respectively). Intracranial pressure (ICP) measurements showed that IIHWP had higher values of oCSFp, mCSFp, and PWA compared to IIHWOP (p = 0.0001, p = 0.0001, and p = 0.0001, respectively). In addition, ICP parameters significantly correlated with RNFL. Conclusions: Clinical parameters suggestive of idiopathic intracranial hypertension are associated with retina and optic nerve OCT parameters. OCT is a useful tool to detect these alterations in a non-invasive fashion.
... Obesity is a major public health issue that has become increasingly prevalent worldwide [20]. According to the World Health Organization, more than 650 million adults worldwide were obese in 2016, and the prevalence of obesity has tripled since 1975 [21]. ...
Current Dietary Guidelines for Americans recommend replacing saturated fat (SFA) intake with polyunsaturated fatty acids (PUFAs) and monosaturated fatty acids (MUFAs) but do not specify the type of PUFAs, which consist of two functionally distinct classes: omega-6 (n-6) and omega-3 (n-3) PUFAs. Given that modern Western diets are already rich in n-6 PUFAs and the risk of chronic disease remains high today, we hypothesized that increased intake of n-3 PUFAs, rather than n-6 PUFAs, would be a beneficial intervention against obesity and related liver diseases caused by high-fat diets. To test this hypothesis, we fed C57BL/6J mice with a high-fat diet (HF) for 10 weeks to induce obesity, then divided the obese mice into three groups and continued feeding for another 10 weeks with one of the following three diets: HF, HF+n-6 (substituted half of SFA with n-6 PUFAs), and HF+n-3 (substituted half of SFA with n-3 PUFAs), followed by assessment of body weight, fat mass, insulin sensitivity, hepatic pathology, and lipogenesis. Interestingly, we found that the HF+n-6 group, like the HF group, had a continuous increase in body weight and fat mass, while the HF+n-3 group had a significant decrease in body weight and fat mass, although all groups had the same calorie intake. Accordingly, insulin resistance and fatty liver pathology (steatosis and fat levels) were evident in the HF+n-6 and HF groups but barely seen in the HF+n-3 group. Furthermore, the expression of lipogenesis-related genes in the liver was upregulated in the HF+n-6 group but downregulated in the HF+n-3 group. Our findings demonstrate that n-6 PUFAs and n-3 PUFAs have differential effects on obesity and fatty liver disease and highlight the importance of increasing n-3 PUFAs and reducing n-6 PUFAs (balancing the n-6/n-3 ratio) in clinical interventions and dietary guidelines for the management of obesity and related diseases.
... Methods This study was a retrospective cohort study. The inclusion criteria were (1) male patients with obesity who met the surgical indications of the "Chinese Guidelines for Surgical Treatment of Obesity and Type 2 Diabetes" (2019 Edition); (2) patients with a body mass index (BMI) of ≥27.5 kg/m2 and obesity-related metabolic diseases, or patients with severe obesity and a BMI of ≥35 kg/m2; and (3) sex hormone levels checked 1 year after surgery. The exclusion criteria included (1) patients with endocrine diseases (thyrotoxicosis, hyperprolactinemia) and hypothalamicpituitary lesions and (2) those with severe major organ dysfunction who could not tolerate anesthesia or surgery. ...
Obesity has been identified as one of the risk factors for male sexual dysfunction, and it also has a certain impact on fertility. For people with obesity, sexual function is an important aspect of quality of life, but it is often overlooked. Society's stigma against obesity exacerbates the psychological stress of patients with obesity and negatively affects sexual function. Current studies have found that bariatric surgery can reduce body weight and improve sexual function in patients with obesity, and obesity-related gonadal dysfunction is also improved or even subsided after surgery. However, attention needs to be paid to postoperative body mass management and mental health status of patients to prevent postoperative body mass recovery and reversal of sex hormones and sexual function. In addition, there is still controversy about the change in sperm quality after bariatric surgery, and there is a lack of research data on sexual function and sperm parameters and mechanisms after bariatric surgery. Therefore, this article reviews the latest research progress of bariatric surgery and sexual dysfunction, as well as related mechanisms and sperm parameters, to provide a reference for bariatric surgery in patients with obesity with sexual dysfunction.
... Despite an obesity indicator error [35], our findings have significant implications for various therapies, weight loss, counseling, and exercises to reduce BMI, WC, HC, and WHR for preventing cardiovascular risk and mortality in adults. An earlier review detailed the global epidemic of obesity and the coherent action to tackle this issue [36]. Furthermore, the American College of Preventive Medicine has presented a practice policy report on weight management counseling of overweight adults based on a review of the current literature and recommendations [37]. ...
Introduction: Despite significant global and national investments in health, primarily aimed at primary and preventive measures, progress in alleviating toll of non-communicable diseases (NCDs) remains sluggish in low- and middle-income countries, hindering the achievement of Sustainable Development Goals by 2030. This review intends to elucidate the barriers and facilitators affecting self-management of NCDs and their determinants, with purpose of informing the development of more accessible and practical preventive strategies. Methods: An extensive electronic literature search was conducted across PubMed, PsycINFO, CINAHL, and Scopus for studies published between 2013 to June 2024, resulting in total of 78 included studies: 56 quantitative, 20 qualitative, and 2 mixed-methods. Findings: The synthesis of findings across these studies identified critical factors influencing NCDs’ self-management. The quantitative analysis highlighted 31 factors grouped into five main determinants: socio-demographic, psychosocial, behavioural, biological, resource-related, and health-system-related. Notably, increased age and educational attainment correlated positively with self-management compliance, while barriers such as forgetfulness and misconceptions negatively impacted adherence. The qualitative review identified 21 sub-themes under five broad themes, emphasizing personal challenges, financial limitations, environmental factors, social stigma, and issues with health providers. Conclusion: Together, these insights reveal the multifaceted challenges of self-management and necessity for tailored interventions.
Skeletal Muscle Health in Metabolic Diseases explores the vital role of skeletal muscle in regulating energy metabolism and its interactions with other organs, such as the liver and brain, in the context of metabolic diseases like obesity, diabetes, and fatty liver disease. This comprehensive guide covers how metabolic disorders impact muscle glucose metabolism, liver function, and brain health, alongside the effects of nutrition and exercise on carbohydrate metabolism. Readers will gain insights into the mechanisms underlying muscle atrophy, oxidative stress, and cellular damage caused by these conditions. Key Features: - In-depth analysis of skeletal muscle’s role in whole-body metabolism and metabolic disease. - Exploration of metabolic dysfunction in relation to liver and brain health. - Insight into the impact of diet and physical activity on muscle and carbohydrate metabolism. - Examination of muscle atrophy and cellular changes in metabolic disorders.
The prevalence of obesity and related health problems has increased drastically in recent decades. By focusing on the phenomenon within the context of changing relationships between humans, other living species, and the environment, the article opens the way to a One Health perspective for understanding and tackle obesity. The study presents empirical data based on interviews with patients and doctors in a hospital highly specialized in the treatment of metabolic diseases and their associated pathologies. Among the results of the research is that a significant part of the patients interviewed have internalized norms, attitudes and behaviours associated with a state of marginalization and isolation. These findings emphasize the crucial yet often overlooked role of meaningful interpersonal relationships at the meso-level in the obesogenic environment.
Scope
The study assesses the metabolic impact of dietary whey proteins across generations.
Method and results
Virgin females are fed 20% energy whey proteins with 70% energy carbohydrates, which reduces body weight gain and visceral adipose compared to controls fed dietary casein. In contrast, the males are unresponsive. The effect is accentuated in reproductive females that also have reduced plasma levels of glucose. The responsive females have increased cecal levels of pyruvic and lactic acid, suggesting a greater catabolism of carbohydrates in the gut. While the male and female offspring born to mothers on whey proteins continue to reduce body weight gain, the female offspring further decreases the visceral and subcutaneous tissues and increases the gut capacity to breakdown dietary carbohydrates and proteins, whereas the male offspring are able to only decrease the visceral and increase protein catabolism in the gut. The ileum of male mice responded by reducing the gene expression for fibroblast growth factor 15 and increasing the expression of chymotrypsinogen B1.
Conclusion
The effect of whey proteins on growth can be passed from the mother to the offspring without a sex preference, whereas the transmission of gut activity and adiposity are dependent on the sex of the offspring.
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Stress, digitalization, comfortable lifestyle, lack of physical exercise, industrialization and food processing have become the leading cause of lifestyle related diseases in this growing world. Overeating, untimely meals have lead to young adults facing the cardiovascular and biochemical changes adversely affecting there well-being. Nutritional status, imbalance between energy intake and expenditure plays a major role in development of obesity. This study was conducted in obese and non-obese young subjects to study the relationship between dietary intake and obesity at
Introduction: Obesity can alter lipid and carbohydrate metabolism. Dyslipidemia (DLP), type 2 diabetes mellitus (DM) and impaired fasting glucose (IFG) have been recognised as a common complication of obesity. Obesity can also lead to other non-metabolic complications. There is an epidemic rise in obesity in the country. A disease practicallyunheard of a few years back is now considered to affect even the younger age group. Obesity and its complications can lead to various cardiovascular diseases making early detection and prevention important. Objectives To study the clinical profile of young obese (Age group of 18-40 years of male and females) individuals in Sri Ramakrishna Hospital, Coimbatore. To study the fasting blood sugar and fasting lipid profile in these subjects. To correlate clinical profile with fasting blood sugar and fasting lipid profile. Materials and Methods: The study will be a descriptive correlative study on young obese inpatients and outpatients in Sri Ramakrishna Hospital. The study will include a minimum of 150 subjects from the general population. A detailed questionnaire will be administered to all study subjects to collect information regarding demographic, socioeconomic, behavioural, and health status. The fasting blood sugar (FBS) of all subjects will be estimated to diagnose diabetes mellitus and impaired fasting glucose. Fasting lipid profile (FLP) of all the subjects will be done to note lipid profile abnormalities. Results will then be analyzed and correlated. Results: A total of 150 cases of young obese subjects were included in the study, evaluated for fasting blood sugar and fasting lipid profile, and clinically correlated. Obesity among young individuals was found to be more common among males (62%) and during the fourth decade (53.3%). There is a significant association between gender and BMI in the present study. In the study, most cases (38.67%) were in the BMI group of 25-30 kg/m² with the occurrence of IFG (54%) being more than DM in this group. T2DM and IFG are statistically significant to BMI. In this study, 82% of cases with DLP were present in obese patients. The BMI is highly significant to the DLP where the p-value is <0.01. The incidence of dyslipidemia was also highest (57.33%) in the BMI group (25-30 kg/m²). Conclusion: The present study showed that there exists a relationship between the presence of altered fasting blood sugar in the form of impaired fasting glucose and type 2 diabetes mellitus in young obese individuals. Thus from this study, we conclude that there is a statistically significant relationship between young obesity and diabetes. There was a direct proportional relationship between dyslipidemia and degree of obesity. Cutaneous manifestations of obesity and lifestyle have a significant correlation with the occurrence of complications of obesity. In the current period, young obesity should be considered an important risk factor for non-communicable diseases and should be treated at the earliest to prevent such complications. Keywords: Obesity, Morbidity, Diabetes Mellitus, Fasting Blood Glucose, Psychological Factors, Alcohol Consumption.
Введение. Ожирение является одним из факторов риска, предрасполагающих людей к множеству заболеваний, в том числе и к появлению глаукомы. Поскольку глаукома, вызывая нарушение зрения, имеет высокую распространенность в мире, крайне важно выявить модифицируемые факторы, которые могут быть связаны с повышением ВГД, чтобы предотвратить развитие глаукомы у лиц высокого риска, и одним из таких факторов является ожирение. Цель исследования. Изучить корреляцию между ВГД и ИМТ у лиц без глаукомы. Материалы и методы. Данные для этого исследования собирались в течение семи месяцев с 1 ноября 2017 г. по 30 мая 2018 г. в клинической офтальмологической больнице Ибн-Аль-Хайсама в Багдаде. ВГД измерялось аппланационным методом, ЦКТ измерялось ультразвуковой пахиметрией и исследованием с помощью щелевой лампы (переднего и заднего сегментов), у каждого субъекта регистрировали массу и рост тела и рассчитывали ИМТ. Результаты. В исследовании приняли участие 175 человек, средний возраст которых составил 46,84±14,55 года, гендерное распределение было близким: 93 мужчины (53,1%) и 82 женщины (46,9%). Средняя масса тела для исследуемой популяции составляла 76,28±19,25 кг, средний рост – 159,53±12,67 см, а расчетный ИМТ имел среднее значение 30,10±7,27 кг/м2. Установлена статистически значимая разница ИМТ в разных возрастных группах (значение р=0,049), ИМТ стабильно увеличивался с 26,88 кг/м2 у лиц возрастной группы 20≤30 лет до 32,0 кг/м2 у лиц возрастной группы 60≤70 лет. Корреляция между средними значениями ВГД (т. е. средними значениями ВГД правого и левого глаза, а также обоих глаз) умеренно положительная с ИМТ, что указывает на то, что по мере увеличения ИМТ ВГД также увеличивается даже после контроля возраста и пола. В этом исследовании также обнаружено, что средние значения ВГД слабо положительно коррелируют с возрастом и массой тела, но слабо отрицательно – с ростом. Выводы. У пожилых людей ИМТ выше, а ВГД положительно коррелирует с ИМТ у людей с ожирением и морбидным ожирением.
Background. Obesity is becoming an endemic risk factor predisposing individuals to multiple diseases, and glaucoma is one of them. Since glaucoma has high prevalence in causing visual morbidity, it is crucial to identify modifiable factors that may be associated with a rise in IOP in order to prevent development of glaucoma in high risk subjects and one of these factors is obesity. Purpose of the study. To investigate the correlation between IOP and BMI in non- glaucomatous subjects. Materials and methods. The data for this cross-sectional study was collected for a period of seven months from the 1st of November 2017 to 30th of May 2018, at Ibn-Alhaitham Teaching Eye Hospital in Baghdad. IOP (measured by applanation method), CCT (measured by ultrasound pachymetry) and slit lamp examination (anterior and posterior segments), body weight and height were recorded for each subject and BMI was calculated. Results. This study enrolled 175 subjects, their mean age was 46.84±14.55 years, the gender distribution was close with 93 males (53.1%) and 82 females (46.9%). The mean body weight for the study population was 76.28±19.25 kg, the mean height was 159.53±12.67 cm, and the calculated BMI had a mean of 30.10±7.27 kg/m2. There was a statistically significant difference in BMI in different age groups (p value = 0.049), BMI steadily increased from 26.88 kg/m2 in subjects with age group (20≤30 years) to 32.0 kg/m2 in subjects with age group (60≤70 years). The correlation between means of IOP (i.e. IOP means of the right eyes, left eyes and of both right and left) are moderately positive with BMI which indicates that as BMI increases the IOP also increases even after controlling for age and gender. Also found in this study that means of IOP are weakly positively correlated with age and body weight, but weakly negatively correlated with height. Conclusions. Older subjects have higher BMI, and IOP is positively correlated with BMI in obese and morbidly obese subjects.
Background and Objective: Overweight and obesity are associated with many chronic conditions. Exercise is used in term of control body weight which aims to prevent diseases. Generally, overweight may not exercise to the target heart rate which aims to decrease weight. This study investigated the effect of whole body vibration (WBV) training on body weight, other body compositions and muscular strength in overweight females. Methods: Thirty-seven overweight females (BMI=25.0-29.9 kg/ m 2) were assigned into two groups: control (CT, n=18) and whole body vibration (WBV, n=19). The participants in the WBV group were performed 5 exercise postures during vibration, 3 days a week for 8 weeks. CT group did not perform vibration training. Body composition, muscular strength, heart rate at rest and blood pressure were measured at before and after training. Results: Compared between CT and WBV groups, WBV showed significant lower in body weight (70.21 ± 9.39 vs 62.56 ± 9.06 kg; p< 0.05), BMI (28.52 ± 2.58 vs 25.73 ± 2.41 kg/m 2 ; p< 0.05), WC (88.10 ±7.82 vs 86.33 ± 8.40 cm; นิ พนธ์ ต้ นฉบั บ • Original Article ศรี นคริ นทร์ เวชสาร 2560; 32(4) 345 Wisutthida Saengjan, et al. วิ สุ ทธิ ดา แสงจั นทร์ และคณะ Srinagarind Med J 2017; 32(4)
Diabetes mellitus and obesity are major public health issues that significantly impact the health care system. The next generation of health-care providers will need a deep understanding of the pathophysiology of these diseases if we are to prevent, treat, and eventually cure these diseases and ease the burden on patients and the health care system. Physiology Core Concepts are a set of core principles, or "big ideas", identified by physiology educators that are thought to promote long-term retention, create a deeper understanding, and help with formation of critical thinking skills. Here we describe our scaffolded teaching approach in an upper year undergraduate pathophysiology course to educate students about these two diseases and discuss how learning about the basis of these highly integrative diseases from the biochemical to whole body level is a meaningful tool in the physiology educator toolbox to reinforce Physiology Core Concepts. This teaching strategy is designed to engage students in the scientific process and hone their problem-solving skills such that they are hopefully equipped to treat and eventually cure these diseases as they move forward in their careers.
BACKGROUND AND OBJECTIVES
The American Academy of Pediatrics endorses metabolic and bariatric surgery (MBS) as a safe and effective treatment of severe obesity in children with class 3 obesity or with class 2 obesity and qualifying comorbidities. The study objective was to determine eligibility and characteristics of adolescents who qualify for MBS based on American Academy of Pediatrics guidelines.
METHODS
This retrospective cohort study analyzed electronic health record data of 603 051 adolescents aged 13 to 17 years between January 1, 2018, and December 31, 2021. Centers for Disease Control and Prevention criteria were used to define obesity classes 2 and 3. Multivariable logistic regression was used to evaluate the factors associated with meeting MBS eligibility criteria.
RESULTS
Of the 603 041 adolescents evaluated, 22.2% had obesity (12.9% class 1, 5.4% class 2, and 3.9% class 3). The most frequently diagnosed comorbid conditions were gastroesophageal reflux disease (3.2%), hypertension (0.5%), and nonalcoholic fatty liver disease (0.5%). Among adolescents with class 2 obesity, 9.1% had 1 or more comorbidities qualifying for MBS, and 4.4% of all adolescents met the eligibility criteria for MBS. In multivariable modeling, males, Black and Hispanic adolescents, and those living in more deprived neighborhoods were more likely to meet MBS eligibility criteria.
CONCLUSIONS
Overall, 1 in 23 adolescents met the eligibility criteria for MBS. Demographic and social determinants were associated with a higher risk for meeting these criteria. The study suggests that the health care system may face challenges in accommodating the demand for MBS among eligible adolescents.
A prevalência de sobrepeso e de obesidade vem se apresentando como um dos principais desafios enfrentados pela saúde no âmbito mundial. Considerada pela medicina uma doença crônica, multifatorial e de complexo tratamento, a obesidade afeta todas as faixas etárias da população e é um importante fator de risco para outras doenças, sendo responsável pela morte de mais de 2,8 milhões de pessoas por ano.
Obesity is a recognised risk factor for many cancers and with rising global prevalence, has become a leading cause of cancer. Here we summarise the current evidence from both population-based epidemiologic investigations and experimental studies on the role of obesity in cancer development. This review presents a new meta-analysis using data from 40 million individuals and reports positive associations with 19 cancer types. Utilising major new data from East Asia, the meta-analysis also shows that the strength of obesity and cancer associations varies regionally, with stronger relative risks for several cancers in East Asia. This review also presents current evidence on the mechanisms linking obesity and cancer and identifies promising future research directions. These include the use of new imaging data to circumvent the methodological issues involved with body mass index and the use of omics technologies to resolve biologic mechanisms with greater precision and clarity.
Background and Aims: Obesity represents an economical setback for the country, and its outbreak threatens the public health. The present study aimed at studying factors affecting women's willingness to
Objective: This study aimed to analyze the effect of a combination of calorie restriction and moderateintensity continuous exercise on FFA levels and visceral fat weight in female mice exposed to a high-caloriediet.Material and Method: This research was randomized posttest used only control group design with femalemice as the sampl Balb/c mice (Mus musculus), 8 weeks old, 20-30 grams. It was randomly divided into fourgroups, namely C (control group), G1 (moderate-intensity continuous exercise group), G2 (calorie restrictiongroup), and G3 (combination group calorie restriction and moderate-intensity continuous exercise) wherein every group consisted six female mice. Providing a high-calorie diet using ad libitum plus D40 as muchas 3-5% of calories (0.0325 mL/gBB) for 4 weeks. The provision of a high-calorie diet was done usingthe sonde technique. Calorie restriction was done 3x/week in 4 weeks by limiting calorie intake to 50% ofstandard foods. The moderate-intensity continuous exercise was carried out by swimming for 15 minutesplus 6% gBB loading, it was done 3 times/week for 4 weeks. The measurement of cholesterol, visceral fatweight, and FFA level was done at the end of treatments.Results: The results found that the mean of cholesterol of C C (171.00±47.74 mg/dL), G1 (126.00±15.92 mg/dL), G2 (131.50±22.37 mg/dL), G3 (121.17±21.23 mg/dL) dan (p=0.032). The mean weight of visceral fatat C (0.68±0.23 grams), G1 (0.25±0.08 grams), G2 (0.28±0.06 grams), G3 (0.20±0.03 grams) and (p=0.000).The mean FFA levels were at C (1511.34±6.19 µmol/L), G1 (1419.31±53.61 µmol/L), G2 (1458.20±28.89µmol/L), G3 (1451.55±43.77 µmol/L) and (p=0.004).Conclusion: Based on the results of the study, it could be concluded that the provision of calorie restrictionand moderate-intensity continuous exercise significantly reduced cholesterol levels, visceral fat weight, FFAlevels and in female mice exposed to a high-calorie diet
Obesity is a current global challenge affecting all ages and is characterized by the up-regulated secretion of bioactive factors/pathways which result in adipose tissue inflammation (ATI). Current obesity therapies are mainly focused on lifestyle (diet/nutrition) changes. This is because many chemosynthetic anti-obesogenic medications cause adverse effects like diarrhoea, dyspepsia, and faecal incontinence, among others. As such, it is necessary to appraise the efficacies and mechanisms of action of safer, natural alternatives like plant-sourced compounds, extracts [extractable phenol (EP) and macromolecular antioxidant (MA) extracts], and anti-inflammatory peptides, among others, with a view to providing a unique approach to obesity care. These natural alternatives may constitute potent therapies for ATI linked to obesity. The potential of MA compounds (analysed for the first time in this review) and extracts in ATI and obesity management is elucidated upon, while also highlighting research gaps and future prospects. Furthermore, immune cells, signalling pathways, genes, and adipocyte cytokines play key roles in ATI responses and are targeted in certain therapies. As a result, this review gives an in-depth appraisal of ATI linked to obesity, its causes, mechanisms, and effects of past, present, and future therapies for reversal and alleviation of ATI. Achieving a significant decrease in morbidity and mortality rates attributed to ATI linked to obesity and related comorbidities is possible as research improves our understanding over time.
Background: It was shown that men who were conceived during the Dutch famine of 1944–1945 had higher rates of obesity at age 19 y than those conceived before or after it.
Objective: Our objective was to study the effects of prenatal exposure to the Dutch famine on obesity in women and men at age 50 y.
Design: We measured the body size of 741 people born at term between November 1943 and February 1947 in Amsterdam. We compared people exposed to famine in late, mid, or early gestation (exposed participants) with those born before or conceived after the famine period (nonexposed participants).
Results: The body mass index (BMI; in kg/m²) of 50-y-old women exposed to famine in early gestation was significantly higher by 7.4% (95% CI: 0.7%, 14.5%) than that of nonexposed women. BMI did not differ significantly in women exposed in mid gestation (−2.1%; −7.0%, 3.1%) or in late gestation (−1.3%; −6.3%, 3.9%). In 50-y-old men, BMI was not significantly affected by exposure to famine during any stage of gestation: BMI differed by 0.4% (−3.5%, 4.5%) in men exposed to famine in late gestation, by −1.2% (−5.5%, 3.3%) in those exposed in mid gestation, and by 0.5% (−4.6%, 6.0%) in those exposed in early gestation compared with nonexposed men.
Conclusions: Maternal malnutrition during early gestation was associated with higher BMI and waist circumference in 50-y-old women but not in men. These findings suggest that pertubations of central endocrine regulatory systems established in early gestation may contribute to the development of abdominal obesity in later life.
Data from four National Health Examination Surveys conducted of the US population from 1960 to 1980 were analyzed to determine
secular trends in obesity for white and for black adolescents and young adults of both sexes. Body mass index was categorized
into four levels using cut points determined by the 50th, 75th, and 85th percentiles at the first survey in 1960–1962. The
weighted proportions of persons in these body mass categories were determined, and statistical models were developed to describe
secular trend and race effects. No consistent secular trends were found for white or black youths aged 12–17 years. No significant
secular trends in obesity were found for white or black young males aged 18–34 years. Both for white and for black adult females,
there were significant secular increases in the proportion of adult females in each of the successively heavier categories
of body mass index. These increases were identical for white and for black adult females on the log-odds scale, but black
adult females were already significantly heavier at the first survey. This race effect persisted throughout the entire time
interval.
It was shown that men who were conceived during the Dutch famine of 1944-1945 had higher rates of obesity at age 19 y than those conceived before or after it.
Our objective was to study the effects of prenatal exposure to the Dutch famine on obesity in women and men at age 50 y.
We measured the body size of 741 people born at term between November 1943 and February 1947 in Amsterdam. We compared people exposed to famine in late, mid, or early gestation (exposed participants) with those born before or conceived after the famine period (nonexposed participants).
The body mass index (BMI; in kg/m(2)) of 50-y-old women exposed to famine in early gestation was significantly higher by 7. 4% (95% CI: 0.7%, 14.5%) than that of nonexposed women. BMI did not differ significantly in women exposed in mid gestation (-2.1%; -7.0%, 3.1%) or in late gestation (-1.3%; -6.3%, 3.9%). In 50-y-old men, BMI was not significantly affected by exposure to famine during any stage of gestation: BMI differed by 0.4% (-3.5%, 4.5%) in men exposed to famine in late gestation, by -1.2% (-5.5%, 3.3%) in those exposed in mid gestation, and by 0.5% (-4.6%, 6.0%) in those exposed in early gestation compared with nonexposed men.
Maternal malnutrition during early gestation was associated with higher BMI and waist circumference in 50-y-old women but not in men. These findings suggest that pertubations of central endocrine regulatory systems established in early gestation may contribute to the development of abdominal obesity in later life.
Chronic diseases are the main public health problem in Western countries. There are indications that these diseases originate in the womb. It is thought that undernutrition of the fetus during critical periods of development would lead to adaptations in the structure and physiology of the fetal body, and thereby increase the risk of diseases in later life. The Dutch famine-though a historical disaster-provides a unique opportunity to study effects of undernutrition during gestation in humans. This thesis describes the effects of prenatal exposure to the Dutch famine on health in later life. We found indications that undernutrition during gestation affects health in later life. The effects on undernutrition, however, depend upon its timing during gestation and the organs and systems developing during that critical time window. Furthermore, our findings suggest that maternal malnutrition during gestation may permanently affect adult health without affecting the size of the baby at birth. This may imply that adaptations that enable the fetus to continue to grow may nevertheless have adverse consequences of improved nutrition of pregnant women will be underestimated if these are solely based on the size of the baby at birth. Little is known about what an adequate diet for pregnant women might be. In general, women are especially receptive to advice about diet and lifestyle before and during a pregnancy. This should be exploited to improve the health of future generations.
To determine the trends in locations and food sources of Americans stratified by age group for both total energy and the meal and snack subcomponents.
Nationally representative data was taken from the 1977 to 1978 Nationwide Food Consumption Survey and the 1989 to 1991 and 1994 to 1996 (and 1998 for children age 2 through 9) Continuing Surveys of Food Intake by Individuals. The sample consisted of 63,380 individuals, age 2 and up. For each survey year, the percentage of total energy intake from meals and snacks was calculated separately for 2- to 18-year-olds, 19- to 39-year-olds, 40- to 59-year-olds, and those 60 years and older. The percentage of energy intake by location (at-home consumption or preparation, vending, store eaten out, restaurant/fast-food, and school) and by specific food group was computed for all age groups separately.
The trends in location and food sources were almost identical for all age groups. Key dietary behavior shifts included greater away-from-home consumption; large increases in total energy from salty snacks, soft drinks, and pizza; and large decreases in energy from low- and medium-fat milk and medium- and high-fat beef and pork.
Total energy intake has increased over the past 20 years, with shifts away from meals to snacks and from at-home to away-from-home consumption. The similarity of changes across all age groups furthers the assertion that broad-based environmental changes are needed to improve the diets of Americans.
Physical activity declines during adolescence, but the underlying reasons remain unknown.
We prospectively followed 1213 black girls and 1166 white girls enrolled in the National Heart, Lung, and Blood Institute Growth and Health Study from the ages of 9 or 10 to the ages of 18 or 19 years. We used a validated questionnaire to measure leisure-time physical activity on the basis of metabolic equivalents (MET) for reported activities and their frequency in MET-times per week; a higher score indicated greater activity.
The respective median activity scores for black girls and white girls were 27.3 and 30.8 MET-times per week at base line and declined to 0 and 11.0 by year 10 of the study (a 100 percent decline for black girls and a 64 percent decline for white girls, P<0.001). By the age of 16 or 17 years, 56 percent of the black girls and 31 percent of the white girls reported no habitual leisure-time activity. Lower levels of parental education were associated with greater decline in activity for white girls at both younger ages (P<0.001) and older ages (P=0.005); for black girls, this association was seen only at the older ages (P=0.04). Pregnancy was associated with decline in activity among black girls (P<0.001) but not among white girls, whereas cigarette smoking was associated with decline in activity among white girls (P<0.001). A higher body-mass index was associated with greater decline in activity among girls of both races (P< or =0.05).
Substantial declines in physical activity occur during adolescence in girls and are greater in black girls than in white girls. Some determinants of this decline, such as higher body-mass index, pregnancy, and smoking, may be modifiable.
On the basis of 3 comparable population-based surveys conducted in Brazil, we identified clear changes in the relative magnitude of women's undernutrition and overnutrition. In 1975, there were almost 2 cases of underweight to 1 case of obesity, whereas in 1997, there were more than 2 cases of obesity to 1 case of underweight. In 1997, Brazilian low-income women were significantly more susceptible than high-income women to both underweight and obesity.
The prevalence of overweight and obesity has increased markedly in the last 2 decades in the United States.
To update the US prevalence estimates of overweight in children and obesity in adults, using the most recent national data of height and weight measurements.
As part of the National Health and Nutrition Examination Survey (NHANES), a complex multistage probability sample of the US noninstitutionalized civilian population, both height and weight measurements were obtained from 4115 adults and 4018 children in 1999-2000 and from 4390 adults and 4258 children in 2001-2002.
Prevalence of overweight (body mass index [BMI] > or =95th percentile of the sex-specific BMI-for-age growth chart) among children and prevalence of overweight (BMI, 25.0-29.9), obesity (BMI > or =30.0), and extreme obesity (BMI > or =40.0) among adults by sex, age, and racial/ethnic group.
Between 1999-2000 and 2001-2002, there were no significant changes among adults in the prevalence of overweight or obesity (64.5% vs 65.7%), obesity (30.5% vs 30.6%), or extreme obesity (4.7% vs 5.1%), or among children aged 6 through 19 years in the prevalence of at risk for overweight or overweight (29.9% vs 31.5%) or overweight (15.0% vs 16.5%). Overall, among adults aged at least 20 years in 1999-2002, 65.1% were overweight or obese, 30.4% were obese, and 4.9% were extremely obese. Among children aged 6 through 19 years in 1999-2002, 31.0% were at risk for overweight or overweight and 16.0% were overweight. The NHANES results indicate continuing disparities by sex and between racial/ethnic groups in the prevalence of overweight and obesity.
There is no indication that the prevalence of obesity among adults and overweight among children is decreasing. The high levels of overweight among children and obesity among adults remain a major public health concern.
Objective:
The purpose of this study is to document the prevalence of households with underweight and overweight persons (henceforth referred to as dual burden households) and their association with income and urban residence. The explorations by urban residence and income will test whether dual burden households differ from 'underweight only' and 'overweight only' households, respectively. These comparisons are relevant to differentiating or adapting nutrition-related interventions wherever obesity and undernutrition cluster at the household level.
Population:
Data analysis is based on national surveys conducted in Brazil, China, Indonesia, the Kyrgyz Republic, Russia, Vietnam and the United States.
Methods:
All persons were first classified into categories for underweight and overweight, using body mass index (BMI) cutoffs, and then all households were categorized into four types: dual burden, overweight, underweight and normal. Income and urban residence were explored as key risk factors for being a dual burden household, with the effects modeled separately for each country. Multiple logistic regression was used to explore income and urban risk factors, controlling for household size, region of residence and either urban residence or income, as appropriate.
Results:
In six of the countries studied, 22-66% of households with an underweight person also had an overweight person. Countries with the highest prevalence of dual burden households were those in the middle range of gross national product (GNP). The dual burden household is easily distinguished from the 'underweight only' households in Brazil, China, Indonesia, the United States and Vietnam. In these five countries dual burden households were more likely to be urban and more likely to be among the highest income tertile. There were no significant differences between dual burden and 'underweight only' households in Russia and the Kyrgyz Republic. In contrast, dual burden households were not easily distinguished from the 'overweight only' households in China, Indonesia, the Kyrgyz Republic, the United States and Vietnam. In Brazil and Russia dual burden households were more likely to be lower income and urban than 'overweight only' households.
Conclusion:
The prevalence of dual burden households presents a significant public health concern, particularly for those countries in the middle range of GNP. In some countries (China, Indonesia, the Kyrgyz Republic, the United States and Vietnam), dual burden households share sociodemographic profiles with overweight households, raising concerns for underweight individuals who may inadvertently become the focus of obesity prevention initiatives. For this reason, obesity prevention efforts should focus on messages that are beneficial to the good health of all, such as increasing fruit and vegetable intake, improving overall diet quality and increasing physical activity.
This paper explores the major changes in diet and physical activity patterns around the world and focuses on shifts in obesity.
Review of results focusing on large-scale surveys and nationally representative studies of diet, activity, and obesity among adults and children.
Youth and adults from a range of countries around the world.
The International Obesity Task Force guidelines for defining overweight and obesity are used for youth and the body mass index > or =25 kg/m(2) and 30 cutoffs are used, respectively, for adults.
The nutrition transition patterns are examined from the time period termed the receding famine pattern to one dominated by nutrition-related noncommunicable diseases (NR-NCDs). The speed of dietary and activity pattern shifts is great, particularly in the developing world, resulting in major shifts in obesity on a worldwide basis. Data limitations force us to examine data on obesity trends in adults to provide a broader sense of changes in obesity over time, and then to examine the relatively fewer studies on youth. Specifically, this work provides a sense of change both in the United States, Europe, and the lower- and middle-income countries of Asia, Africa, the Middle East, and Latin America.
The paper shows that changes are occurring at great speed and at earlier stages of the economic and social development of each country. The burden of obesity is shifting towards the poor.
It is generally believed that overweight is less prevalent than undernutrition in the developing world, particularly in rural areas, and that it is concentrated in higher socioeconomic status (SES) groups.
The purpose of this study was to examine patterns of adult female overweight and underweight in the developing world by using categories of urban or rural status and SES strata.
Body mass index (BMI; in kg/m(2)) data collected in 36 countries from 1992 to 2000 by nationally representative cross-sectional surveys of women aged 20-49 y (n = 148579) were classified as indicating underweight (BMI < 18.5) and overweight (BMI >/= 25). Associations between the nutritional status of urban and rural women and each country's per capita gross national income (GNI) and level of urbanization were explored in the overall sample and among different SES groups.
Overweight exceeded underweight in well over half of the countries: the median ratio of overweight to underweight was 5.8 in urban and 2.1 in rural areas. Countries with high GNIs and high levels of urbanization had not only high absolute prevalences of overweight but also small urban-rural differences in overweight and very high ratios of overweight to underweight. In the more-developed countries, overweight among low-SES women was high in both rural (38%) and urban (51%) settings. Even many poor countries, countries in which underweight persists as a significant problem, had fairly high prevalences of rural overweight.
In most developing economies, prevalences of overweight in young women residing in both urban and rural areas are higher than those in underweight women, especially in countries at higher levels of socioeconomic development. Research is needed to assess male and child overweight to understand the dynamics facing these groups as well.
To examine trends in fast-food consumption and its relationship to calorie, fat, and sodium intake in black and white adolescent girls.
A longitudinal multicenter cohort study of the development of obesity and cardiovascular risk factors in black and white female adolescents. Data collection occurred annually using a validated 3-day food record and a food-patterns questionnaire.
A biracial and socioeconomically diverse group of 2379 black and white girls recruited from 3 centers.
Three-day food records and a food-patterns questionnaire were examined for intake of fast food and its association with nutrient intake. We compared patterns of exposure to fast food and its impact on intake of calories, fat, and sodium.
Fast-food intake was positively associated with intake of energy and sodium as well as total fat and saturated fat as a percentage of calories. Fast-food intake increased with increasing age in both races. With increasing consumption of fast food, energy intake increased with an adjusted mean of 1837 kcal for the low fast-food frequency group vs 1966 kcal for the highest fast-food frequency group (P<.05). Total fat in the low fast-food frequency group was 34.3% as opposed to 35.8% in the highest fast-food frequency group (P<.05). Saturated fat went from 12.5% to 13% and sodium increased from 3085 mg to 3236 mg in the lowest vs the highest fast-food frequency group (P<.001).
Dietary intake of fast food is a determinant of diet quality in adolescent girls. Efforts to reduce fast-food consumption may be useful in improving diet and risk for future cardiovascular disease.
"The dietary transition in the developing world is accelerating toward an increased burden of chronic disease. It is increasing human mortality and disease burdens, and it is lowering economic productivity. The dietary transition is driven by changing preferences fueled by growing incomes, changing relative prices, urbanization, and food technology and distribution systems. This paper identifies policy options from the food supply and demand sides that can influence the transition toward increasingly healthy outcomes. These options have had mixed success in industrialized countries, and the policy tradeoffs in the developing world will be even more complicated. Additional technical research is needed to assess competing risks and help develop policy options. There is also a need for research to engage different actors in the policymaking process. In a debate in which much is at stake, there is a potentially powerful role for researchers to bring these actors to the table. In the end, this may help improve the decisionmaking processes underlying food policies that aim to redirect the diet transition toward healthier outcomes. " Authors' Abstract
Three billion people-more than half of the global population-are malnourished, suffering from hunger, vitamin and mineral deficiency, or overeating. And for the first time in history the world's overweight population now rivals the number that is underweight. The hungry and the overweight often face similar impairments: increased risk of disease and disability, reduced productivity, and reduced life expectancy. The World Bank estimates that hunger cost India between 3 and 9 percent of its GDP in 1996, while obesity cost the United States $118 billion-some 12 percent of what the nation spends on health care. For individuals as well as societies, malnutrition is a drag on development. But the reverse is also true: poor development choices spawn malnourished societies. Where hunger is the problem, governments have often failed to assure access to land and other productive resources, as well as basic social services. Where overeating is the issue, policymakers have typically neglected nutrition education, allowing giant food companies to influence people's food choices by default. In an age of unprecedented wealth, there is no excuse for malnutrition on such a massive scale. From the Indian state of Kerala to the island of Singapore, governments that appreciate the role of nutrition in national development and make good nutrition a priority demonstrate that both hunger and obesity can largely be eliminated.
Overweight and obesity represent a rapidly growing threat to the health of populations in an increasing number of countries. Indeed they are now so common that they are replacing more traditional problems such as undernutrition and infectious diseases as the most significant causes of ill-health. Obesity comorbidities include coronary heart disease, hypertension and stroke, certain types of cancer, non-insulin-dependent diabetes mellitus, gallbladder disease, dyslipidaemia, osteoarthritis and gout, and pulmonary diseases, including sleep apnoea. In addition, the obese suffer from social bias, prejudice and discrimination, on the part not only of the general public but also of health professionals, and this may make them reluctant to seek medical assistance. WHO therefore convened a Consultation on obesity to review current epidemiological information, contributing factors and associated consequences, and this report presents its conclusions and recommendations. In particular, the Consultation considered the system for classifying overweight and obesity based on the body mass index, and concluded that a coherent system is now available and should be adopted internationally. The Consultation also concluded that the fundamental causes of the obesity epidemic are sedentary lifestyles and high-fat energy-dense diets, both resulting from the profound changes taking place in society and the behavioural patterns of communities as a consequence of increased urbanization and industrialization and the disappearance of traditional lifestyles. A reduction in fat intake to around 20-25% of energy is necessary to minimize energy imbalance and weight gain in sedentary individuals. While there is strong evidence that certain genes have an influence on body mass and body fat, most do not qualify as necessary genes, i.e. genes that cause obesity whenever two copies of the defective allele are present; it is likely to be many years before the results of genetic research can be applied to the problem. Methods for the treatment of obesity are described, including dietary management, physical activity and exercise, and antiobesity drugs, with gastrointestinal surgery being reserved for extreme cases.
Although a link between small body size at birth and later type 2 diabetes has been repeatedly documented, less is known about the associations between the disease and growth during infancy. The aim of this study was to explore the pathways of infant and early growth that lead to type 2 diabetes in adult life.
We carried out a longitudinal study of 8760 subjects born in Helsinki from 1934 to 1944. On average, they had 8 measurements of height and weight between birth and 1 year of age and another 10 measurements between 1 and 12 years of age. We identified people with type 2 diabetes using a national register.
Among babies whose birth weights were <or=3.5 kg, the rate of infant growth was unrelated to later type 2 diabetes. Among babies with birth weights >3.5 kg, slow growth in length between birth and 3 months of age predicted later disease. Rapid gain in BMI after age 2 years increased the risk of later disease in both groups of babies, but this effect was greatest among children who had slow growth in length between birth and 3 months of age. In children whose Z-scores for length decreased, an SD increase in BMI at age 12 years was associated with an odds ratio (OR) for type 2 diabetes of 1.77 (95% CI 1.50-2.09). The corresponding OR in subjects whose Z-scores for length increased was 1.42 (95% CI 1.20-1.69). Rapid gain in childhood BMI was associated with high maternal BMI and socioeconomic factors (fewer people in the home and lower social class).
Babies with above-average birth weights may develop type 2 diabetes later in life if poor living conditions lead to faltering growth in length in the first few months after birth. We speculate that growth faltering at this time is associated with lifelong impairment of insulin metabolism and inability to meet the challenge of rapid childhood increase in BMI.
Chronic diseases are the main public health problem in Western countries. There are indications that these diseases originate in the womb. It is thought that undernutrition of the fetus during critical periods of development would lead to adaptations in the structure and physiology of the fetal body, and thereby increase the risk of diseases in later life. The Dutch famine—though a historical disaster—provides a unique opportunity to study effects of undernutrition during gestation in humans. This thesis describes the effects of prenatal exposure to the Dutch famine on health in later life. We found indications that undernutrition during gestation affects health in later life. The effects on undernutrition, however, depend upon its timing during gestation and the organs and systems developing during that critical time window. Furthermore, our findings suggest that maternal malnutrition during gestation may permanently affect adult health without affecting the size of the baby at birth. This may imply that adaptations that enable the fetus to continue to grow may nevertheless have adverse consequences of improved nutrition of pregnant women will be underestimated if these are solely based on the size of the baby at birth. Little is known about what an adequate diet for pregnant women might be. In general, women are especially receptive to advice about diet and lifestyle before and during a pregnancy. This should be exploited to improve the health of future generations.
Physical inactivity contributes to weight gain in adults, but whether this relationship is true for children of different ethnic groups is not well established.
To assess participation in vigorous activity and television watching habits and their relationship to body weight and fatness in US children.
Nationally representative cross-sectional survey with an in-person interview and medical examination. SETTING and
Between 1988 and 1994, 4063 children aged 8 through 16 years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups.
Episodes of weekly vigorous activity and daily hours of television watched, and their relationship to body mass index and body fatness.
Eighty percent of US children reported performing 3 or more bouts of vigorous activity each week. This rate was lower in non-Hispanic black and Mexican American girls (69% and 73%, respectively). Twenty percent of US children participated in 2 or fewer bouts of vigorous activity perweek, and the rate was higher in girls (26%) than in boys (17%). Overall, 26% of US children watched 4 or more hours of television per day and 67% watched at least 2 hours per day. Non-Hispanic black children had the highest rates of watching 4 or more hours of television per day (42%). Boys and girls who watch 4 or more hours of television each day had greater body fat (P<.001) and had a greater body mass index (P<.001) than those who watched less than 2 hours per day.
Many US children watch a great deal of television and are inadequately vigorously active. Vigorous activity levels are lowest among girls, non-Hispanic blacks, and Mexican Americans. Intervention strategies to promote lifelong physical activity among US children are needed to stem the adverse health consequences of inactivity.
Background. Many human fetuses and infants have to adapt to a limited supply of nutrients, and in doing so they permanently change their physiology and metabolism. These programmed changes may be the origins of a number of diseases in later life, including coronary heart disease, stroke, diabetes and hypertension.
Coronary heart disease. We have become accustomed to the idea that coronary heart disease, the commonest cause of death in the Western world, may result from the “unhealthy” lifestyle that is associated with increasing affluence. The influences of this “unhealthy” lifestyle (e. g. obesity, cigarette smoking, dietary fat, stress), however, go only a small way towards explaining why increasing affluence in the Third world is so regularly followed by epidemics of the disease, or why in the Western world these epidemics have risen steeply to become the commonest cause of death but thereafter have declined. Neither do they explain why the highest rates of coronary heart disease in Western countries occur among the poor?
Fetal origins. Answers to these questions may come from an understanding of how the structure of the heart and processes such as blood pressure regulation and the way the body handles sugar and fat are established in the womb. The “fetal origins” hypothesis states that coronary heart disease and the disorders related to it – hypertension, adult-onset diabetes and stroke – originate through adaptations that the fetus makes when it is under-nourished. Unlike adaptations made in adult life those made during early development tend to have permanent effects on the body's structure and function – a phenomenon sometimes referred to as programming. They allow the fetus to survive and continue to grow but at the price of a shortened life.
The effects of early gestational undernutrition and subsequent refeeding patterns on offspring food intake, body weight and adiposity were examined. Pregnant rats were food restricted to 50% of their preconception intake levels during the first 2 weeks of pregnancy and were then either returned to ad libitum feeding or pair-fed to nonrestricted control rats. Male and female offspring of previously deprived, ad libitum refed mothers gained significantly more weight when fed a standard low fat, high carbohydrate diet than did control offspring. When the maintenance diet was changed at 140 days of age to a high fat diet, both groups of previously deprived male offspring gained weight at greater than control rates. In contrast, the three groups of female rats gained weight at comparable rates after the diet change. Adipocyte hypertrophy and elevated carcass lipid content were seen in high fat-fed male but not female offspring of previously deprived mothers. Adipose tissue lipoprotein lipase activity was unaffected by these manipulations.
Pregnant rats underfed in the first 2 weeks of gestation had offspring with normal body weight at birth and weaning. However, starting at about 5 weeks of age the male offspring became hyperphagic and gained more weight than the controls. The female offspring did not overeat and did not become obese. Both male and female progeny showed increased fat cell size as adults. In males the epididymal and retroperitoneal fat pads were significantly enlarged nd adipocytes in these pads were hypertrophied. In females and fat pads were not enlarged, but adipocytes in the parametrial pads were hypertrophied.
Recent data indicate that low-birthweight adults are at a higher risk than their high-birthweight peers of developing ischemic heart disease or a cluster of conditions known as the IRS, which includes dyslipidaemias, hypertension, unfavorable body fat distribution and NIDDM. Thus far these observations have been limited to Caucasians from the United Kingdom. we extended these observations to a broader segment of the general population by studying the association of birthweight and adult health outcomes in a biethnic population of the United States. We divided a group of 564 young adult Mexican-American and non-Hispanic white men and women participants of the San Antonio Heart Study into tertiles of birthweight and compared metabolic, anthropometric, haemodynamic, and demographic characteristics across these tertile categories. Additionally, we studied birthweight as a predictor of the clustering of diseases associated with the IRS, defined as any two or more of the following conditions: hypertension, NIDDM or impaired glucose tolerance, dyslipidaemia. Normotensive, non-diabetic individuals whose birthweight was in the lowest tertile had significantly higher levels of fasting serum insulin and a more truncal fat deposition pattern than individuals whose birthweight was in the highest tertile, independently of sex, ethnicity, and current socioeconomic status. Also, the odds of expressing the IRS increased 1.72 times (95% confidence interval: 1.16-2.55) for each tertile decrease in birthweight. These findings were independent of sex, ethnicity, and current levels of socioeconomic status or obesity. In conclusion, low birthweight could be a major independent risk factor for the development of adult chronic conditions commonly associated with insulin resistance in the general population.
Babies who are small at birth or during infancy have increased rates of cardiovascular disease and non-insulin-dependent diabetes as adults. Some of these babies have low birthweights, some are small in relation to the size of their placentas, some are thin at birth, and some are short at birth and fail to gain weight in infancy. This paper shows how fetal undernutrition at different stages of gestation can be linked to these patterns of early growth. The fetuses' adaptations to undernutrition are associated with changes in the concentrations of fetal and placental hormones. Persisting changes in the levels of hormone secretion, and in the sensitivity of tissues to them, may link fetal undernutrition with abnormal structure, function, and disease in adult life.
We argue that over the past 300 years human physiology has been undergoing profound environmentally induced changes made possible by numerous advances in technology. These changes, which we call technophysio evolution, increased body size by over 50%, and greatly improved the robustness and capacity of vital organ systems. Because technophysio evolution is still ongoing, it is relevant to forecasts of longevity and morbidity and, therefore, to forecasts of the size of the elderly population and pension and health care costs.
National data indicate that children and youth do not meet Healthy People 2010 objectives for fruit and vegetable intake. Television viewing is hypothesized as a contributing factor because of its documented role in encouraging consumption of highly advertised foods that may lead to the replacement of fruits and vegetables.
A sample of 548 ethnically diverse students (average age: 11.7 +/- 0.8 years) from public schools in 4 Massachusetts communities were studied prospectively over a 19-month period from October 1995 to May 1997. We examined the associations between baseline and change in hours of television and video viewing per day (the predictor variables) and change in energy-adjusted intake of fruits and vegetables by using linear regression analyses to control for potentially confounding variables and the clustering of observations within schools.
For each additional hour of television viewed per day, fruit and vegetable servings per day decreased (-0.14) after adjustment for anthropometric, demographic, dietary variables (including baseline percent energy from fat, sit-down dinner frequency, and baseline energy-adjusted fruit and vegetable intake), and physical activity. Baseline hours of television viewed per day was also independently associated with change in fruit and vegetable servings (-0.16).
Television viewing is inversely associated with intake of fruit and vegetables among adolescents. These associations may be a result of the replacement of fruits and vegetables in youths' diets by foods highly advertised on television.
Many health disparities in the United States are linked to inequalities in education and income. This review focuses on the relation between obesity and diet quality, dietary energy density, and energy costs. Evidence is provided to support the following points. First, the highest rates of obesity occur among population groups with the highest poverty rates and the least education. Second, there is an inverse relation between energy density (MJ/kg) and energy cost (US dollars/MJ), such that energy-dense foods composed of refined grains, added sugars, or fats may represent the lowest-cost option to the consumer. Third, the high energy density and palatability of sweets and fats are associated with higher energy intakes, at least in clinical and laboratory studies. Fourth, poverty and food insecurity are associated with lower food expenditures, low fruit and vegetable consumption, and lower-quality diets. A reduction in diet costs in linear programming models leads to high-fat, energy-dense diets that are similar in composition to those consumed by low-income groups. Such diets are more affordable than are prudent diets based on lean meats, fish, fresh vegetables, and fruit. The association between poverty and obesity may be mediated, in part, by the low cost of energy-dense foods and may be reinforced by the high palatability of sugar and fat. This economic framework provides an explanation for the observed links between socioeconomic variables and obesity when taste, dietary energy density, and diet costs are used as intervening variables. More and more Americans are becoming overweight and obese while consuming more added sugars and fats and spending a lower percentage of their disposable income on food.
Cardiovascular disease (CVD) causes 12.4 million deaths annually, most (9.6 million) occurring in developing countries. Hypertension, the most common CVD, arises within the context of obesity, but the underlying mechanisms remain obscure. Obesity and salt intake are two important risk factors for hypertension and are the focus of this paper. Traditional African populations show a low prevalence of hypertension, but hypertension is more common in migrant African populations in the West than in other ethnic groups. One explanation is genetic, but no causative gene has been confidently identified. Nongenetic susceptibilities such as fetal programming are an alternative explanation. Hypothetically, fetal programming induced by transient stimuli permanently alters fetal structure and function at the cellular, organ and whole-body levels. Birth weight is inversely related to blood pressure and hypertension risk, suggesting that susceptibility to hypertension risk factors such as obesity and salt sensitivity are themselves programmed. In support of this hypothesis, obesity (especially central obesity) is also inversely related to size at birth. Likewise, salt sensitivity might derive from undernutrition in utero, reducing the nephron number and resetting the pressure-natriuresis curve rightward. However, no robust human data or evidence of enhanced salt sensitivity among African-origin populations exist. In the United States, blacks have a greater prevalence of low birth weight than whites, suggesting that the higher prevalence of hypertension among blacks is related to fetal programming. Nevertheless, we need to be scrupulous in ascribing risk to the myriad other confounders of this relationship, including environmental and behavioral correlates of ethnicity, before concluding that excess risk of hypertension in Africans is programmed in utero. J. Nutr. 134: 211-216, 2004.
Obesity is a major health problem in the United States and around the world. To date, relationships between obesity and aspects of the built environment have not been evaluated empirically at the individual level.
To evaluate the relationship between the built environment around each participant's place of residence and self-reported travel patterns (walking and time in a car), body mass index (BMI), and obesity for specific gender and ethnicity classifications.
Body Mass Index, minutes spent in a car, kilometers walked, age, income, educational attainment, and gender were derived through a travel survey of 10,878 participants in the Atlanta, Georgia region. Objective measures of land use mix, net residential density, and street connectivity were developed within a 1-kilometer network distance of each participant's place of residence. A cross-sectional design was used to associate urban form measures with obesity, BMI, and transportation-related activity when adjusting for sociodemographic covariates. Discrete analyses were conducted across gender and ethnicity. The data were collected between 2000 and 2002 and analysis was conducted in 2004.
Land-use mix had the strongest association with obesity (BMI >/= 30 kg/m(2)), with each quartile increase being associated with a 12.2% reduction in the likelihood of obesity across gender and ethnicity. Each additional hour spent in a car per day was associated with a 6% increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was significantly associated with urban form for white cohorts. Relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts.
Measures of the built environment and travel patterns are important predictors of obesity across gender and ethnicity, yet relationships among the built environment, travel patterns, and weight may vary across gender and ethnicity. Strategies to increase land-use mix and distance walked while reducing time in a car can be effective as health interventions.
To examine the relative size of the effects of fitness and fatness on mortality in Russian men, and to make comparison to US men.
Prospective closed cohort.
1359 Russian men and 1716 US men aged 40-59 y at baseline (1972-1977) who were enrolled in the Lipids Research Clinics Study.
Fitness was assessed using a treadmill test and fatness was assessed as body mass index (BMI) calculated from measured height and weight. Hazard ratios were calculated using proportional hazard models that included covariates for age, education, smoking, alcohol intake and dietary keys score. All-cause and cardiovascular disease (CVD) mortality were assessed through 1995.
In Russian men, fitness was associated with all-cause and CVD mortality, but fatness was not. For mortality from all causes, compared to the fit-not fat, the adjusted hazard ratios were 0.87 (95% CI: 0.55, 1.37) among the fit-fat, 1.86 (95% CI: 1.31, 2.62) among the unfit-not fat and 1.68 (95% CI: 1.06, 2.68) among the unfit-fat. Among US men, the same hazard ratios were 1.40 (95% CI: 1.07, 1.83), 1.41 (95% CI: 1.12, 1.77) and 1.54 (95% CI: 1.24, 2.06), respectively. There were no statistically significant interactions between fitness and fatness in either group of men for all-cause or CVD mortality.
The effects of fitness on mortality may be more robust across populations than are the effects of fatness.
This paper examines the speed of change in diet, activity, and obesity in the developing world, and notes potential exacerbating biological relationships that contribute to differences in the rates of change. The focus is on lower- and middle-income countries of Asia, Africa, the Middle East, and Latin America. These dietary, physical activity, and body composition changes are occurring at great speed and at earlier stages of these countries' economic and social development. There are some unique issues that relate to body composition and potential genetic factors that are also explored, including potential differences in body mass index (BMI)--disease relationships and added risks posed by high levels of poor fetal and infant growth patterns. In addition there is an important dynamic occurring--the shift in the burden of poor diets, inactivity and obesity from the rich to the poor. The developing world needs to give far greater emphasis to addressing the prevention of the adverse health consequences of this shift to the nutrition transition stage of the degenerative diseases.
To determine whether children's sweetened-beverage consumption has changed over a 21-year period (1973 to 1994) in Bogalusa, LA, and whether trends in energy intake, milk consumption, and body mass index (BMI) varied among the sweetened-beverage consumption groups.
Information on food and nutrient intake was derived from a single 24-hour dietary recall collected from children who participated in one of seven cross-sectional surveys.
A total of 1,548 10-year-old children (65% white, 35% African American; 51% female, 49% male) were randomly selected to participate in the study.
The C