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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Metabolic syndrome (MetS) being a biological abnormality confers the highest risk of type 2 diabetes mellitus (T2DM). Aim: To assess MetS indicators in the newly diagnosed T2DM Pakistani population. Methods: A cross-sectional study (N = 123) with newly diagnosed T2DM patients (gender: both, MeanAge: 49.24 ± 6.84 years) was selected from Medical OPD, Pakistan Institute of Medical Sciences, Islamabad. Basic profile, family history, and physical activity were recorded through a predesigned questionnaire, dietary intake through seven days Food Diary and Food Frequency Questionnaire. Blood pressure and selected clinical signs and symptoms were recorded. Anthropometric measurements included mid-upper arm circumference (MUAC), body mass index (BMI), waist circumference (WC), waist-and-hip ratio (WHR), waist-to-height ratio (WHtR), and conicity index. Lab parameters included fasting blood glucose, HbA1c, insulin levels, and lipid profile. Homeostatic model assessment of insulin resistance (HOMA-IR) was computed to assess insulin resistance. Results: Almost all parameters related to MetS were higher than normal. The prevalence of MetS was 59.7%. BMI, MUAC, and WHtR were independently associated with HOMA-IR, but WC, WHR, and the conicity index had no relationship MetS indicators. Conclusion: The prevalence rate of MetS was found to be 59.7% in newly diagnosed T2DM patients. MUAC was found to be a better parameter for the diagnosis of central obesity and insulin resistance in the selected population. [ABSTRACT FROM AUTHOR]

Background: Today, food insecurity is recognized as an important public health problem that can have detrimental effects on families. Aim: The aim of this study was to assess the determinants and consequences of food insecurity in families having children under the age of 2 years. Method: In this cross-sectional study, 307 mothers and their children under the age of 2 years were selected by stratified random sampling. Demographic and socioeconomic data were collected by completing questionnaires through face-to-face interview. Household food insecurity (HFI) status was determined using the United States Department of Agriculture (USDA) household food security questionnaire. Results: Based on the results, 67.4% of families were high food secure. Low and very low food security was 25.7% and 6.9%, respectively. House size (Beta = −0.019, 95% CI: −0.029, −0.009), father's job (Beta = −4.758, 95% CI:−6.777, −2.738), father education (Beta = −0.370, 95% CI: −0.717, −0.023), and economic status (Beta = −0.628, 95% CI: −0.809, −0.448) were significantly related to the USDA total food insecurity score (p < 0.05). Regression analysis showed that children birth weight, father's body mass index (BMI), and mother's waist circumference had a significant positive correlation with weight for age (Z-score) of children. Children's birth weight, father's BMI, and HFI status had significant and positive correlation with weight for length (Z-score). Moreover, the significant association between children's birth height, mother's BMI, and mother's waist circumference with length for age (Z-score) were observed (p < 0.05). Conclusion: We found the father's job was the most effective factor in food insecurity and economic status of the family was in the second place. Also, HFI had a relationship with weight status of children under the age of 2 years. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to determine the serum level of asprosin, a novel glucogenic and orexigenic hormone, in NAFLD and hypothyroidism patients. Methods: This is a case–control study that included three groups of age and sex-matched subjects: hypothyroid patients with NAFLD (n = 26), hypothyroid patients without NAFLD (n = 25) and normal control subjects (n = 27). A detailed clinical history was obtained, and an examination was performed. Laboratory tests included fasting plasma glucose and insulin, lipid profile, TSH, free T4, AST, ALT, albumin, and asprosin. The homeostatic model assessment of insulin resistance (HOMA-IR) score was calculated. Abdominal ultrasonography was performed to calculate the hepatorenal index and define participants with NAFLD. The data were statistically analyzed. Results: There was a statistically significant difference between the three groups regarding serum asprosin concentration (p < 0.01). Serum asprosin levels were significantly higher in the patients with hypothyroidism and NAFLD compared to both other groups [2.70 ng/mL (2.17–4.10), 1.26 ng/mL (0.96–2.50), and 1.72 ng/mL (1.41–2.12), respectively]. There was no significant difference between the other two groups. There was a significant positive correlation of moderate strength between asprosin and HOMA-IR, BMI, and waist circumference. Asprosin and HOMA-IR were significantly higher in patients with NAFLD compared to subjects with normal liver (p < 0.001). Conclusion: The coexistence of NAFLD and hypothyroidism is more strongly associated with increased asprosin than is the presence of hypothyroidism alone. This could be due to increased insulin resistance as a possible link. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to examine the associations of a healthy lifestyle index (HLI) with several anthropometric indices and obesity among Hong Kong Chinese women. A total of 3174 women (56.16 ± 8.43 years) were included. The HLI consisted of diet, physical activity, sedentary time, sleep duration, skipping breakfast, smoking, and alcohol. Each factor was scored as 0 (unhealthy) or 1 (healthy). The overall HLI was the sum of these points, ranging from 0 (the least healthy) to 7 (healthiest). Percent body fat (PBF), body fat mass (BFM), fat free mass (FFM), waist circumference (WC), waist-to-hip ratio (WHR), height, and weight were measured using the InBody 270 device. The number of women with 0–2, 3, 4, 5, 6–7-point HLI groups were 551, 759, 954, 645, and 265, respectively. As HLI increased, most anthropometric indices declined while FFM increased. The adjusted βs (95 % confidence intervals (95 % CIs)) for PBF (%), BFM (kg), WC (cm), WHR, height (cm), weight (kg), BMI (kg/m^2), and FFM (kg) were −0.653 (-0.829, −0.476), −0.582 (-0.751, −0.414), −0.719 (-0.971, −0.467), −0.005 (-0.006, −0.004), −0.181 (-0.347, −0.015), −0.602 (-0.850, −0.355), −0.188 (-0.282, −0.095), and 0.339 (0.213, 0.465), respectively. Additionally, compared to the 0–2-point group, the odds ratios (95 % CIs) of the 6–7-point groups were 0.54 (0.38–0.75) for central obesity and 0.55 (0.37–0.82) for general obesity. HLI was inversely associated with PBF, BFM, WC, WHR, height, weight, BMI, central obesity, and general obesity, but was positively associated with FFM. [ABSTRACT FROM AUTHOR]

Copyright of Revista Horizonte Médico is the property of Universidad de San Martin de Porres and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Key summary points: Aim: Sarcopenic Obesity (SO) is a complex health concern requiring effective predictors for early detection and intervention. The Waist-to-Calf Ratio (WCR) is a new index that incorporates both measurements, providing a promising approach for assessing the imbalance between abdominal fat and leg muscle mass. This study assessed the association of the WCR with SO in community-dwelling older adults. the imbalance between abdominal fat and leg muscle mass. The present study aimed to examine the association of WCR with SO and reveal the predictive effect of SO in community-dwelling older adults. Findings: Our findings reveal a significant association between WCR and SO, independent of age, sex, malnutrition, and frailty. Message: The primary discovery of this study is that WCR may be a potential valuable predictor for SO in community-dwelling older adults. Background: Proponents argue that a high waist-to-calf ratio (WCR) may indicate an imbalance between muscle and fat in the body, making it a potential predictor for sarcopenic obesity (SO). The WCR is a new index incorporating both measurements, providing a reliable approach for assessing the imbalance between abdominal fat and leg muscle mass. The present study aimed to examine the association of WCR with SO and reveal the predictive effect of SO in community-dwelling older adults. Methods: The study population was composed of 234 geriatric outpatients with obesity. WCR was calculated by dividing the waist circumference (in cm) by the calf circumference (in cm). SO was defined according to the ESPEN and EASO Consensus Statement. Results: The mean age was 72.7 ± 5.8 years, and 78.7% (n = 175) were female. Eighty-one patients (34.6%) were considered as sarcopenic obese. The WCR was 3.04 [Interquartile range (IQR), 2.88–3.32] in the sarcopenic obese group, and in the nonsarcopenic obese group, it was 2.82 [IQR, 2.7–3.0] (p < 0.001). Independent of age, sex, nutritional and frailty status WCR was associated with SO (OR 12.7, 95% CI 4.0–40.1 and p < 0.001). The cut-off value of WCR for SO was calculated as 2.94 with 72.8% sensitivity and 67.3% specificity (Area Under Curve: 0.72 and Positive likelihood ratio: 2.23, p < 0.001). Conclusions: WCR, a simple and accessible method, indicates promise as a possible and potential diagnostic tool for SO in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Background: Sarcopenic obesity (SO) is defined as a decrease in lean body mass and an increase in body fat mass (BFM) due to aging. Detecting SO in elderly women is important from the perspective of extending healthy life expectancy. While various indices of SO are currently used, there is no global consensus regarding diagnostic criteria for SO. This study aimed to examine the relationship between obesity indices (waist circumference (WC), body mass index (BMI), and body fat percentage (BFP)) and sarcopenia indices (total body muscle mass (TBM), appendicular lean mass (ALM), skeletal mass index (SMI)), and physical function (gait speed (GS), handgrip strength (HGS)). Methods: Subjects were 170 community-dwelling healthy elderly women aged 65–79 years (mean: 72.7 ± 5.78 years) who underwent measurements for WC, BMI, and BFP. A WC of ≥ 90cm was defined as the obese group, BMI was determined as weight (kg) divided by height squared (m2) and a cutoff of ≥ 25 kg/m2 was used to define the obesity group. BFM was measured using the bioelectrical impedance analysis (BIA) method and BFP was calculated from body weight and a cutoff of ≥ 30% was used to define the obesity group. TBM and ALM (kg) were measured using the BIA method, ALM (kg) was corrected for height (m2) to obtain SMI (kg/m2). Physical function was assessed by GS and HGS, which were measured by the 5-m walk test and a digital grip strength meter, respectively. Results: When obesity was assessed using BMI, WC and BFP, obese individuals had higher TBM, ALM and SMI, and lower GS among the sarcopenia indicators. HGS did not differ significantly between the non-obese and obese groups. Conclusion: Our findings suggest HGS is thought to reflect muscle strength without being affected by obesity indices, suggesting that it may be useful in detecting possible sarcopenia in obese individuals. [ABSTRACT FROM AUTHOR]

Jawarish Bisbasa, a Unani polyherbal formulation, is used traditionally in the clinical treatment of central obesity. It is a polyherbal semi-solid preparation of eleven medicinal herbs mainly used as spices. Aim of the study: The main objective of this study was to evaluate the effect of Unani Formulation Jawarish Bisbasa and compare the changes in lipid profiles and Anthropometric Parameters before and after treatment in patients with hyperlipidaemia associated with central obesity. Materials and methods: An open-label clinical validation study was conducted at the Regional Research Institute of Unani Medicine, Mumbai research OPD. The study included 120 cases of each gender with BMIs of 34.99 kg/m2 for men and 32.49 kg/m2 for women, while 88 cases completed the study. Enrolled cases received Unani Formulation Jawarish Bisbasa 7gm BD twice daily with warm water for 8 weeks. The pathological investigations and Anthropometric Parameters related to the study, particularly BMI, Waist Circumference, Waist to hip ratio, Saggital Abdominal Diameter, LDL, HDL, and VLDL values were statistically analysed at baseline, first, follow-up, and at the end of the study by using unpaired Student t-test and one-way analysis of variance. (ANOVA). Extremely significant BMI, Waist Circumference, Waist to hip ratio, Saggital Abdominal Diameter, and lowering of ESR, Total cholesterol, and Triglycerides when the values of before-treatment and after-treatment were analyzed in hyperlipidemia associated with central obesity. There were no side effects reported during the treatment. [ABSTRACT FROM AUTHOR]

Background: Non Communicable Diseases have been identified among top ten global threats by WHO. The role of Screening in Ice berg disease is pre-established. In India, Community Based Assessment Checklist is used to identify high-risk people for Non-Communicable Diseases. Methods: A cross sectional study done among 265 participants from households situated in field practice area attached to Government Medical College, Surat. Data was collected using World Health Organization Stepwise approach to surveillance. Results: Out of total participants 83 (31.32%) were classified high risk (CBAC>4) for Non-Communicable Diseases. Mean age of participants was 43.79 ± 9.36 years. One-tenth 25 (9.4%) of participants were on treatment. Those classified high risk were significantly associated with age (p<0.05), education (p=0.03), occupation (p<0.01). Predictors for Non-Communicable Diseases identified were smoking (aOR=4.7, p=0.003), alcohol (aOR= 2.3, p<0.001), higher Body Mass Index (aOR= 3.8, p=0.03) and higher waist size (aOR= 4.3, p<0.001). Sensitivity, Specificity of tool and Area under Curve were found to be 73.3%, 75.8% and 0.72 respectively. Conclusion: To prevent and control Non-Communicable Diseases key behavioral risk factors to be targeted include smoking, alcohol, higher Body Mass Index and waist size which could be due to unhealthy diet & absence of exercise. [ABSTRACT FROM AUTHOR]

The Chinese visceral adipose index (CVAI) is more significantly associated with cardiometabolic risk factors than other obesity indices. This study investigated the relationship between CVAI and left ventricular (LV) remodeling. This study included 75,132 Koreans who underwent echocardiography during a health checkup. They were grouped according to quartile levels of the CVAI, body mass index (BMI), waist circumference (WC), and visceral adiposity index (VAI). LV remodeling was defined as the presence of abnormal relative wall thickness (ARWT) and left ventricular hypertrophy (LVH). Multivariate adjusted logistic regression analysis (adjusted OR [95% confidence interval]) was used to analyze the association between ARWT and LVH according to the quartile levels of each index. Receiver operating characteristic (ROC) graphs and areas under the curve (AUC) were calculated to identify the predictive ability of the indices for ARWT and LVH. ARWT was associated proportionally with CVAI quartiles in both men (second quartile: 1.42 [1.29–1.56], third quartile: 1.61 [1.46–1.77], fourth quartile: 2.01 [1.84–2.21]), and women (second quartile: 1.06 [0.78–1.45], third quartile: 1.15 [0.86–1.55], and fourth quartile: 2.09 [1.56–2.80]). LVH was significantly associated with third (1.74 [1.07–2.83]) and fourth quartile (1.94 [1.18–3.20]) groups of CVAI in women. ROC and AUC analyses indicated that CVAI was superior to other indices in predicting ARWT in men and LVH and ARWT in women. The CVAI is an effective surrogate marker of LV remodeling, particularly in women. • CVAI predicted the likelihood of LVH and ARWT better than BMI, waist circumference, and VAI in women. • Our study suggests that the VAI has poor predictive power for LV remodeling, whereas the CVAI is significantly better in the Asian population. [ABSTRACT FROM AUTHOR]

Background: Metabolic dysfunction-associated steatotic liver (MASLD) disease is the commonest hepatic cause of liver fibrosis and cirrhosis after the introduction of the direct acting antivirals and eradication of hepatitis C. MASLD is usually associated with metabolic syndrome and elevated inflammatory markers. Magnetic resonance spectroscopy (MRS) offers a non-invasive diagnostic, alternative to liver biopsy. This is a case–control diagnostic-accuracy study conducted on 40 patients in the Hepato-gastroenterology Unit in the Internal Medicine Department, Ain Shams University Hospitals, to study the role of MRI spectroscopy as a new diagnostic model for assessment of liver steatosis in non-diabetic MASLD patients compared to the standard ultrasound and clinical criteria. MASLD was diagnosed by a combination of a validated ultrasound hepatic steatosis score grading system and hepatic steatosis index using clinical and laboratory parameters. MRS was performed in all patients and fat peak, water peak, and fat fraction % were measured, and diagnostic accuracy of different MRS is compared to the US scoring and different laboratory and clinical parameters. To our knowledge this is the first study conducted on MRS in our region and Egypt. Results: This study revealed no statistically significant difference between the two groups regarding HbA1C, creatinine, while there was highly statistically significant difference regarding fasting blood sugar, 2 h post-prandial glucose level, urine albumin, and low-density lipoprotein levels. Hepatic steatosis score grading by abdominal ultrasound on the 20 controls showed no fatty changes with grade 0 (50%), and on the 20 MASLD patients showed that 2 cases were grade 1 steatosis (5%), 9 cases were grade 2 steatosis (22.5%), and 9 cases were grade 3 steatosis (22.5%). The diagnostic accuracy of predicting hepatic steatosis using different MRS parameters: fat peak, water peak, and fat fraction had area under the curve of 99.9%, 88.6%, and 100%, respectively. The sensitivity and specificity of fat fraction in detecting hepatic steatosis were 100%. The sensitivity and specificity of the fat peak in detecting hepatic steatosis were 100% and 95%, respectively. Moreover, the sensitivity and specificity of the water peak in detecting the hepatic steatosis were 88.6% and 85%, respectively. There is a statistically significant correlation between the three MRS parameters and the abdominal ultrasound hepatic steatosis score grades. Conclusion: MRS parameters: fat fraction, fat peak, and water peak, have high diagnostic accuracy for predicting the liver steatosis. Moreover, MRS has the added advantage of being a non-invasive and a tool with low radiation risk. MRS also shows the metabolic changes in the liver and could be an eligible outcome in therapeutic clinical trials. [ABSTRACT FROM AUTHOR]

Copyright of Kinesiologia Slovenica is the property of Faculty of Sport and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim. The main aim of the study was to assess the incidence of metabolic syndrome and its individual components in patients subject to a confinement measure, treated with antipsychotics in mono -- or polytherapy. Additional objectives included the analysis of associations between the occurrence of metabolic syndrome and patients' age, psychiatric diagnosis, overweight or obesity, and the presence of addictions to psychoactive substances. Method. The study involved 61 patients of the Department of Forensic Psychiatry, including 9 women and 52 men, subject to a confinement measure from September 2019 to August 2021. All parameters of metabolic syndrome and BMI were measured twice, at the beginning of the stay at the Department and after six months of treatment with atypical antipsychotics. Appropriate statistical comparative analyses were then performed. Results. There was no relationship between the occurrence of metabolic syndrome and the age of the subjects, medical diagnosis, addiction to psychoactive substances, including smoking. It has not been confirmed that the chronic use of atypical antipsychotics with parallel prophylactic and health-promoting effects in conditions of confinement leads to the development of metabolic syndrome and worsens its symptoms, apart from a marked increase in waist circumference and an increase in BMI. Conclusions. Systematic measurements of BMI and waist circumference during treatment with atypical antipsychotics may be accurate tools in assessing the risk of metabolic syndrome. Long-term confinement hospitalizations should include psychoeducational interventions aimed at minimizing metabolic complications of pharmacotherapy. [ABSTRACT FROM AUTHOR]

• 139 CAD subjects randomized to EPA+DHA or none for 30 mo had EATV measured by CT. • EPA+DHA & control had similar reductions in EATV perhaps due to statin treatment. • Higher EATV was linked to greater fatty, rupture-prone plaque, boosting MI risk. • Change in waist circumference was the only predictor of an increase in EATV at 30 mo. • Waist circumference may obviate need for CT measure of EATV to predict cardiac risk. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation lower triglyceride levels. The impact on epicardial adipose tissue volume (EATV), which is associated with cardiovascular events, is unclear. To determine if triglyceride reduction with EPA+DHA supplementation decreases EATV and whether EATV affects coronary plaque. 139 subjects with coronary artery disease (CAD) on statins were randomized to 3.36 g EPA+DHA daily or none (control) for 30 months. EATV, coronary plaque volumes and coronary artery calcium score were measured with coronary computed tomographic angiography. Change in triglyceride level correlated with change in EATV (r =0.236; p =0.006). Despite a 6.7% triglyceride reduction (p =0.021) with EPA+DHA supplementation compared to no change in control (between group p =0.034); both groups had similar reductions in EATV possibly due to statin treatment. EATV above the median (>115.6 cm3) was the only determinant of baseline coronary fatty plaque volume (β=2.4, p =0.010). After multivariate adjustment, waist circumference, a surrogate of abdominal visceral adiposity, was the only determinant of baseline EATV (odds ratio {OR]:1.093; 95% confidence interval [CI]:1.003-1.192, p =0.042). Moreover, increase in waist circumference was the only predictor of an increase in EATV at 30 months (β=0.320, p =0.018). EATV is associated with higher coronary fatty plaque volume and is regulated by waist circumference but not EPA+DHA supplementation at 30-month follow-up in CAD patients on statin treatment. The direct correlation between waist circumference and EATV suggests that maintaining a healthy weight may limit EATV and coronary fatty plaque volume, potentially leading to a decrease in cardiovascular events. [Display omitted] [ABSTRACT FROM AUTHOR]

Aims: To determine the effect of a 16-week fitness program (strength vs. aerobic) on different indicators of body composition and components of health-related physical fitness in youths with Down syndrome. Methods and procedures outcomes: Fifty adolescents (19 girls and 31 boys; average age, 18.33 ± 1.42 years) with Down syndrome were recruited and randomized to two groups (strength group vs. aerobic group). Adolescents allocated in the aerobic group carried out a physical activity program three times a week for 16 weeks meanwhile adolescents allocated in the strength group performed a fitness program three times a week for 16 weeks. Results: The exercise group had significant improvements in all health-related physical fitness variables (p <.05) but not on body composition. Conclusions and implications: A sixteen week fitness program consisting of three sessions of 60 min is able to increase levels of health-related physical fitness but not on body composition in youths with Down syndrome. The aerobic program does not seem to show significant differences. [ABSTRACT FROM AUTHOR]

Studies showing the relationship between meal frequency, weight loss and anthropometric measurements are contradictory. This study aims to determine the effect of meal frequency on weight loss, anthropometric measurements, and body composition. This is a parallel designed randomized control trial that was conducted with 40 female volunteers between the ages of 19–64 years, with a Body Mass Index (BMI) ≥27 who applied to a private clinic. Participants were randomized in two treatment arms (3 meals + 3 snacks/day (n = 20) vs 3 meals/day (n = 20)) and same dietary energy restriction (–500kcal) was applied for 3 months. Food consumption was questioned with 3 day food records, and anthropometric measurements and body composition were measured before the study and repeated each week till the end of the study by the researcher. All of the participants completed the study period. Body weight (kg), BMI (kg/m2), total body fat (kg), body fat percentage (%), fat free mass (kg) and waist circumference (cm) decreased, while fat free mass percentage (%) increased significantly in both of the groups at the end of the study (p < 0.05). The rate of difference for body weight, BMI (kg/m2) and waist circumference (cm) were similar among the groups. When difference in body composition analyses was examined, the rate of reduction in total body fat (–18.82 ± 4.97% vs −14.87 ± 7.44%) and body fat percentage (%)(–10.79 ± 4.63% vs −7.68 ± 7.04%) and the rate of increase in fat free mass percentage (%)(7.65 ± 3.16% vs 5.04 ± 3.44%) were significantly higher in 3 meals + 3 snacks group (p < 0.05). When energy restricted and balanced weight loss programs are applied, alteration in body weight, BMI and waist circumference is not affected from meal frequency, but body composition does. NCT05581862 (Date of Trial Registration: 13/10/2022) [ABSTRACT FROM AUTHOR]

Sarcopenic obesity (SO) and dynapenic obesity (DO) represent two manifestations of excessive fat accumulation concurrent with compromised muscle mass and function, thereby necessitating an examination of their implications for health. This study aims to investigate the relationship between SO/DO and mortality, taking into account various adiposity measures and existing sarcopenia criteria, with further stratified analyses based on age and gender. The study sample comprised 1779 older adults residing in the community from the I-Lan Longitudinal Aging Study (ILAS). Body composition was assessed via dual-energy X-ray absorptiometry. The diagnosis of sarcopenia was adhered to the 2019 consensus of the Asian Working Group for Sarcopenia, while adiposity was measured by waist circumference (WC), body mass index (BMI), and fat percentage. SO/DO was defined as the coexistence of sarcopenia/dynapenia and obesity. Multivariate Cox proportional hazard regression models were adopted to examine the association between SO or DO, defined by WC, BMI, fat percentage, and mortality. This 11-year follow-up study of 1779 participants aged 63.9 ± 9.2 years involved 15,068 person-years and 229 deaths. WC-defined SO (HR 1.9, 95% CI 1.1–3.3, p = 0.021) and WC-defined DO (HR 1.4, 95% CI 1.1–1.9, p = 0.022) significantly increased mortality risk, whereas definitions employing alternative adiposity metrics exhibited no statistical significance. WC-defined SO was associated with increased risk of mortality among middle-aged adults, while WC-defined DO was associated with increased risk of mortality among older adults. In sex-specific analysis, WC-defined DO was also associated with increased risk of mortality in men (HR 1.6, 95% CI 1.1–2.4, p = 0.019), while defined by other measurements showed no associations in both sexes. The study identified a significant link between SO/DO, defined by WC, and an 11-year mortality risk, advocating for WC-defined adiposity as an obesity measure and personalized interventions considering SO and DO's distinct impacts on mortality in middle-aged and older adults. [ABSTRACT FROM AUTHOR]

While serum osteopontin (OPN)'s established role in cardiometabolic risk is recognized, its potential as a predictor of metabolic syndrome (MetS) improvement through a urine assay has not yet been demonstrated. In this study, we propose its potential predictive role over a 12-month period of standard care, with the ability to complement anthropometric measures. Hierarchical clustering revealed a notable association of urinary OPN (uOPN) with MetS criteria and overcame anthropometric measures in predicting the improvement at 12 months (OR of 2.74 [95% CI 1.32 to 6.29]). uOPN significantly contributed to the homogeneity of the nodes in the random forest and ultimately enhanced the performance of anthropometric measures when assessed for accuracy and area under the curve (AUC). Our findings offer insights into potential applications in cardiometabolic medicine for uOPN, which is easily detectable in non-invasive biological samples through an affordable assay. • Cardiometabolic diseases are linked with aging process. • Osteopontin has an established role in Cardiometabolic risk, but not when assayed in urine. • Osteopontin has a potential as predictor of metabolic syndrome improvement over 12 months of standard of care. • Osteopontin may improve the accuracy of anthropometric measure in defining cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Central obesity has been shown to better indicate health risks compared to general obesity. Measures of central obesity include waist-to-height ratio (WHtR), waist-to-hip ratio (WHR) and waist circumference (WC). The National Institute of Health and Care Excellence (NICE) recently recommended the use of WHtR alongside body mass index (BMI) to identify risks in adults and children, whilst recognising the need for more evidence relating to WHtR in children. This study explores risk thresholds for central obesity measures throughout adolescence. It compares these with those currently recommended in England and discusses whether these thresholds are age- and sex-specific. Data on adolescents aged 11 to 18 years from the Health Survey for England (HSE) during 2005 to 2014 was used to calculate WHtR, WHR and WC percentiles. Next, smoothed lambda-mu-sigma (LMS) curves were created and the percentiles which align with the adult thresholds at age 18 years identified. This allows the most appropriate risk related thresholds for each measure during adolescence to be determined. WHtR LMS curves are stable and flat throughout adolescence. WHR decreases in girls and WC increases in both boys and girls, during adolescence. Across all measures, there is slightly more fluctuation in higher percentiles, and in girls' WHR. In practice, WHtR thresholds are simple to use to identify central obesity related risks. In particular, they are recommended because the same thresholds can be used for males and females and for adolescents and adults. The results support NICE guidance to use WHtR thresholds alongside BMI thresholds to identify individual risk. This study uses central obesity measures, including waist-to-height and waist-to-hip ratios, to investigate risk-related thresholds for adolescents. It is the first to do so using English data. It provides support for current NICE recommendations to use adult waist-to-height thresholds in adults and children, alongside BMI measures in clinical and non-clinical settings. [ABSTRACT FROM AUTHOR]

Smith Magenis Syndrome (SMS) is a rare genetic disorder caused by RAI1 haploinsufficiency. Obesity in people with SMS is believed partially due to dysfunction of the proximal melanocortin 4 receptor (MC4R) pathway. We therefore studied effects of treatment with the MC4R agonist setmelanotide on obesity and hunger, as well as metabolic, cardiac and safety, in individuals with SMS. People with SMS received once-daily setmelanotide injections, with the dose titrated bi-weekly to a maximum of 3 mg over ∼1 month; and a full-dose treatment duration of 3mo. The primary outcome was percent change in body weight. Secondary outcomes included hunger, waist circumference, body composition, and safety. 12 individuals, ages 11–39 y, enrolled and 10 completed the full-dose treatment phase. Mean percent change in body weight at end-treatment was − 0.28 % [(95 % CI, −2.1 % to 1.5 %; n = 12; P = 0.66]. Participants experienced a significant decrease in total cholesterol associated with a significant decrease in HDL-cholesterol and a trend for lower LDL-cholesterol. Self-reported hunger was reduced at end-treatment (p = 0.011). All participants reported adverse events (AEs), most commonly injection-site reactions and skin hyperpigmentation. No AEs led to withdrawal or death. In this trial, setmelanotide did not significantly reduce body weight in participants with SMS. Participants reported significant differences in hunger, but such self-reports are difficult to interpret without a placebo-treated group. The changes in lipid profiles require further investigation. Results of this study do not suggest that dysfunction of the proximal MC4R pathway is the main etiology for obesity in people with SMS. • Nonsignificant weight changes in individuals with SMS after setmelanotide treatment. • Lipid profiles changed in response to setmelanotide treatment for obesity in SMS. • SMS-related obesity may not be primarily caused by proximal MC4R pathway insufficiency. [ABSTRACT FROM AUTHOR]

To determine if global, central, or peripheral adiposity is associated with prevalent and worsening cartilage lesions following anterior cruciate ligament reconstruction (ACLR). In 107 individuals one-year post-ACLR, adiposity was assessed globally (body mass index), centrally (waist circumference), and peripherally (knee subcutaneous adipose tissue thickness) from magnetic resonance imaging (MRI). Tibiofemoral and patellofemoral cartilage lesions were assessed from knee MRIs at 1- and 5-years post-ACLR. Poisson regression evaluated the relation of adiposity with prevalent and worsening tibiofemoral and patellofemoral cartilage lesions adjusting for age, sex, and activity level. The prevalence ratios of adiposity with tibiofemoral (presence in 49%) and patellofemoral (44%) cartilage lesions ranged from 0.99 to 1.03. Adiposity was more strongly associated with longitudinal changes in tibiofemoral (worsening in 21%) and patellofemoral (44%) cartilage lesions. One-unit increase in global (kg/m2), central (cm), and peripheral (mm) adiposity was associated with a higher risk of worsening tibiofemoral cartilage lesions by 17% (risk ratios [95% confidence interval (CI)]: 1.17 [1.09 to 1.23]), 5% (1.05 [1.02 to 1.08]), and 9% (1.09 [1.03 to 1.16]), and patellofemoral cartilage lesions by 5% (1.05 [1.00 to 1.12]), 2% (1.02 [1.00 to 1.04]) and 2% (1.02 [1.00 to 1.04]), respectively. Greater adiposity was a risk factor for worsening cartilage lesions up to 5 years post-ACLR. Clinical interventions aimed at mitigating excess adiposity may be beneficial in preventive approaches for early post-traumatic osteoarthritis. [ABSTRACT FROM AUTHOR]

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This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes. A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted. This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m2) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period. Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae. • Prolonged COVID-19 lockdown is associated with deterioration in anthropometric and glycaemic outcomes in adults with T2DM. • High SES is associated with poorer anthropometric and glycaemic outcomes following prolonged confinement. • Adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease. The relationship between the trajectories of obesity indicators and incident NAFLD is unknown. Therefore, this study aims to explore the sex-specific association between the trajectories of obesity indicators and the incidence of NAFLD. In total, 9067 participants were recruited for this longitudinal study. Obesity indicators use body mass index (BMI) and waist circumference (WC). The trajectory of obesity indicators was analyzed using the growth mixture modeling. The multivariate logistic regression model was used to analyze the association between obesity indicators' trajectories and incident NAFLD. Over a median follow-up of 1.82 years, 1013 (11.74%) participants developed NAFLD. We identified BMI and WC change trajectories as the stable group, increasing group, and decreasing group. After adjusting for baseline level and other confounders, multivariate logistic regression analysis showed that compared with stable group of BMI, the increasing group, and decreasing group odds ratio and 95% confidence interval of NAFLD were 2.10 (1.06–4.15), and 0.25 (0.09–0.67) in men, and 1.82 (1.08–3.04) and 0.32 (0.16–0.64) in women. Compared with stable group of WC, the increasing group was 2.57 (1.39–4.74) in men, the increasing group, and decreasing group were 2.29 (1.70–3.10) and 0.28 (0.12–0.64) in women. Sensitivity analysis showed that the results were stable. The BMI and WC changing trajectories are significantly associated with the incidence of NAFLD in men and women. Populations of real-world health examinations can be categorized based on obesity indicator changes to prevent NAFLD. • The BMI and WC changing trajectories were associated with NAFLD in men and women. • The increasing trend was the risk factor and the decreasing trend was the protective factor for NAFLD onset. • Deterioration of BMI and WC status can be the sensitive predictors of NAFLD before its occurrence. • Maintaining a low BMI and WC over an extended period is crucial for preventing and treating NAFLD. [ABSTRACT FROM AUTHOR]

This study investigated how a time-restricted intermittent fasting for 6 weeks influences overweight and obese young adults. Twentyfive (n = 25) individuals between the ages of 18 and 29 were recruited through university banners and were randomly assigned to 2 Groups: Group A and Group B. Each Group fasted for 16 hours. Group A fasted from 8 p.m. to 12 p.m. and Group B fasted from 4 p.m. to 8 a.m. The following baseline measurements were determined before starting the trials: Body anthropometric measurements including body mass (BM, kg), body mass index (BMI, kg·m-2), waist circumference (cm), hip circumference (cm), waist to hip ratio, body fat percentage (%), and resting metabolic rate (mL·kg-1·min-1). Each subject was tested at baseline, at 2 weeks, at 4 weeks, and at 6 weeks (post-test) Statistical analysis included demographic mean (± standard deviation), an independent samples t-test for between Group differences at each measurement term, and a dependent samples t-test for within Group differences between measurement terms. Statistical significance was set at a P = 0.05. After 6 weeks, between Group differences were not statistically different while within Group comparisons indicated a decrease in weight (P = 0.002), BMI (P = 0.0006), waist circumference (P = 0.02), and hip circumference (P = 0.018). [ABSTRACT FROM AUTHOR]

To verify the role of the combination of fitness and fatness in the relationship between physical activity (PA) and cardiometabolic risk in children and adolescents. This is a cross-sectional study performed with 2786 children and adolescents (6 to 17 years). Fitness was determined by the cardiorespiratory fitness (CRF) six-minute walking and running test. Waist circumference (WC) was considered a fatness indicator. A selfreported questionnaire was used to determine PA practice, whereas the clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of triglycerides, total cholesterol/HDL-C ratio, systolic blood pressure, glucose, and WC. Considering the combination of CRF (fitness) and WC (fatness), the following phenotypes were created: Fit/Unfat, Fit/Fat, Unfit/Unfat and Unfit/Fat . Moderation analyses were tested using linear regression models. Significant interactions were found between PA and Unfit/Fat category (β = -0.001; p = 0.001) only for adolescents. The interaction observed in the Unfit/Fat phenotype indicated that adolescents who practise PA for 330 minutes per week presented lower cMetS compared to those who do not practise or practise for 60 minutes respectively. The combination of fitness and fatness moderates the relationship between PA and cardiometabolic risk, suggesting that adolescents, particularly those who are less fit and present high adiposity, should be encouraged to engage in regular PA to improve their metabolic health. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the associations of serum folate and/or vitamin B 12 concentrations with obesity among Chinese children and adolescents. A cross-sectional study was conducted including 3,079 Chinese children and adolescents, aged 6 to 17 years, from Jiangsu, China. Anthropometric indices, such as, children's body mass index (BMI), BMI z-scores, waist circumference, and waist-to-height ratio were utilized. Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B 12 levels with anthropometric indices and odds of obesity. We observed that serum vitamin B 12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity [odds ratio (OR) = 0.68; 95% confidence interval (CI) = 0.59, 0.78] and abdominal obesity (OR = 0.68; 95% CI = 0.60, 0.77). When compared to participants with both serum vitamin levels in the two middle quartiles, those with both serum folate and vitamin B 12 levels in the highest quartile were less prone to general ( OR = 0.31, 95% CI = 0.19, 0.50) or abdominal obesity (OR = 0.46, 95% CI = 0.31, 0.67). Conversely, participants with vitamin B 12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity (OR = 2.06, 95% CI = 1.09, 3.91). Higher serum vitamin B 12 concentrations, but not serum folate concentrations, were associated with lower odds of childhood obesity. Children and adolescents with high levels of vitamin B 12 and folate were less likely to be obese. [ABSTRACT FROM AUTHOR]

ABO blood system is not only important for determining the lifestyle diseases, blood transfusion and exchange but it has also been found to be highly relevant to genetic marker of obesity. Recent studies are trying to explore the relation between blood grouping and obesity, and blood group diets and management of obesity. But still there are limited studies related to reduction of weight from blood group diets. The aim of this study is to examine the association of blood groups and weight reduction through a Moderate-Fat, Balanced Nutrient Reduction Diets among overweight and obese adults. A longitudinal study was conducted over 175 overweight and obese adults (>18 years and <60 years of age) of urban Bihar. A planned diet regime was followed by participants for a period of six months, and their anthropometric measurements were used for statistical analysis. There were substantial decreases in weight, BMI and waist circumference across different blood groups resulted through moderate-fat balanced nutrient reduction diet plan in both genders. For all blood groups, BMI reduction was at least 3.78 kg/m2 through the program, and the program was most effective for blood group O positive participants. [ABSTRACT FROM AUTHOR]

The BMI predicts mortality and cardiovascular disease (CVD) in the general population, while in patients with end-stage chronic kidney disease (CKD) a high BMI is associated with improved survival, a phenomenon referred to as the "obesity paradox". While BMI is easy to determine and helps to categorize patients, it does not differentiate between fat tissue, lean tissue and bone mass. As the BMI may be altered in CKD, e.g. by muscle wasting, we determined in this meta-analysis (i) the association of mortality with fat tissue quantity in CKD and (ii) the association of mortality with abdominal obesity (as measured by waist circumference (WC) or waist-to-hip ratio (WHR)) in CKD. We systematically reviewed databases for prospective or retrospective cohort studies. In eleven studies with 23,523 patients the association between mortality and high fat tissue quantity in CKD was calculated. The pooled hazard ratio (HR) for this association in the CKD group in the dialysis group 0.91 (CI 0.84- 0.98, p = 0.01) which is comparable to the HR for the association with BMI. The HR in patients without dialysis was 0.7 (95% CI 0.53- 0.93, p = 0.01), suggesting a better risk prediction of high fat tissue content with mortality as compared to higher BMI with mortality in patients with CKD without dialysis. Importantly, both BMI and fat tissue quantity in CKD are described by the "obesity paradox": the higher the fat tissue content or BMI, the lower the mortality risk. In thirteen studies with 55,175 patients the association between mortality and high WC or WHR in CKD (with or without dialysis) was calculated. We observed, that the HR in the WHR group was 1.31 (CI 1.08–1.58, p = 0.007), whereas the overall hazard ratio of both groups was 1.09 (CI 1.01–1.18, p = 0.03), indicating that a higher abdominal obesity as measured by WHR is associated with higher mortality in CKD. Our analysis suggests gender-specific differences, which need larger study numbers for validation. This meta-analysis confirms the obesity paradox in CKD using fat tissue quantity as measure and further shows that using abdominal obesity measurements in the routine in obese CKD patients might allow better risk assessment than using BMI or fat tissue quantity. Comparable to the overall population, here, the higher the WHR, the higher the mortality risk. [Display omitted] [ABSTRACT FROM AUTHOR]

This prospective cohort study aimed to investigate the associations between gestational weight gain (GWG) and long-term postpartum maternal weight gain, body mass index (BMI), waist circumference (WC), and the risk of general and abdominal obesity, beyond motherhood (some 27 y after childbirth). Participants were 1953 women enrolled in the Mater-University of Queensland Study of Pregnancy cohort study that started in the early 1980 s, with the most recent follow-up at 27 y postpartum. We examined the prospective associations of GWG in pregnancy with weight, BMI, and WC and the risk of adiposity 27 y after the index pregnancy. We used linear and multinomial logistic regressions to examine the independent effect of GWG on each outcome, adjusting for potential confounders and mediators. The average GWG during pregnancy was 14.88 kg (SD 5.24). One in four women (25.50%) gained below the Institute of Medicine (IOM) recommendations and one in three (34.00%) gained excess weight during pregnancy. Every 100 g/week increment of GWG was associated with 2.0 (95% CI: 1.5, 2.6) kg, 0.7 (0.5, 0.9) kg/m2, 1.3 (0.8, 1.8) cm greater body weight, BMI, and WC, respectively 27 y postpartum. Women who gained inadequate weight in pregnancy had significantly lower odds of general obesity (OR; 0.70, 95% CI:0.53,0.94) or abdominal obesity (0.73; 0.56,0.96), whereas those who gained excess gestational weight had much higher odds of general obesity (4.49; 3.36,6.00) and abdominal obesity (3.09; 2.29,4.16). These associations were independent of potential confounders. Maternal GWG in pregnancy independently and strongly predicted beyond motherhood weight gain trajectory. GWG within IOM recommendation may prevent long-term development of both general and central obesity. [ABSTRACT FROM AUTHOR]

This study aimed to explore and compare the effect of weight change, and waist circumference (WC) change, on the risk of nonalcoholic fatty liver disease (NAFLD) in individuals with metabolically healthy overweight or obesity (MHOW/O) and metabolically unhealthy overweight or obesity (MUOW/O) in a health check-up cohort in China. 5625 adults with overweight or obesity, and free from NAFLD at baseline were included. Metabolically healthy was defined as not having any components of metabolic syndrome. Weight/WC changes were calculated as the relative difference between the first and second visits of check-up. NAFLD was assessed based on abdominal ultrasound. During a median follow-up of 2.1 (IQR: 1.1–4.3) years, 1849 participants developed NAFLD. In MHOW/O participants, the multivariable adjusted HRs (95 % CIs) for NAFLD in weight change ≤ −5.0 %, and − 4.9–− 1.0 % were 0.36 (0.23–0.59), 0.59 (0.43–0.80), respectively, compared to the weight stable group (−0.9% to 0.9 %). The corresponding HRs (95 % CIs) for the association between WC change (≤ 6.0 %, - 5.9 to −3.0 %) and NAFLD in MHOW/O participants were 0.41 (0.27–0.62), and 0.74 (0.54–1.01), respectively, compared to the WC stable group (−2.9–2.9 %). Similar patterns were observed in MUOW/O participants. A more marked gradient of cumulative incidence of NAFLD across weight/WC change categories was observed in MHOW/O than in MUOW/O individuals. A more evident association between weight/WC loss and risk of NAFLD was observed in MHOW/O than in MUOW/O individuals. Our findings indicate the practical significance of encouraging all individuals with overweight and obesity to achieve a clinically relevant level of weight/WC loss to prevent NAFLD, even among metabolic healthy groups. [ABSTRACT FROM AUTHOR]

Obesity has been shown to be an independent risk factor for the development of CKD. Little is known about pathways of interaction of visceral fat mass estimated by waist circumference (WC) and metabolic factors with the renal and intraglomerular hemodynamic profile in healthy, non-obese individuals. The study population of this post-hoc analysis in 80 healthy individuals, who participated in a randomized, controlled clinical trial (www.clinicaltrials.gov : NCT02783456) was divided into two groups based on median of WC (high WC and low WC group). Renal hemodynamic profiles were analyzed using steady state input clearance (infusion of para-amino-hippuric acid and inulin). Intraglomerular pressure (IGP) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated (Gomez equation). The analysis included healthy, non-smoking individuals, aged 27 ± 9 years with median WC of 84.75 ± 9 cm. Glomerular filtration rate (GFR) (110 ± 15 vs. 127 ± 16 ml/min/m2, p < 0.001), renal plasma flow (RPF) (620 ± 109 vs. 700 ± 104 ml/min, p = 0.001) and IGP (36.7 ± 2.3 vs. 38.5 ± 3.1 mmHg, p = 0.003) were lower in the high WC compared to the low WC group. Patients in the high WC group showed higher renal vascular resistance (RVR) (85 ± 19 vs. 70 ± 12 mmHg/(ml/min), p < 0.001), higher RA (4034 ± 1177 vs. 3069 ± 786 dyn∗s/cm5, p < 0.001) and higher RE (2283 ± 339 vs. 2118 ± 280 dyn∗s/cm5, p = 0.021) compared to the low WC group. Individuals in the high WC group showed higher leptin levels (p = 0.003) and higher HOMA-IR (p = 0.024) compared to the low WC group. Increased WC in healthy young individuals was associated with reduced GFR and RPF likely mediated by increased RVR. • Visceral fat mass modifies the intraglomerular hemodynamic profile. • The study cohort consisted of 80 healthy, non-obese individuals. • Renal hemodynamics were analyzed using steady state input clearance. • Visceral fat mass as estimated using waist-circumference (WC). • Increased WC was associated with reduced glomerular filtration rate. [ABSTRACT FROM AUTHOR]

Type 2 Diabetes Mellitus (T2D) has heterogeneous clinical phenotypes related to different risk of developing diabetes complications. We investigated the correlation between generalized and abdominal adiposity and the prevalence of both micro- and macrovascular complications in Caucasian patients with T2D. We evaluated 769 individuals with T2D consecutively referred to our diabetes center. Body mass index (BMI), waist circumference (WC), waist to hip (W/H) ratio, glycated hemoglobin (HbA1c), systolic and diastolic blood pressure, lipid profile, smoking habit, diabetes therapy, and micro- and macrovascular complications were recorded. Patients were divided into three groups based on BMI and WC: non-obese with normal WC (nWC, n = 220), non-obese with excess of abdominal fat (AF, n = 260) and obese (Ob, n = 289). We found that nWC, compared with AF and Ob individuals, were predominantly males (p<0.01), had lower HbA1c (p<0.01), diastolic blood pressure (p<0.01), triglycerides (p<0.01), and showed a significantly lower prevalence of diabetic retinopathy (DR) (p = 0.01). The rate of proliferative DR was significantly higher in Ob (13.2 %) compared to the other groups (p = 0.03). Multivariate analyses showed a significantly decreased prevalence of DR in nWC compared to both AF (OR 0.58, 95 CI 0.34–0.96; p = 0.03) and Ob (OR 0.57, 95 CI 0.33–0.98; p = 0.04) individuals. Conversely, DR was associated, mainly in women, to higher WC and W/H ratio. The prevalence of the other diabetes-related complications was similar among the studied groups. In our population, nWC subjects showed a lower prevalence of DR. An increased generalized and abdominal adiposity was associated to a higher prevalence of DR, especially among females. • Adiposity is a key determinant of diabetes-related vascular complications. • The risk for diabetes retinopathy increases in non-obese subjects with abnormal visceral fat. • Females are particularly at risk for retinal injury related to increased visceral fat. • High visceral fat in non-obese subjects is associated to early stages of diabetes retinopathy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the impact of anthropometric indices of obesity (body mass index [BMI], waist circumference, waist hip ratio, and body fat percentage) on the incidence of hypertension in adults with prehypertension. Methods: A longitudinal study design using secondary data form the Korean Genome and Epidemiology Study was employed. The study included 1,838 adults with prehypertension tracked every two years from 2001 to 2018. Statistical analyses, including frequency assessments, number of cases per 1,000 person-years, log-rank tests, Kaplan-Meier curves, and Cox's proportional hazards regression, were conducted using SPSS version 25. Results: Over the observation period (15,783.6 person-years), 1,136 individuals developed hypertension. The incidence of hypertension was significantly higher in the obesity groups defined by BMI (hazard ratio [HR] = 1.33), waist circumference (HR = 1.34), waist hip ratio (HR = 1.29), and body fat percentage (HR = 1.31) compared to the non-obese group. These findings indicate an increased risk of hypertension associated with obesity as measured by these indices. Conclusion: The study underscores the importance of avoiding obesity to prevent hypertension in individuals with prehypertension. Specifically, BMI, waist circumference, waist hip circumference, and body fat percentage were identified as significant risk factors for hypertension. The results suggest the need for individualized weight control interventions, emphasizing the role of health professionals in addressing the heightened hypertension risk in this population. [ABSTRACT FROM AUTHOR]

Background: Smart wearable technology has potential benefits for promoting physical activity and preventing sarcopenia. Objective: The purpose of this study was to explore the efficacy of a wearable activity tracker with 2-stage goal-setting for daily steps on older adults' physical activity and sarcopenia indicators. Methods: The study used a clustered trial design and was conducted in March to June 2022. Participants were community-dwelling adults older than 60 years who were recruited from 4 community centers in Taipei City. The intervention was designed with 2-stage goals set to 5000 steps/day in the first 4 weeks and 7500 steps/day in the final 4 weeks while wearing a commercial wearable activity tracker. Data were collected by self-reported questionnaires, a body composition analyzer, a handle grip tester, and 5 sit-to-stand tests. Results: All 27 participants in the experimental group and 31 participants in the control group completed the 8-week intervention. Total and light-intensity physical activities, skeletal muscle index, and muscle strength increased, while sedentary time, BMI, and the waist circumference of participants decreased in the experimental group, with significant group-by-time interactions compared to the control group. Conclusions: A wearable activity tracker with gradual goal-setting is an efficient approach to improve older adults' physical activity and sarcopenia indicators. Smart wearable products with behavioral change techniques are recommended to prevent sarcopenia in older adult populations. [ABSTRACT FROM AUTHOR]

Background: The first-line treatment for polycystic ovary syndrome (PCOS) is lifestyle modification. However, it is currently unknown whether digital medicine can assist patients with PCOS in maintaining a healthy lifestyle while alleviating PCOS symptoms. Objective: This study aims to evaluate the efficacy of WeChat-based digital intervention versus metformin treatment in women with PCOS and insulin resistance. Methods: A total of 80 women with PCOS and insulin resistance were recruited from an endocrinology clinic and randomly assigned to receive either a WeChat-based digital intervention (n=40, 50%) or metformin (n=40, 50%) for 12 weeks. The WeChat-based digital intervention consisted of 3 modules; a coach assisted the patients in using the intervention. The primary outcome was the change in a homeostatic model assessment for insulin resistance. At baseline and after the 12-week intervention, anthropometric parameters, menstruation frequency, sex hormone levels, metabolic factors, and body fat distribution were measured in the clinic. Furthermore, self-assessed web-based questionnaires on diet, exercise, sleep, anxiety, and depression were obtained. Results: A total of 72 participants completed the follow-up (for a 90% follow-up rate), including 35 of 40 (88%) participants from the digital intervention group and 37 of 40 (93%) participants from the metformin group. The homeostatic model assessment for insulin resistance in the digital intervention group was significantly improved after 12 weeks of treatment with a mean change of –0.93 (95% CI –1.64 to –0.23), but no statistical difference was observed between the groups (least squares mean difference –0.20; 95% CI –0.98 to 0.58; P =.62). Both digital intervention and metformin treatment significantly improved menstruation frequency (digital intervention: P <.001; metformin: P <.001) and reduced body weight (digital intervention: P <.001; metformin: P <.001) and total fat mass (digital intervention: P <.001; metformin: P <.001). Furthermore, the digital intervention had a significant advantage over metformin in improving waist circumference (least squares mean difference –1.84; 95% CI –3.44 to –0.24; P =.03), waist-to-hip ratio (least squares mean difference –0.02; 95% CI –0.03 to 0.00; P =.03), total fat mass (least squares mean difference –1.59; 95% CI –2.88 to –0.30; P =.02), and dehydroepiandrosterone sulfate (least squares mean difference –69.73; 95% CI –129.70 to –9.75; P =.02). In terms of safety, the main adverse events were sensations of hunger in the digital intervention group (2/40, 5%) and gastrointestinal adverse events in the metformin group (12/40, 30%). Conclusions: Our data suggest that digital intervention is an effective treatment option for patients with PCOS, with an efficacy comparable to that of metformin, and that it can also alleviate the negative effects of medications and make it easier and more efficient to adhere to lifestyle treatments. WeChat-based digital interventions have the potential to provide a new path for the improvement and health of women with PCOS in China. Trial Registration: ClinicalTrials.gov NCT05386706; https://clinicaltrials.gov/study/NCT05386706 [ABSTRACT FROM AUTHOR]

Background: The literature on whether physical activity (PA) and PA and diet (PA+Diet) mobile apps improve cardiovascular disease (CVD) risk factors is promising. Objective: The aim of this meta-review is to provide an evidence synthesis of systematic reviews and meta-analyses examining the influence of PA and PA+Diet apps on the major CVD risk factors. Methods: We systematically searched 5 databases until January 12, 2022. Included systematic reviews and meta-analyses (1) reported the CVD risk factor outcomes of BMI, waist circumference, body weight, blood pressure (BP), hemoglobin A1c (HbA1c), fasting blood glucose, blood lipids, or PA; (2) enrolled healthy participants ≥18 years who may or may not have the metabolic syndrome, diabetes mellitus, or preexisting CVD risk factors; (3) reviewed PA or PA+Diet app interventions integrating behavioral change techniques (BCT) to deliver their information; and (4) had a nonapp control. Results: In total, 17 reviews (9 systematic reviews and 8 meta-analyses) published between 2012 and 2021 qualified. Participants were middle-aged, mostly women ranging in number from 10 to 62,219. Interventions lasted from 1 to 24 months, with the most common behavioral strategies being personalized feedback (n=8), self-monitoring (n=7), and goal setting (n=5). Of the PA app systematic reviews (N=4), the following CVD risk factors improved: body weight and BMI (n=2, 50%), BP (n=1, 25%), HbA1c (n=1, 25%), and blood lipids (n=1, 25%) decreased, while PA (n=4, 100%) increased. Of the PA+Diet app systematic reviews (N=5), the following CVD risk factors improved: body weight and BMI (n=3, 60%), BP (n=1, 20%), and HbA1c (n=3, 60%) decreased, while PA (n=3, 60%) increased. Of the PA app meta-analyses (N=1), the following CVD risk factors improved: body weight decreased (–0.73 kg, 95% CI –1.45 to –0.01; P =.05) and PA increased by 25 minutes/week (95% CI 0.58-1.68; P <.001), while BMI (–0.09 kg/m2, 95% CI –0.29 to 0.10; P =.35) and waist circumference (–1.92 cm, 95% CI –3.94 to 0.09; P =.06) tended to decrease. Of the PA+Diet app meta-analyses (n=4), the following CVD risk factors improved: body weight (n=4, 100%; from –1.79 kg 95% CI –3.17 to –0.41; P =.01 to –2.80 kg 95% CI –4.54 to –1.06, P =.002), BMI (n=1, 25%; –0.64 kg/m2, 95% CI –1.09 to –0.18; P =.01), waist circumference (n=1, 25%; –2.46 cm, 95% CI –4.56 to –0.36; P =.02), systolic/diastolic BP (n=1, 25%; –4.22/–2.87 mm Hg, 95% CI –6.54 to –1.91/ –4.44 to –1.29; P <.01), and HbA1c (n=1, 25%; –0.43%, 95% CI –0.68 to –0.19; P <.001) decreased. Conclusions: PA and PA+Diet apps appear to be most consistent in improving PA and anthropometric measures with favorable but less consistent effects on other CVD risk factors. Future studies are needed that directly compare and better quantify the effects of PA and PA+Diet apps on CVD risk factors. Trial Registration: PROSPERO CRD42023392359; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392359 [ABSTRACT FROM AUTHOR]

Copyright of Archivos Latinoamericanos de Nutrición is the property of Sociedad Latinoamericana de Nutricion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There is a lack of consensus regarding universally accepted criteria for metabolic health (MH). A simple definition of MH was systematically derived in a recent prospective cohort study. The present cross-sectional study aimed to explore the applicability of these criteria in Korean population, using coronary calcification as an indicator of cardiovascular risk. In total, 1049 healthy participants, who underwent coronary artery calcification testing at university hospital health promotion centers between January and December 2022, were included. Applying the main components of the newly derived definition, MH was defined as follows: (1) systolic blood pressure < 130 mmHg and no use of blood pressure-lowering medication; (2) waist circumference < 90 cm for males and < 85 cm for females; and (3) absence of diabetes. Multivariate logistic regression was conducted to examine the odds ratio (OR) and 95 % confidence interval (CI) for coronary artery calcium score across different phenotypes. The prevalence of coronary artery calcification in this study was 41.1 %. Compared with metabolically healthy, normal weight subjects, those with the metabolically healthy obesity phenotype did not exhibit increased odds for coronary atherosclerosis. (OR 0.93 [95 % CI 0.48–1.79]) Conversely, metabolically unhealthy subjects had increased risk, regardless of their body mass index category (OR 3.10 [95 % CI 1.84–5.24] in metabolically unhealthy normal weight; OR 3.21 [95 % CI 1.92–5.37] in metabolically unhealthy overweight; OR 2.73 [95 % CI 1.72–4.33] in metabolically unhealthy obese phenotype). These findings suggest that the new definition for MH has the potential to effectively distinguish individuals at risk for cardiovascular disease from those who are not. [ABSTRACT FROM AUTHOR]

• TyG-related indices has the utility for risk assessment and prevention of CVD. • TyG-BMI, TyG-WC and TyG-WHtR are significantly associated with new-onset CVD in non-diabetic populations. • TyG-WC and TyG-WHtR have remarkable predictability in non-diabetic populations. Cardiovascular disease (CVD) risk assessment is a crucial component of public health. We aimed to determine the predictive value of the triglyceride-glucose (TyG) index and TyG-related indices for new-onset CVD. This prospective study included 7,808 participants aged 40-69 years from the Ansung-Ansan cohort database. Our analysis was stratified by diabetes status. The hazard ratio (HR) with a 95% confidence interval (CI) for incident CVD was computed using multiple Cox proportional-hazards regression models. To evaluate the predictive performance of these indices for new-onset CVD, we calculated the Harrell's C-index (95% CI). In this study, a total of 6,890 participants did not have diabetes at baseline, while 918 participants had diabetes. In participants without diabetes, compared to the lowest tertile, fully adjusted HR and 95% CI for new-onset CVD in the highest tertile were as follows: TyG (HR 1.42, 95% CI 1.06–1.90), TyG-body mass index (BMI) (HR 1.92, 95% CI 1.19–3.10), TyG-waist circumference (WC) (HR 2.37, 95% CI 1.61–3.49), and TyG-waist-to-height ratio (WHtR) (HR 2.20, 95% CI 1.47–3.28). However, no significant associations were observed between TyG, modified TyG indices, and new-onset CVD in participants with diabetes. Notably, the C-indice of TyG-WC and TyG-WHtR were significantly higher than those of TyG and TyG-BMI in participants without diabetes. TyG-BMI, TyG-WC, and TyG-WHtR were associated with an increased risk of new-onset CVD in participants without diabetes. Furthermore, TyG-WC and TyG-WHtR showed better predictive performances for new-onset CVD than TyG and TyG-BMI in participants without diabetes. [ABSTRACT FROM AUTHOR]

Background: With the natural cessation of estrogen, after menopause, women, especially those who are overweight, are at a high risk for cardiovascular disease. Diet control and adequate physical activity (PA) are recommended as the essence of promoting cardiovascular health for women after menopause. Objective: The aim of this study was to examine the effects of a theory-based educational program on health behaviors and cardiovascular health outcomes among overweight postmenopausal Chinese women compared with conventional didactic education. Methods: In this randomized controlled trial, 288 participants were randomly allocated to intervention (n = 144) or control (n = 144) groups. The control group received conventional didactic education. The intervention group received a 3-month theory-based educational program. Primary outcomes were PA and dietary behavior. Secondary outcomes included cardiovascular health knowledge, self-efficacy in PA and diet, and cardiovascular health outcomes. Data were collected at baseline (T0), 3 months (T1), 6 months (T2), and 12 months (T3). Results: The intervention group demonstrated significantly greater improvements in PA, dietary behavior, self-efficacy in PA and diet, and several cardiovascular health outcomes (body weight, body mass index, waist circumference, blood pressure, and Framingham risk score [body mass index]) at postintervention compared with the control group (all P s <.05). These significant effects maintained at T2, and the effects on self-efficacy in PA and diet also were maintained at T3. Conclusions: A theory-based educational program may be an effective strategy for improving PA, dietary behavior, self-efficacy in PA and diet, and several cardiovascular health outcomes for overweight postmenopausal Chinese women. However, further strategies are needed to enhance the sustainability of the positive changes. [ABSTRACT FROM AUTHOR]

Background: Obesity is a global health challenge. Traditional approaches, including increased physical activity, dietary interventions, and medical therapy, often yield limited success, propelling some patients toward costly and invasive procedures like bariatric surgery. Laser acupuncture has been suggested as a complementary therapeutic approach to overcome this challenge. The present study investigated the effectiveness of laser acupuncture treatment in weight loss and abdominal subcutaneous fat reduction. Methods: A randomized, blinded, sham-controlled clinical trial was conducted, with 30 subjects each in the intervention and control groups. Patients in the intervention group underwent 12 sessions of laser acupuncture treatment within a month (three sessions/week), whereas those in the control group received sham laser treatment on identical acupoints. The patients were instructed not to alter their physical activity levels or dietary regimens. All parameters were evaluated before and after the treatment. Results: Significant reductions in weight, body mass index, and waist circumference were noted in both intervention and control groups. Further analysis revealed a more significant decrease in the laser acupuncture group. Abdominal sonography revealed a marked decrease in periumbilical fat thickness in the intervention group. Conversely, laboratory evaluations showed no significant difference between the two groups. Conclusion: Laser acupuncture is an effective method for weight loss in patients with periumbilical abdominal fat. The observed impact on subcutaneous fat suggests its potential as a non-invasive intervention for individuals seeking weight management alternatives. Further research is warranted to validate these findings and explore the underlying mechanisms of laser acupuncture in adipose tissue modulation. [ABSTRACT FROM AUTHOR]

Background: Although vitamin D deficiency has been studied in various populations, there are few data on its prevalence and associated factors among Moroccan women. Aim: To determine the prevalence of vitamin D deficiency and investigate its association with body mass index (BMI), waist circumference, and serum concentrations of parathyroid hormone, calcium, and phosphorus in a sample of Moroccan adult women. Methods: This is a cross-sectional study conducted at Mohammed V Military Hospital of Instruction, Rabat. Anthropometric measurements and biochemical analyses were performed using standard procedures Results: A total of 714 women aged 18–65 years participated in this study. The overall prevalence of vitamin D deficiency was 74.4%. Approximately 24% and 51% of women had severe and moderate vitamin D deficiency, respectively. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were inversely correlated with BMI in vitamin D-deficient subjects (P = 0.036) and with parathyroid hormone 1–84 (PTH1-84) levels in the study sample (P = 0.010). PTH1-84 concentrations were greater among overweight/obese individuals compared to their non-overweight peers (P = 0.001) and tended to be higher among vitamin D-deficient women than vitamin D-sufficient women (P = 0.053). Conclusion: This study showed a very high prevalence of vitamin D deficiency in this sample of Moroccan women. Lower serum 25(OH)D levels were associated with increased BMI in vitamin D-deficient women and with elevated PTH1-84 levels among the study sample. Although these findings come from a convenience sample of women that attended a nutrition clinic, they underscore the urgent need to develop public health interventions to improve women's vitamin D status. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Using nationwide cohort data, we aimed to elucidate whether baseline obesity altered the relationship between loss in body mass index (BMI) or waist circumference (WC) and risk of dementia. METHODS: Among 9689 participants whose BMIs and WCs were repeatedly measured over 1 year, 1:1 propensity score matching was conducted between participants with and without obesity (n = 2976 per group, mean age 70.9). For each group, we explored the association between loss in BMI, or WC, and incidence of dementia during an approximately 4‐year follow‐up period. RESULTS: BMI loss was associated with an increased risk of all‐cause dementia and Alzheimer's disease in participants without obesity; however, this association was absent in participants with obesity. WC loss was associated with decreased Alzheimer's disease risk only in participants with obesity. DISCUSSION: Only unfavorable loss (loss from non‐obese state) in BMI, not WC, can be a metabolic biomarker of prodromal dementia. [ABSTRACT FROM AUTHOR]

We investigated whether changes in body mass index (BMI) and waist circumference (WC) are associated with cardiovascular risk in patients with NAFLD using a nationwide dataset. Using the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) data in Korea, a total of 19,057 subjects who underwent two consecutive medical check-ups (2009–2010 and 2011–2012) and who had a fatty-liver index (FLI) value of ≥ 60 were included in the analysis. Cardiovascular events were defined as the occurrence of stroke or transient ischemic attack, coronary heart disease, and cardiovascular death. After multivariable adjustment, the risk of cardiovascular events was significantly lower in subjects with decreases in both BMI and WC (HR, 0.83; 95% CI, 0.69–0.99) and those with increased BMI and decreased WC (HR, 0.74; 95% CI, 0.59–0.94) when compared with those who showed increases in both BMI and WC. The effect of cardiovascular risk reduction among the group with increased BMI but decreased WC was particulary pronounced among those who had metabolic syndrome during the second check-up (HR, 0.63; 95% CI 0.43–0.93, p for interaction 0.02). Changes in BMI and WC were significantly associated with cardiovascular risk in NAFLD patients. NAFLD patients with increased BMI and decreased WC had the lowest cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Introduction: The increasing prevalence and morbidity of diabetics makes the need for holistic treatment of the disease urgent in order to prevent serious physical complications and mental illnesses such as depression and anxiety. Aim: This study focuses on the study of people with type 2 diabetes and the identification of signs of depression and anxiety in them. Material and Method:. The sample of the study consisted of 123 patients with type 2 diabetes who visit the Karpenisi Health Centre for regular examinations or prescriptions. Data were collected by the completion by the participants of the questionnaires "MED DIET SCORE", "International Physical Activity Questionnaire" and the H.A.D.S. "Hospital Anxiety and Depression scale". The independent variables were sociodemographic and clinical characteristics of the sample. Statistical analysis was performed using the SPSS-25 statistical package. Statistical significance was set at <0.05 level. Results: Of the total type 2 diabetics who participated in the study, 69 were men and 54 were women, with an average age of 69.28 years. The results of the mental health assessment questionnaire showed that 26.80% have high levels of depression and 21.10% have high levels of anxiety. However, the results after the inductive statistical analysis showed that there is a relationship between a high level of depression and reduced physical activity p<0,05. Also, the overall H.A.D.S. - Depression is positively associated with Body Mass Index (BMI) (r=0.22, p=0.018), Waist Circumference (r=0.18, p=0.048), and Age (r=0.33, p<0.001). Conclusions: Type 2 diabetes are directly related to the onset of depressive symptoms, especially in vulnerable groups such as the elderly, widows and those living alone. [ABSTRACT FROM AUTHOR]

Objectives The current study aimed to determine the proxy measurements for height in children with Cerebral Palsy (CP). Materials & Methods In a cross-sectional descriptive study, the length/height of Nigerian children with CP was studied over eighteen months using descriptive statistics. The study subjects comprised children aged 15 months to 17 years with CP. Height/length, weight, arm span, forearm length, mid-upper arm circumference, foot length, head circumference, hip circumference, leg length, and tibia length were measured to the nearest 0.1 cm using standard procedures. The relations between segmental measurements and weight with height were investigated using linear regression. Results A total of 31 children were studied. The correlation between height/ length and other linear measurements has a significantly strong positive relationship. Regression analysis showed that when used singly, the weight and thigh length offered a high explanation for the height variability with little estimation error. On the other hand, weight had a lower mean difference between observed and predicted height (0.21 and -0.76, respectively), with thigh length overestimating the height. Conclusion Weight measurement may be the preferred proxy for height in children with CP. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)