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Despite the increasing worldwide prevalence of obesity and iron deficiency (ID), there are still no guidelines on how to treat and manage obesity-related ID. The aim of this systematic review and meta-analysis was to investigate whether weight loss can re-establish iron homoeostasis among subjects with unhealthy weight (overweight [OW] or obesity). PubMed, Medline, Embase, Web of Science, and the Cochrane Library were systemically searched for studies that compared the iron status before and after a weight-loss intervention. A random-effects model was used to calculate the pooled and subgroup weighted mean differences (WMDs) of iron biomarkers. In total, 879 subjects were pooled across 14 studies. Improved haemoglobin was found in longitudinal studies (WMD = 2.50 g/dl, 95% confidence interval [CI]: 0.88, 4.12 g/dl, I 2 = 14%) but not in randomized controlled trials or after being stratified by dietary programmes. Significantly increased transferrin saturation was observed in pooled (WMD = 1.68%, 95% CI: 0.97%, 2.39%, I 2 = 44%) and subgroup analyses. A meta-regression showed that changes in the iron status were positively correlated with changes in the body mass index (BMI) and the intervention duration but negatively correlated with the baseline body weight/BMI, age, gender and a standard hypocaloric diet. Our data suggested that in spite of energy restrictions, weight loss may help re-establish iron homoeostasis in people who are OW or obese., (© 2020 World Obesity Federation.)

Obese sarcopenia is a progressive loss of skeletal muscle mass and strength with increases in adipocytes. The aim of this study was to investigate the effects of combination of exercise training and resveratrol on the pathological pathway from obesity to sarcopenia, and potential therapy for skeletal muscle declines in physical function. Two animal models were experimented: (1) C57BL/6J male mice were fed either a high-fat diet (HFD) for 8 weeks to induce obesity and resveratrol (low-, middle-, and high-dose) for 4 weeks. (2) senescence-accelerated mouse prone 8 (SAMP8) mice with sarcopenia were used. Skeletal muscle function of SAMP8 mice expressed an age-associated decline. In SAMP8 mice, resveratrol (150 mg/Kg BW, daily) was administered by oral gavage two times a week for 1 month of the experimental period. Exercise training based on adaptations in the muscle is training twice a week for 4 weeks. SAMP8 mouse skeletal muscle in each group was analyzed by H and E staining, transferase dUTP nick end labeling, and Western blot analysis. Mitochondrial function expression, apoptosis and relative hypertrophy signaling in HFD-induced obesity mice and SAMP8 mice were determined by Western blot analysis. Results of the present study indicate that effect of resveratrol on skeletal muscles of HFD-induced obesity mice is linked to an increase in Bcl-2 and phosphatidylinositol 3 kinase/AKT expressions. On the other hand, resveratrol, and its combination with exercise training, attenuate the aging-related mitochondrial dysfunction involving Bad, caspase 3, and interleukin-6 expressions in SAMP8 mice. Combination of exercise training and resveratrol induced hypertrophy in skeletal muscles of sarcopenia SAMP8 mice. Therefore, we suggest combination of exercise training and resveratrol as a therapeutic potential in obese sarcopenia., Competing Interests: None

Obesity and low serum testosterone (T) levels are interrelated and strongly influenced by dietary factors, and their alteration entails a great risk of hypogonadism. Substantial evidence suggests a bidirectional relationship between nutrient metabolism (e.g., glucose, lipids, and iron) and T levels in men; however, T-related dietary patterns remain unclear. This study investigated the dietary patterns associated with serum total T levels and its predictive effect on hypogonadism and the body composition. Anthropometry, blood biochemistry, and food frequency questionnaires were collected for 125 adult men. Dietary patterns were derived using a reduced rank regression from 32 food groups. Overall prevalence rates of central obesity and hypogonadism were 48.0% and 15.7%, respectively. An adjusted linear regression showed that age, insulin, red blood cell (RBC) aggregation, and transferrin saturation independently predicted serum total T levels (all p < 0.01). The total T-related dietary pattern (a high consumption of bread and pastries, dairy products, and desserts, eating out, and a low intake of homemade foods, noodles, and dark green vegetables) independently predicted hypogonadism (odds ratio: 5.72; 95% confidence interval: 1.11‒29.51, p < 0.05) for those with the highest dietary pattern scores (Q4) compared to those with the lowest (Q1). Scores were also negatively correlated with the skeletal muscle mass ( p for trend = 0.002) but positively correlated with the total body fat mass ( p for trend = 0.002), visceral fat mass ( p for trend = 0.001), and to a lesser extent, subcutaneous fat mass ( p for trend = 0.035) after adjusting for age. Randomized controlled trials are needed to confirm that improvement in dietary pattern can improve T levels and reduce hypogonadism.

Sedentary behaviors and dietary intake are independently associated with obesity risk. In the literature, only a few studies have investigated gender differences for such associations. The present study aims to assess the association of sedentary behaviors and unhealthy foods intake with obesity in men and women in a comparative manner. The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2013/RISKESDAS 2013). In total, 222,650 men and 248,590 women aged 19–55 years were enrolled. A validated questionnaire, physical activity card, and food card were used for the assessments. The results showed that the prevalence of obesity (body mass index of ≥27.5 kg/m²) was higher in women (18.71%) than in men (8.67%). The mean body mass index in women tended to be higher than in men. After adjusting for age and education, the gender effect on obesity persisted in women and was more significant than in men. There was also a positive and significant effect on obesity of sedentary behaviors and unhealthy foods intake. Moreover, fatty and fried foods displayed a positive multiplicative interaction, increasing obesity risk in women more than in men and indicating a possible dietary risk in in women in relation to obesity. The study suggests that the implementation of educational programs on nutrition and physical activity is particularly important for promoting a healthy body weight among Indonesian women.

Whether being overweight or obese is associated with increased risk of iron deficiency anemia (IDA) remains controversial. We evaluated the dietary intakes and risk for IDA in relation to body mass index (BMI). One thousand two hundred and seventy-four females aged ≥ 19 years, enrolled in the third Nutrition and Health Survey in Taiwan (NAHSIT) 2005-2008, were selected. Half of the women were either overweight (24.0%) or obese (25.3%). The overall prevalence of anemia, iron deficiency and IDA among adult women was 19.5%, 8.6% and 6.2%. BMI showed a protective effect on IDA: overweight (odds ratio, OR: 0.365 (0.181-0.736)) and obese (OR: 0.480 (0.259-0.891)) when compared with normal weight. Univariate analysis identified increased IDA risk for overweight/obese women who consumed higher dietary fat but lower carbohydrate (CHO) (OR: 10.119 (1.267-80.79)). No such relationship was found in IDA women with normal weight (OR: 0.375 (0.036-4.022)). Analysis of interaction(s) showed individuals within the highest BMI tertile (T3) had the lowest risk for IDA and the risk increased with increasing tertile groups of fat/CHO ratio; OR 0.381 (0.144-1.008; p = 0.051), 0.370 (0.133-1.026; p = 0.056) and 0.748 (0.314-1.783; p = 0.513); for T1, T2 and T3, respectively. In conclusion, a protective effect of BMI on IDA may be attenuated in women who had increased fat/CHO ratio.

Background: In adults, low circulating interleukin 10 (IL10) has been associated with obesity and type 2 diabetes. However, studies investigating IL10 in overweight and obese children have yielded conflicting results. The aim of this study was to investigate factors associated with serum IL10 concentration in young Chinese adolescents., Methods: Young adolescents (n=325) ages 13.33±1.10 years were recruited into the cross-sectional study from 2010 to 2011. Parameters of obesity, individual components of MetS, iron status and serum IL10 were evaluated., Results: Compared with their normal weight counterparts, overweight adolescents had lower serum IL10 but higher TNFα, nitric oxide (NO) and IL1β concentrations (all p<0.05). Obese adolescents had increased IL1β but decreased hepcidin concentration compared with normal weight (p<0.01 and p<0.05; respectively). A strong inverse relationship (p<0.0001) was found between IL10 and pro-inflammatory cytokines (TNFα and IL1β). Multivariate linear regression analysis showed serum IL1β was significantly correlated with IL10 (β=-0.156, p<0.0001). When overweight and obese adolescents were assessed separately from normal weight, only IL1β was inversely associated with serum IL10 (β=-0.231, p=0.0009). The association between IL10 and IL1β was weaker in adolescents with normal weight (β=-0.157, p=0.0002), after adjusting for gender, TNFα, IFNγ and NO., Conclusions: Our study confirmed that low IL10 concentration is associated with overweight and obesity in young adolescents. We also demonstrated for the first time that pro-inflammatory cytokine IL1β is independently associated with IL10. A decline in IL10 concentration in overweight and obese adolescents may further contribute to the IL1β-mediated inflammatory environment associated with obesity.

Obesity is an epidemic health problem related to morbidity and mortality of metabolic and cardiovascular diseases. However, little is known regarding the development of cardiometabolic diseases in an obese subgroup with a healthy metabolic risk profile. This study examined the prevalence of baseline metabolically healthy obese subjects and its impacts on the incidences of cardiometabolic diseases using a nation-wide population cohort. Metabolically healthy obese were prevalent in 8.2% of the baseline population and 28.5% of the obese subjects. Subjects included were 1,547 men and women (age range, 18-59 years), who were free of components of the metabolic syndrome except waist criteria. During an average 5.4-year follow-up, the cumulative incidences of hypertension, type 2 diabetes and the metabolic syndrome were 7.8%, 1.2% and 5.6%, respectively. The hazard ratios (95% CIs) for the metabolic syndrome incidence were significantly higher at BMI levels of >=23.0 kg/m² [4.68 (2.22-9.86)] for BMI of 23-24.9 kg/m²; 8.82 (4.01-19.4) for BMI of 25-26.9 kg/m²; and 24.43 (12.33-48.41) for BMI of >=27 kg/m²). The hazard ratios for diabetes or hypertension incidence were significantly higher at BMI levels of >=25.0 kg/m2. Each kg/m² of BMI gained was associated with an 18% increase in the risk of developing hypertension and a 26% increase in risk for the metabolic syndrome. We conclude that metabolically healthy obese individuals are at higher risk to develop hypertension, type 2 diabetes and the metabolic syndrome than their non-obese counterparts. Our data provide further evidence that opposes the notion of metabolically healthy obese as harmless conditions.

Background/purpose: Obesity and metabolic syndrome (MS) are major risk factors for the development of type 2 diabetes and cardiovascular diseases (CVD). This study estimated the prevalence of obesity and MS in Taiwan., Methods: Data from a nationwide cross-sectional population-based survey of 5936 participants (2815 men, 3121 women; age range, 20-79.9 years) in 2002 were analyzed. Obesity was defined as a body mass index (BMI) > or = 27 kg/m(2) according to the criteria of the Department of Health in Taiwan. The prevalence of MS was estimated using the definitions of the modified Adult Treatment Panel III (ATP III), the International Diabetes Federation for Chinese (MS-IDF(C)) and the MS criteria for Taiwanese (MS-TW)., Results: The overall prevalence of obesity in men was significantly greater than in women (19.2% vs. 13.4%, p < 0.0001). The age-standardized prevalence of MS was 15.7% by the modified ATP III criteria, 14.3% by the MS-IDF(C) criteria and 16.4% by the MS-TW criteria. The prevalence of obesity and MS significantly increased with age (trend test, p < 0.0001) in men and women. The risk of MS and its components increased significantly with BMI, and showed a marked increase with BMI > or = 24 kg/m(2). MS as classified by the MS-IDF(C) criteria failed to identify subjects at high risk of CVD who did not have abdominal obesity, including those with hypertension, type 2 diabetes and dyslipidemia., Conclusion: This study found a high prevalence of obesity and MS in Taiwan. The definitions of MS by the modified ATP III and MS-TW criteria were better able to detect high CVD risk than the MS-IDF(C) criteria.

Background and Purpose: In 2005, the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) guideline lowered the fasting glucose cut point used to define metabolic syndrome (MS). This study investigated the influence of MS on ischemic stroke (IS) risk using both the original and revised definitions. In addition, because abdominal obesity is the measure of obesity used in the guideline to define MS, we also investigated whether general obesity (GOB) should be considered in the definition of MS., Methods: Baseline data from 3453 adults (> or =20 years of age) in the Cardiovascular Diseases Risk Factor Two-Township Study were linked to insurance claim and death certificate records. The 2001 and 2005 NCEP-ATP III definitions were used with Asian and Taiwanese specific cut-off values for waist circumference and body mass index. Hazard ratios of MS and GOB on IS were calculated using Cox models, and the Kaplan-Meier method was used to derive free-of-IS survival curves., Results: During 10.4 years of follow-up, 132 persons developed IS. Hazard ratios of subjects with 1 to 2 and > or =3 MS component disorders were 2.69 and 4.30, respectively, under the 2001 definition, and 3.16 and 5.15, respectively, under the 2005 definition (all P values <0.05). MS subjects with GOB had reduced survival at a borderline significance level. Adding GOB in the MS definition did not significantly alter the number of subjects with MS nor the ability to predict stroke risk. Replacing abdominal obesity with GOB in MS definition reduced the number slightly and increased the hazard ratio., Conclusions: MS predicted IS and the 2005 NCEP definition showed a stronger dose-response relationship with IS. Adding GOB to the existing MS definition had limited benefit.

Background: Delineating the natural history of metabolic syndrome (MetS) is prerequisite to prevention. This study aimed to build Markov models to simulate each component’s progress and to test the effect of different initial states on the development of MetS. Methods: MetS was defined with revised AHA/NHLBI criteria. Each reversible multistate Markov chain consisted of 8 states (no component, five isolated component states, 2-component state, and MetS state). Yearly transition probabilities were calculated from a five-year population-based follow up studywhich enrolled 2,247 individuals with mean aged 32.4 years at study entry. Results: In men, high BP or a 2-component state was most likely to initiate the progress of MetS. In women, abdominal obesity or low HDL were the most likely initiators. Metabolic components were likely to occur together. The development of MetS was an increasing monotonic function of time. MetS was estimated to develop within 15 years in 12.7% of young men with no component, and 2 components developed in 16.3%. MetS was estimated to develop in 10.6% of women with at the age of 47, and 2 components developed in 14.3%. MetS was estimated to develop in 24.6% of men and 27.6% of women with abdominal obesity, a rate higher than in individuals initiating with no component. Conclusions: This modeling study allows estimation of the natural history of MetS. Men tended to develop this syndrome sooner than women did, i.e., before their fifth decade of life. Individuals with 1 or 2 components showed increased development of MetS. [ABSTRACT FROM AUTHOR]

ABSTRACT: Aim: Metabolic syndrome (MetS) is a major culprit in cardiovascular disease and chronic kidney disease (CKD) in Western populations. We studied the longitudinal association between MetS and incident CKD in Chinese adults. Methods: A cohort study was conducted in a nationally representative sample of 4248 Chinese adults in Taiwan. The MetS was defined according to a unified criteria set by several major organizations and CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73 m2. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) adjusted for sex, age, body mass index (BMI) and serum levels of total cholesterol. Results: The prevalence of MetS among participants at baseline recruitment was 15.0% (637/4248). During a median follow-up period of 5.40 years, 208 subjects (4.9%) developed CKD. The multivariate-adjusted HR of CKD in participants with MetS compared with those without was 1.42 (95% CI = 1.03, 1.73). Additionally, there was a significantly graded relationship between the number of the MetS components and risk of CKD. Further, the relation between MetS and incident CKD was more robust in subjects with BMI >27.5 kg/m2 than in those with lower BMI. Conclusion: The results suggest that the presence of MetS was significantly associated with increased risk of incident CKD in a Chinese population. These findings warrant future studies to test the impact of preventing and treating MetS on the reduction of the occurrence of CKD. [ABSTRACT FROM AUTHOR]

Obesity has become a significant problem for developing countries, including Indonesia. High duration of sedentary activity and high intake of unhealthy foods were associated with high risk of overweight and obesity. The objective of this study was to compare the distributions of sedentary activity and dietary behavior with overweight/obesity risks between urban and rural areas among children and adolescents aged 10–18 years in Indonesia. This is a cross-sectional study. Data from a national survey in 33 Indonesian provinces (Basic Health Research /Riskesdas 2013) were analyzed. Multiple logistic regression models were used to calculate the odds ratio (OR) adjusted with all variables, such as age, gender, residency, education level, physical activity, and food intake. An urban–rural residence difference was found in the factors related to obesity. Daily caffeinated soft drinks and energy drinks consumption (OR = 1.12, 95% CI: 1.01–1.23) were related to risk of overweight and obesity in urban areas. Daily grilled foods (OR = 1.32, 95% CI: 1.22–1.42) and salty food (OR = 1.09, 95% CI: 1.04–1.15) consumption were significantly associated with obesity in rural areas but not in urban areas. Furthermore, sedentary activity was correlated with overweight and obesity among those who lived in urban and rural areas. Our findings suggest that education, environmental, and policy interventions may need to specifically target urban settings, where access is high to a wide range of processed and traditional high-sugar, high-fat snack foods and beverages. [ABSTRACT FROM AUTHOR]

Elevated soluble cluster of differentiation 163 (sCD163) concentrations, a marker of macrophage activation, are associated with obesity. Weight reduction decreases circulating CD163 levels, and changes in sCD163 levels are associated with improved metabolic dysfunction. Currently, the relationship between sCD163 and diet remains unclear. This study investigated dietary patterns associated with sCD163 concentrations and its predictive effect on metabolic syndrome (MetS). Data on anthropometrics, blood biochemistry, and a food frequency questionnaire were collected from 166 Taiwanese adults. sCD163 levels independently predicted MetS (odds ratio (OR): 5.35; 95% confidence interval (CI): 2.13~13.44, p < 0.001), non-alcoholic fatty liver disease (OR: 2.19; 95% CI: 1.03~4.64, p < 0.001), and central obesity (OR: 3.90; 95% CI: 1.78~8.55, p < 0.001), after adjusting for age and sex. An adjusted linear regression analysis revealed strong correlations between levels of sCD163 and aspartate transaminase (AST) (β = 0.250 (0.023~0.477), p < 0.05) and red blood cell aggregation (β = 0.332 (0.035~0.628), p < 0.05). sCD163-associated dietary pattern scores (high frequencies of consuming noodles and desserts, and eating at home, and a low intake frequency of steamed/boiled/raw food, white/light-green-colored vegetables, orange/red/purple-colored vegetables, dairy products, seafood, dark-green leafy vegetables, and soy products) were positively correlated with MetS, liver injury biomarkers, and sCD163 levels (all p for trend < 0.05). Individuals with the highest dietary pattern scores (tertile 3) had a 2.37-fold [OR: 2.37; 95% CI: 1.04~5.37, p < 0.05] higher risk of MetS compared to those with the lowest scores (tertile 1). Overall, the study findings suggest the importance of a healthy dietary pattern in preventing elevated sCD163 levels and diet-related chronic disease such as MetS. [ABSTRACT FROM AUTHOR]

Abstract: Background: Optimal cutoffs for obesity indices are rarely studied in Asians. We evaluated these cutoffs for diabetes, hypertension, dyslipidemia and any risk factor for the Taiwanese general population. Methods: Body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR), waist–height ratio (WHeiR) and other data for 4683 (2280 men and 2403 women) participants of the population-based Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia were used. Areas under curves (AUCs) were analyzed and optimal cutoffs were estimated by maximizing the sums of sensitivity and specificity. Potential confounders included age, smoking, alcohol, betel nut chewing and exercise. Results: Optimal cutoffs for men and women, respectively, were 23.7–26.3 and 22.1–23.2kg/m2 for BMI; 85.0–87.0 and 74.0–83.0cm for WC; 0.87–0.90 and 0.78–0.83 for WHR; and 0.48–0.52 and 0.48–0.52 for WHeiR. AUCs were not significantly different among the indices for diabetes in men and for hypertension in women. In men, WHR was significantly inferior to the other indices for predicting hypertension, dyslipidemia and any risk factor. In women, BMI was significantly inferior to the others for diabetes. For dyslipidemia and any risk factor in women, WHeiR showed the largest AUCs and significant differences were seen in the following pairs: WHeiR vs. BMI and WHeiR vs. WHR for dyslipidemia and WC vs. WHR and WHeiR vs. WHR for any risk factor. Conclusions: WC and WHeiR have similar efficacy and are superior to BMI and WHR. However, WHeiR has the extra benefit of a unisex cutoff within a narrow range. [Copyright &y& Elsevier]