Indicators Of Abdominal Obesity Research Articles

Prevalence and characteristics of metabolic phenotypes: The Rhineland study, Germany

Background Body mass index (BMI) is a commonly used yet crude indicator of obesity as it does not provide any information about body composition or metabolic characteristics. The definition of obesity needs to be improved and is still a matter of on-going debate. Other single body measures and/or metabolic characteristics perform better at capturing adiposity-related health risk. Percentage of body fat (PBF) is an indicator of risk for several comorbidities related to obesity. Nevertheless, obese individuals differ not only in the amount of excess fat mass but also in regional fat distribution. Thus, waist circumference (WC) and waist to hip ratio (WHR) have been used as a proxy measures for body fat distribution and identifying individuals at-risk. More recently, metabolically healthy (MH) and metabolically unhealthy (MU) phenotypes based on several metabolic profiles have been suggested as a clinically more relevant classification for obesity. Objective To estimate (a) the prevalence of metabolic healthy and unhealthy phenotypes and (b) the prevalence of individuals at-risk defined by PBF, WC and WHR in German adults aged 30–93 years and (c) the proportion of overlap between these two risk assessments. Method We used cross-sectional data on anthropometric measures, body composition and clinical characteristics from the Rhineland Study, Germany. Metabolically healthy and unhealthy phenotypes were defined by a pre-established classification combining the following clinical criteria: blood pressure ≥ 130/85 mmHg, triglycerides ≥ 150 mg/dL, HDL cholesterol 0.1 mg/L, glycated haemoglobin (HbA1c) ≥ 6.5%. Study participants having two or more of these cardio metabolic abnormalities were considered as MU. We identified 6 metabolic phenotypes: normal weight (BMI Results Based on data from the first 990 participants (440 M and 550 W), overall prevalence of MU phenotype was 13.3%, with higher prevalence in men (7.8%) than in women (5.5%). The mean (± SD) age for the MH group was 55.8 ± 14.0 y and for the MU group 62.5 ± 12.2 y. According to BMI groups, the prevalence of MU for normal weight, overweight and obese participants were 4.3%, 16.9% and 33.5%, respectively. The prevalence of individuals at-risk identified by PBF was 46.8% of which 6.3% were classified as MU; for WC the prevalence was 52.4% of which 11.6% were categorized as MU. The prevalence of individuals at-risk based on WHR was 50.2%; 12.2% of those were categorized as MU. Conclusion Adiposity indicators, specifically WC and WHR that classify abdominal fat, identified the higher prevalence of individuals at metabolic risk than the classification of MU phenotypes. Adiposity indicators, specifically WC and WHR that classify abdominal fat, identified the higher prevalence of individuals at metabolic risk than the classification of MU phenotypes. These classification schemes slightly overlap and seem to identify partly different people. Therefore, a stratification of metabolic phenotypes including metabolic profile and indicators of abdominal obesity could improve the identification of individuals at metabolic risk.

Acute effects of high-intensity interval, resistance or combined exercise protocols on testosterone - cortisol responses in inactive overweight individuals.

The purpose of this study was to compare the hormonal responses to one session of high-intensity interval training (HIIT, 4 × 4 min intervals at 85-95% maximum heart rate [HRmax], interspersed with 4 min of recovery at 75-85% HRmax), resistance training (RT at 50-70% of one repetition maximum 12-15 repetitions per set with 60s of recovery) or both (HIIT+RT) exercise protocol in a cohort of physical inactivity, overweight adults (age 18-30 years old). Randomized, parallel-group clinical trial among fifty-one men (23.6 ± 3.5 yr; 83.5 ± 7.8 kg; 28.0 ± 1.9 kg/m2), physical inactivity (i.e., <150 min of moderate-intensity exercise per week for >6 months), with abdominal obesity (waist circumference ≥90 cm) or body mass index ≥25 and ≤30 kg/m2 were randomized to the following 4 groups: high-intensity interval training (HIIT, n = 14), resistance training (RT, n = 12), combined high-intensity interval and resistance training (HIIT+RT, n = 13), or non-exercising control (CON, n = 12). Cortisol, total- and free-testosterone and total-testosterone/cortisol-ratio (T/C) assessments (all in serum) were determined before (pre) and 1-min post-exercise for each protocol session. Decreases in cortisol levels were -57.08 (95%CI, -75.58 to -38.58; P = 0.001; ɳ2 = 0.61) and - 37.65 (95%CI, -54.36 to -20.93; P = 0.001; ɳ2 = 0.51) in the HIIT and control group, respectively. Increases in T/C ratio were 0.022 (95%CI, 0.012 to 0.031; P = 0.001; ɳ2 = 0.49) and 0.015 (95%CI, 0.004 to 0.025; P = 0.007; ɳ2 = 0.29) in the HIIT and control group, respectively. In per-protocol analyses revealed a significant change in cortisol levels [interaction effect F(7.777), ɳ2 = 0.33] and T/C ratio [interaction effect F(5.298), ɳ2 = 0.25] between groups over time. Additionally, we showed that in both the intention-to-treat (ITT) and per protocol analyses, HIIT+RT did not change serum cortisol, total or free testosterone. The present data indicate a HIIT reduced cortisol and increased total-testosterone/cortisol-ratio levels significantly in physically inactive adults. Further study is required to determine the biological importance of these changes in hormonal responses in overweight men.

Built environment, contextual income, and obesity in older adults: evidence from a population-based study.

The objective was to verify the association between built environment, contextual income, and obesity in older adults in Florianópolis, Santa Catarina State, Brazil. This was a cross-sectional study in a sample of 1,197 older people (≥ 60 years) evaluated in the EpiFloripa Older Adults Cohort in 2013/2014. The outcomes were overall obesity, abdominal obesity, waist circumference (WC), and body mass index (BMI). Contextual income in the census tract and characteristics of the built environment were analyzed using data from the Florianópolis Institute of Urban Planning (IPUF) and the 2010 Population Census. Logistic and multilevel linear regression models were used. For older women, intermediate mean income was associated with lower odds of abdominal and overall obesity, while higher percentage of paved streets in the census tract was associated with lower odds of abdominal obesity; one percentage point increment in local commerce decreased WC by 0.20cm, and a one percentage point increase in paved streets decreased WC by 0.43cm and BMI by 0.22kg/m2. For older men, better street connectivity and intermediate percentage of local commerce were associated with lower odds of overall obesity; the increment in street density decreased WC by 0.34cm and BMI by 10kg/m2; a one-point increment in lighting increased WC by 0.51cm and BMI by 0.11kg/m2. The results showed different associations according to sex and target outcome, highlighting the need for further studies to explore additional relevant contextual variables for these outcomes in older adults.

Novel indicator of abdominal obesity strongly associated with cardiovascular disease

Novel indicator of abdominal obesity strongly associated with cardiovascular disease

Abdominal obesity and insulin resistance after an episode of acute pancreatitis

BackgroundEmerging evidence indicates that individuals after an episode of acute pancreatitis (AP) are at an increased risk of developing metabolic derangements. While the link between general obesity and insulin resistance (IR) is well established, only a few studies have investigated the association between abdominal obesity and IR. The aim of this study was to investigate the associations between abdominal obesity and several indices of IR in individuals after an episode of AP. MethodsPatients were eligible for this cross-sectional study if they were previously admitted with a primary diagnosis of AP based on the recent international guidelines. Fasting venous bloods were collected to measure glucose, insulin, free fatty acids, glycerol, adiponectin (AD), omentin (OM), and vaspin (VAS). The IR indices – HOMA-IR, Adipo-IR, insulin*glycerol (IG) index, HOMA-AD, HOMA-OM, and HOMA-VAS were calculated. Modified Poisson regression was conducted, with statistical model adjusting for patient-, metabolic-, and pancreatitis-related risk factors. Areas under ROC curve were calculated and Bland–Altman plots were created. ResultsOf the 92 individuals recruited, 41 had abdominal obesity. HOMA-IR, IG index, HOMA-OM, and HOMA-VAS were significantly associated with abdominal obesity, both in unadjusted and adjusted models. Area under ROC curves for HOMA-IR, IG index, HOMA-OM, and HOMA-VAS were 0.698, 0.695, 0.756, and 0.735, respectively. There was a good agreement between observed HOMA-IR values and values obtained from HOMA-OM (P = 0.733) and HOMA-VAS (P = 0.595). ConclusionIndividuals with abdominal obesity after AP have a significantly higher IR, independent of diabetes and other covariates. Visceral adipose tissue specific adipokines, omentin and vaspin, hold promise for future clinical investigation of tissue-specific IR.

Correlation between changes of body fat distribution and insulin resistance after Roux-en-Y gastric bypass

Objective To investigate the effect of laparoscopic Roux-en-Y gastric bypass(LYGB) on body fat distribution, and relationship between the changes of body fat distribution and improvement of insulin resistance. Methods A total of 65 patients with type 2 diabetes who underwent LYGB were selected for a retrospective analysis.Metabolic parameters, anthropometric measurements, body composition and fat distribution measured by dual-energy X-ray absorptiometry(DEXA) were collected separately before and 6 months post LYGB. All data of pre- and postoperation were compared with pair t test, Pearson correlation analysis was used to evaluate correlation of two variables. Results Weight, body mass index, waist circumference, waist-to-hip ratio, triglyceride, fasting plasma glucose, fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were significantly decreased in 6 months after surgery (P<0.05). Total fat mass, body fat mass of trunk, upper and lower limbs decreased significantly (P<0.05). Percent fat mass at the whole body, Android region, upper and lower limbs decreased significantly (P<0.05). After 6 months postoperatively, abdominal obesity indices waist circumfernce decreased from (98.10±13.03) cm to (91.60±7.68) cm (P<0.01) and percent fat mass at the Android region decreased from (35.71±10.24)% to (29.44±12.11) % (P<0.05), HOMA-IR decreased from 3.62±5.18 to 1.79±1.52 (P<0.05). The improvement of postoperative insulin resistance is positively correlated with the changes in waist circumference (P<0.01) and percent fat mass of Android region (P<0.05). Conclusions The body fat distribution changes after LYGB, change of abdominal fat distribution is positively correlated to the improvement of insulin resistance. Key words: Gastric bypass; Diabetes mellitus, type 2; Body fat distribution; Insulin resistance

Abdominal obesity and reduction of glomerular filtration.

The objective was to evaluate the association between nutritional status and the glomerular filtration rate (GFR) in remaining quilombolas. Cross-sectional study carried out on 32 remaining quilombola communities in the municipality of Alcântara-MA. The nutritional indicators (IN) used were: body mass index (BMI); Waist circumference (WC); Waist-to-hip ratio (WHR); Waist-to-height ratio (WHtR); conicity index (CI) and estimated visceral adipose tissue (VAT). GFR was estimated from the CKD-EPI creatinine-cystatin C formula. The Shapiro Wilk test was used to evaluate the normality of the quantitative variables. In order to compare the second IN sex, the chi-square test was applied. The Anova or Kruskal-Wallis tests were used to verify the association between IN and GFR. Of the 1,526 remaining quilombolas studied, 89.5% were black or brown, 51.2% were women, 88.6% belonged to economic classes D and E and 61.2% were farmers or fishermen. Clinical investigation revealed 29.2% of hypertensive patients, 8.5% of diabetics and 3.1% with reduced GFR. The BMI revealed 45.6% of the remaining quilombolas with excess weight. When compared to men, women presented a higher prevalence of overweight by BMI (56.6% vs 33.8%, p <0.001) and abdominal obesity CC (52.3% vs 4.3%), WHR (76,5% vs 5.8%), WHtR (82.3% vs 48.9%) and VAT (27.1% vs 14.5%) (p <0.001). Comparing the means of IN according to the GFR, it was observed that the higher the mean value of the IN lower the GFR (p <0.05). The GFR reduced with increasing mean values of nutritional indicators of abdominal obesity, regardless of sex.

Indicators of Obesity and Serum Levels of Triglycerides in the First Trimester of Pregnancy as the Predictors of Gestational Diabetes Mellitus among Urmia Women

Background: Obesity is a major risk factor of gestational diabetes mellitus (GDM), therefore, we aimed to determine which indicators of obesity can be used as predictors of GDM and also to study the association of maternal serum levels of triglycerides (TG) in early pregnancy to expression of GDM. Methods: A total of 436 primigravida women, who attended public health centers in 6 - 10 weeks of gestation, were prospectively followed until 24 - 28 weeks of gestation to control the expression of GDM. The indicators of abdominal obesity and the serum concentration of TG were measured at 6-10 weeks of gestation. All participants underwent a 75 g oral glucose tolerance test (OGTT) as a routine test at 24 - 28 weeks. Results: The incidence of GDM among our participants was 9.6%. The serum concentration of TG in 16.5% of them was more than 199 mg\dL. The majority of participants (62.8%) had a body mass index (BMI) more than its normal range. Waist circumference (WC) in the majority (84.4%) was 80 - 95.9 cm. The mean (SD) waist to height ratio (WHtR) and waist to hip ratio (WHR) were 0.58 (0.05) and 0.84 (0.06), respectively. WC, WHtR, WHR, BMI, and the serum levels of TG in early pregnancy are associated with the expression of GDM. Conclusions: Abdominal obesity and serum levels of TG can be used as early predictors of GDM. Strategies consisted of monitoring of TG levels in women planning for pregnancy as well as training obese and overweight women to modify their lifestyle in the means of decreasing the body fat mass can help to partially prevent GDM.

Association and Discriminatory Power of Abdominal Obesity for the Prevention of Sarcopenia and Vice Versa in Postmenopausal Women

Both abdominal obesity and sarcopenia are associated with cardiometabolic disorders mainly in postmenopausal women. In addition, there appears to be a reverse association between abdominal obesity and sarcopenia. The objective of the study was to identify the association and the discriminatory power of abdominal obesity for the prevention of sarcopenia and vice versa in postmenopausal women. The sample includes 257 women with age 57,2 years, The abdominal obesity and the variables determinants of sarcopenia were assessed by bioelectrical impedance analysis. The association of variables was been tested using logistic regression and the discriminatory power through Receiver Operating Characteristic (ROC) considering a confidence interval of 95%. The presence of abdominal obesity with the cutoff point of 153 cm² of visceral fat was discriminatory power for sarcopenia, as well as the musculoskeletal mass index with the cuttof point of 35,2% discriminated the absence of abdominal obesity. After adjusting for confounders it was observed still association between abdominal obesity and sarcopenia and association between musculoskeletal mass index and absence of abdominal obesity. The results of the study suggest that abdominal obesity discriminates and is associated with sarcopenia, such as musculoskeletal mass index discriminates the absence and is inversely associated whit of abdominal obesity in postmenopausal women.

Data on prevalence of obesity and waist circumference in Turkey: Systematic review, meta-analysis and meta regression of epidemiological studies on cardiovascular risk factors

Obesity is the most important epidemic of the 21st century and its incidence is increasing steadily in Turkey. The aim of this study was to assess the current status and temporal change in the prevalence of obesity in Turkey with a systematic review and metaanalysis of epidemiological studies conducted in the last 15 years. Ovid Medline, the Web of Science Core Collection and the Turkish Academic Network and Information Center (ULAKBIM) databases, as well as the web pages of the Turkish Ministry of Health, the Turkish Statistical Institute, and cardiology, nephrology and endocrinology associations were searched for epidemiological studies conducted within Turkey the last 15 years. Research focusing on local data was excluded. Studies included in the analysis were assessed with a special bias score and categorized as having low or high risk of bias. Body mass index (BMI), waist circumference, obesity and prevalence of abdominal obesity were calculated as crude values. Meta-regression analysis was performed to assess heterogeneity and change over time. The agreement between the two investigators on the selection and bias scoring of the studies was excellent (kappa=0.95), but the heterogeneity between the studies was high. BMI (10 studies, n=93.554) was calculated as 28.2 kg/m2 for women and 26.5 kg/m2 for men. The prevalence of obesity (12 trials, n=106.553) was 33.2% in females and 18.2% in males. In 6 studies (n=66.591) that included a measurement of waist circumference, the values were 89.72 cm in women and 93.57 cm in men. Especially in women, the prevalence of abdominal obesity (5 studies, n=62331) was greater than that of general obesity (50.8% in women vs 20.8% in men). Meta-regression analysis revealed that the variance of the obesity prevalence between the studies could partly be explained by the age differences, but there was no temporal change in the prevalence of obesity during the years the studies were conducted. The prevalence of obesity, especially abdominal obesity, is considerably high in Turkish women and increases with advancing age. This finding points out that nationwide action plans against obesity, especially for women, should be designed and implemented by health policy makers.

Observational Study on Implementation and Effectiveness of Cognitive Behaviour Therapy Targeting Eating Behaviour for Patients with Abdominal Obesity in an Ordinary Primary Health Care Setting

Objective: To describe the implementation of Cognitive Behavioural Therapy Targeting Eating Behaviour (CBT-TEB) and to determine the short-term effectiveness in reducing abdominal obesity and body mass index (BMI) where the therapy was provided in ordinary primary care centres. Methods: A screening questionnaire was given to consecutive patients and after that a health dialogue, blood pressure and plasma glucose check were offered. Eightythree persons aged 18-69 years consented to participate in the CBT-TEB intervention. Inclusion criteria were the combination of abdominal obesity and BMI ≥ 25. Primary outcome measures were changes from baseline to six months after end of therapy in waist circumference (WC), waist-to-hip ratio (WHR), weight, and BMI. Changes in eating behaviours: emotional eating and uncontrolled eating, obesity related psychosocial problems as well as patients´ and group leaders´ experiences of the CBT-TEB programme were also assessed. Pulse, systolic and diastolic blood pressure, total cholesterol, high-density lipoproteins (HDL-C), low-density lipoproteins (LDL-C) and triglycerides were measured. Results: Mean reductions after six months (total sample, last observation carried forward): WC 4.8 (sd 7.0) cm, WHR 0.027 (sd 0.04), weight 4.4 (sd 4.9) kg, BMI 1.6 (sd 1.8) kg/m2. Mean reductions after six months in therapy completers: WC 5.5 (7.3) cm, WHR 0.031 (0.05), weight 5.0 (5.0) kg, BMI 1.8 (1.8) kg/m2. Cognitive restraint eating increased and uncontrolled eating, emotional eating and obesity-related psychosocial problems decreased significantly during therapy. Patients´ experiences of the therapy exceeded their expectations. Group leaders´ experiences were positive. Conclusions: It was feasible to implement CBT-TEB in primary care with health educators and district nurses as group leaders after short training. The therapy was well accepted by patients and staff. The short-term effectiveness of CBT-TEB was satisfying and seems to surpass most or all published CBT-based programmes for reduction of weight and abdominal obesity in patients attending primary care.

Correlation of abdominal obesity indices with blood pressure in young adults: A cross-sectional study

Background: The youth of this era are the sufferings of overweight and obesity because of sedentary lifestyle, eating habits, altered pattern of behaviour and mental stress. Abdominal obesity is a predominant risk factor of cardiovascular disease. With this background, this study was proposed to correlate abdominal obesity with blood pressure (BP) in young adults. Materials and Methods: A total of 205 young male adults of 20–25 years were selected from various local educational institutions. Estimation for waist circumference (WC), hip circumference (HC) and BP recording was done. Waist–hip ratio (WHR) was calculated from WC and HC. Recording of BP was performed between 8 and 9 am after 5–10 min rest. On the basis of WC, participants were classified into two groups, i.e., WC ≤90 cm and WC >90 cm. On the basis of WHR, participants were classified into two groups, i.e., WHR

The Modifying Impact of Long-Term Endurance Training on Inflammatory Cytokine IL-1B Level and VO2max in Premenopausal Women with Abdominal Obesity

Background: A growing body of literature suggests that obesity is associated with low-grade inflammation and is regarded as a major risk factor for chronic diseases, such as diabetes and metabolic syndrome. Objectives: The purpose of this study was to examine whether an endurance training program can affect the inflammatory cytokine, interleukin-1β (IL-1β), in sedentary obese women. Methods: Thirty sedentary obese women (30 ≤ BMI ≤ 36), aged 30 - 40 years, were selected through convenience and purposive sampling. They were then divided into exercise (n, 15) and control (n, 30) groups, based on random sampling using a table of random numbers. The exercise group received 3 months of supervised endurance training. Blood samples were obtained before and at the end of the program for measuring serum IL-1β level in the groups. Pre- and posttraining anthropometric indices, as well as maximal oxygen consumption (VO2max) as an index of cardiovascular fitness, were also measured in the groups. Data were compared using independent paired t test. Results: The endurance training program resulted in a significant decline in body weight, abdominal obesity, and other anthropometric indices (P 0.05). Conclusions: The increased level of serum IL-1β, as an inflammatory cytokine, could be attributed to weight loss or cardiovascular fitness due to endurance training in obese women.

Abdominal obesity and risk of hip fracture: a meta-analysis of prospective studies.

Epidemiological investigations evaluating the association of abdominal obesity with hip fracture risk have yielded conflicting results. Therefore, a meta-analysis was conducted to qualitatively summarize the evidence of the associations between waist circumference, waist-hip ratio, and hip circumference and the risk of hip fracture, respectively. PubMed, Embase, and Web of Science were searched for relevant articles published up to March 2017. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random-effects model. Dose-response relationship was assessed by restricted cubic spline. Seven studies involving 180,600 participants for hip circumference, six studies involving 199,828 participants for waist-hip ratio, and five studies involving 170,796 participants for waist circumference were finally included in this meta-analysis. The combined RRs with 95% CIs of hip fracture for the highest versus lowest category of waist circumference, waist-hip ratio, and hip circumference were 1.58 (95% CI 1.20-2.08), 1.32 (95% CI 1.15-1.52), and 0.87 (95% CI 0.74-1.02), respectively. For dose-response analysis, a nonlinear relationship was found (P nonlinearity<0.001) between waist circumference and the risk of hip fracture, and a linear relationship (P nonlinearity=0.911) suggested that the risk of hip fracture increased about 3.0% (1.03 (1.01-1.04)) for each 0.1 unit increment of waist-hip ratio. This meta-analysis suggested that abdominal obesity as measured by waist circumference and waist-hip ratio might be associated with an increased risk of hip fracture. From a public health perspective, indicators of abdominal obesity may be usable predictors of hip fracture risk.

Long-term supplementation of decaffeinated green tea extract does not modify body weight or abdominal obesity in a randomized trial of men at high risk for prostate cancer.

BackgroundEvidence continues to demonstrate the role of obesity in prostate carcinogenesis and prognosis, underscoring the need to identify and continue to evaluate the effective interventions to reduce obesity in populations at high risk. The aim of the study was to determine the effect of daily consumption of decaffeinated green tea catechins (GTC) formulation (Polyphenon E® (PolyE)) for 1 year on biomarkers of obesity in men who are at high risk for prostate cancer.Materials and MethodsA randomized, double-blinded trial was conducted targeting 97 men diagnosed with HGPIN or ASAP. Subjects were randomized to receive GTC (PolyE) (n = 49) or placebo (n = 48) for 1 year. Anthropometric data were collected at baseline, 6 and 12 months and data analyzed to observe change in weight, body mass index (indicator of obesity) and waist: hip ratio (indicator of abdominal obesity).ResultsDecaffeinated GTC containing 400 mgs of the bioactive catechin, EGCG administered for 1 year to men diagnosed with ASAP and HGPIN appears to be bioavailable, well tolerated but not effective in reducing biomarkers of obesity including body weight, body mass index and waist: hip ratio.ConclusionsThe results of our trial demonstrates that men who are obese and at high risk for prostate cancer should resort to effective weight management strategies to reduce obesity and not resort to ineffective measures such as taking supplements of green tea to reduce biomarkers of obesity. Changes in body mass index and abdominal obesity seen in other studies were potentially due to caffeine and not GTC.

Simple Anthropometric Indices are Useful for Predicting Non-alcoholic Fatty Liver Disease [NAFLD] in Asian Indians

With the rising prevalence of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) has become the most common liver disorder in both developed and developing nations. Several studies on NAFLD have described waist circumference, a surrogate marker of visceral fat accumulation and waist height ratio as a better screening tool for NAFLD and metabolic syndrome than body mass index (BMI). We conducted this study to assess simple abdominal obesity indices as a predictor of NAFLD and determine the appropriate cut-off levels with reference to NAFLD. 1000 subjects with NAFLD detected ultrasonographically and 360 controls attending a Gastroenterology Clinic at Cuttack, Odisha were included in the study and subjected to detailed anthropometric measurements. The abdominal anthropometric cut offs were determined using ROC analysis. Statistical analysis was performed by using SPSS software version 16. All receiver operating curve (ROC) curves of waist circumference, waist-height ratio and BMI were significantly above the diagonal line. There were no significant differences in the area under the curve values among these abdominal obesity indices in each gender. The appropriate cut-off point of waist circumference in screening for NAFLD was 89cm for men and 84cm for women and the optimal cut-off point of waist-height ratio was 0.53 for men and 0.57 for women and the cut-off point of waist to hip ratio was 0.94 for men and 0.87 for women with very good sensitivity and specificity. The simple anthropometric parameters, such as BMI, waist circumference, waist-hip ratio and waist-height ratio are useful for predicting NAFLD in Indian adults. The anthropometry cut offs would be very useful in setting target points of life style modification and weight reduction. Besides, our study also clearly demonstrated that a simple assessment of BMI is as efficacious as other anthropometry parameters in predicting NAFLD.

Mediterranean diet decreases adolescent waist circumference.

To explore the effects of a multicomponent-multilevel school-based educational intervention on the nutritional habits and abdominal obesity indices of a representative adolescent sample. A representative sample of 1610 adolescents aged 12-17 years in 23 public high schools of three municipalities in the Attica region in Greece participated in a programme funded by the European Union (August 2013-August 2014). Participants underwent dietary assessment with the use of the Mediterranean Diet Quality Index in children and adolescents (KIDMED), blood pressure (BP) assessment and screening for general and abdominal obesity by measuring body mass index, waist circumference (WC) and waist-to-height ratio (WHtR), at baseline and following a 6-month school-based intervention. The intervention involved nutritional education, physical activity and body image awareness using a multilevel approach to the adolescent participants, their parents, school teachers and health staff. Analysis included 1032 adolescents (mean age ± SD 14·1 ± 1·6 years). Following intervention, mean KIDMED score ± SD increased significantly from 5·6 ± 2·4 to 5·8 ± 2·4 (P = 0·004). Higher percentage of boys (P = 0·028) and younger adolescents (P < 0·001) had optimal KIDMED scores ≥ 8. Significant decreases were observed in overweight and obesity (P = 0·033), mean systolic (P = 0·049) and diastolic (P < 0·001) BP, WC (P < 0·001) and WHtR (P < 0·001). WC decreased as the KIDMED score increased (P = 0·020). Living with both parents (P = 0·036), higher maternal (P = 0·039) and paternal (P = 0·004) education and having a younger father (P = 0·034) were associated with better adherence to Mediterranean diet, post-intervention. Increased adherence to MD was associated with decreased WC, indicating a potential of multicomponent-multilevel school-based interventions to combat adolescent abdominal obesity.

Association between obesity and femoral neck strength according to age, sex, and fat distribution.

Fat regulates bone metabolism, but the associations of total and abdominal obesity with bone health are inconsistent. We investigated the association between indicators of obesity and composite indices of femoral neck (FN) strength reflecting the risk of hip fracture. This population-based cross-sectional study examined data from the Korea National Health and Nutrition Examination Surveys. Participants were divided into groups according to age (25-49/≥50years) and sex. We examined total fat mass (TFM) and percentage fat mass (pFM) as indicators of total obesity and truncal fat mass (TrFM) as an indicator of abdominal obesity. We calculated the composite indices of FN strength and anthropometric clinical indicators of abdominal obesity. TFM, pFM, and TrFM were negatively associated with the composite indices, irrespective of age and sex (P<0.001-0.005). Most anthropometric clinical indicators of abdominal obesity showed negative associations with the composite indices regardless of age and sex (P<0.001-0.048), except for women aged 25-49years. In men, magnitudes of the negative contributions of TFM to the composite indices were significantly stronger at age 25-49years than at age ≥50years. Magnitudes of negative associations of TFM with the composite indices were greater in men than in women. TrFM had a more detrimental effect than TFM on FN strength in men aged 25-49years and in women of both ages. Indicators of total and abdominal obesity negatively associated with FN strength, and magnitudes of their effects on bone health differed according to age, sex, and fat distribution.

Intake and Dietary Food Sources of Fibre in Spain: Differences with Regard to the Prevalence of Excess Body Weight and Abdominal Obesity in Adults of the ANIBES Study.

The aim was to study the intake and food sources of fibre in a representative sample of Spanish adults and to analyse its association with excess body weight and abdominal obesity. A sample of 1655 adults (18–64 years) from the ANIBES (“Anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles”) cross-sectional study was analysed. Fibre intake and dietary food sources were determined by using a three-day dietary record. Misreporters were identified using the protocol of the European Food Safety Authority. Mean (standard deviation) fibre intake was 12.59 (5.66) g/day in the whole sample and 15.88 (6.29) g/day in the plausible reporters. Mean fibre intake, both in the whole sample and the plausible reporters, was below the adequate intake established by European Food Safety Authority (EFSA) and the Institute of Medicine of the United States (IOM). Main fibre dietary food sources were grains, followed by vegetables, fruits, and pulses. In the whole sample, considering sex, and after adjusting for age and physical activity, mean (standard error) fibre intake (adjusted by energy intake) was higher in subjects who had normal weight (NW) 13.40 (0.184) g/day, without abdominal obesity 13.56 (0.192) g/day or without excess body weight and/or abdominal obesity 13.56 (0.207) g/day compared to those who were overweight (OW) 12.31 (0.195) g/day, p < 0.001 or obese (OB) 11.83 (0.266) g/day, p < 0.001, with abdominal obesity 12.09 (0.157) g/day, p < 0.001 or with excess body weight and/or abdominal obesity 12.22 (0.148) g/day, p < 0.001. There were no significant differences in relation with the fibre intake according to the body mass index (BMI), presence or absence of abdominal obesity or excess body weight and/or abdominal obesity in the plausible reporters. Fibre from afternoon snacks was higher in subjects with NW (6.92%) and without abdominal obesity (6.97%) or without excess body weight and/or abdominal obesity (7.20%), than those with OW (5.30%), p < 0.05 or OB (4.79%), p < 0.05, with abdominal obesity (5.18%), p < 0.01, or with excess body weight and/or abdominal obesity (5.21%), p < 0.01, in the whole sample. Conversely, these differences were not observed in the plausible reporters. The present study demonstrates an insufficient fibre intake both in the whole sample and in the plausible reporters and confirms its association with excess body weight and abdominal obesity only when the whole sample was considered.

Copy Number Variations in Candidate Genes and Intergenic Regions Affect Body Mass Index and Abdominal Obesity in Mexican Children.

Introduction. Increase in body weight is a gradual process that usually begins in childhood and in adolescence as a result of multiple interactions among environmental and genetic factors. This study aimed to analyze the relationship between copy number variants (CNVs) in five genes and four intergenic regions with obesity in Mexican children. Methods. We studied 1423 children aged 6–12 years. Anthropometric measurements and blood levels of biochemical parameters were obtained. Identification of CNVs was performed by real-time PCR. The effect of CNVs on obesity or body composition was assessed using regression models adjusted for age, gender, and family history of obesity. Results. Gains in copy numbers of LEPR and NEGR1 were associated with decreased body mass index (BMI), waist circumference (WC), and risk of abdominal obesity, whereas gain in ARHGEF4 and CPXCR1 and the intergenic regions 12q15c, 15q21.1a, and 22q11.21d and losses in INS were associated with increased BMI and WC. Conclusion. Our results indicate a possible contribution of CNVs in LEPR, NEGR1, ARHGEF4, and CPXCR1 and the intergenic regions 12q15c, 15q21.1a, and 22q11.21d to the development of obesity, particularly abdominal obesity in Mexican children.