Adverse Health Consequences Of Obesity Research Articles

Genetically and environmentally predicted obesity in relation to cardiovascular disease: a nationwide cohort study

Evidence indicates that the adverse health effects of obesity differ between genetically and environmentally influenced obesity. We examined differences in the association between obesity and cardiovascular disease (CVD) between individuals with a genetically predicted low, medium, or high body mass index (BMI). We used cohort data from Swedish twins born before 1959 who had BMI measured between the ages of 40-64 years (midlife) or at the age of 65 years or later (late-life), or both, and prospective CVD information from nationwide register linkage through 2016. A polygenic score for BMI (PGSBMI) was used to define genetically predicted BMI. Individuals missing BMI or covariate data, or diagnosed with CVD at first BMI measure, were excluded, leaving an analysis sample of 17,988 individuals. We applied Cox proportional hazard models to examine the association between BMI category and incident CVD, stratified by the PGSBMI. Co-twin control models were applied to adjust for genetic influences not captured by the PGSBMI. Between 1984 and 2010, the 17,988 participants were enrolled in sub-studies of the Swedish Twin Registry. Midlife obesity was associated with a higher risk of CVD across all PGSBMI categories, but the association was stronger with genetically predicted lower BMI (hazard ratio from 1.55 to 2.08 for those with high and low PGSBMI, respectively). Within monozygotic twin pairs, the association did not differ by genetically predicted BMI, indicating genetic confounding not captured by the PGSBMI. Results were similar when obesity was measured in late-life, but suffered from low power. Obesity was associated with CVD regardless of PGSBMI category, but obesity influenced by genetic predisposition (genetically predicted high BMI) was less harmful than obesity influenced by environmental factors (obesity despite genetically predicted low BMI). However, additional genetic factors, not captured by the PGSBMI, still influence the associations. The Strategic Research Program in Epidemiology at Karolinska Institutet; Loo and Hans Osterman's Foundation; Foundation for Geriatric Diseases at Karolinska Institutet; the Swedish Research Council for Health, Working Life and Welfare; the Swedish Research Council; and the National Institutes of Health.

Abstract C078: The association between the oral microbiome and body mass index among Black women

Abstract Background. The prevalence of obesity (defined as ≥30 kg/m2) has increased by 40% over the past two decades. Black women have the highest prevalence of obesity of any US population group, with 57% of Black women classified as obese. The adverse health consequences of obesity include increased risk for type 2 diabetes, cardiovascular disease, cancer, and premature mortality. Evidence has mounted from animal and human studies that the gut microbiota, in particular bacteria, is associated with obesity. Few studies have examined the association between the oral microbiota and obesity. Methods. In the current study, we included Black Women’s Health Study participants who donated a saliva sample using an oral wash kit and whose oral microbiome was sequenced in prior nested case-control studies of pancreatic and lung cancer. Participants were cancer-free at the time of oral wash collection. A total of 624 participants with whole metagenome shotgun sequencing data were available for this research. Body mass index (BMI, kg/m2) was calculated and classified according to the World Health Organization: normal weight (18.5–24.9 kg/m2, n=132), overweight (25.0–29.9 kg/m2, n=228), and obesity (≥30.0 kg/m2, n=264). Raw sequencing reads were processed using PathoScope (v 2.0). Data were filtered based on total read counts for individual operational taxonomic units (OTUs) and average relative genus abundance. Thus, 3,629 OTUs representing 103 genera were retained. We corrected for batch effects using ComBat-Seq. We conducted differential abundance analyses, adjusting for age, smoking, alcohol, diabetes, and tooth loss. For detecting differentially abundant microbes, we used DESeq2, Limma, and ANCOM-BC, both separately and in combination, at the genus and species levels. Results. Fifty-two genera were differentially abundant by BMI category in at least one of our analyses. Of these, three genera—Corynebacterium, Haemophilus, and Solobacterium—were commonly differentially abundant across all analyses. Notably, Solobacterium was more abundant in individuals with obesity, compared to individuals with normal or overweight, whereas Corynebacterium and Haemophilus were less abundant in individuals with overweight but not normal weight or obesity. On the species level, 98 species were differentially abundant by BMI category in at least one of our analyses. Three species were differentially abundant across all analyses: Cardiobacterium valvarum, Neisseria bacilliformis, and S. moorei (the only known species of Solobacterium). Conclusions. Our findings demonstrate that multiple oral microbial taxa are significantly differentially abundant by BMI category in Black women, who have a higher prevalence of obesity than any other race-gender group and suffer greatly from the adverse health effects of obesity. In particular, women with obesity had a higher abundance of S. moorei. This bacterium was also recently identified as more abundant in the gut microbiome of Chinese men and women with obesity and the abundance decreased with a weight loss intervention. Citation Format: Jessica L. Petrick, Howard J. Fan, Lynn Rosenberg, Julie R. Palmer, W. Evan Johnson. The association between the oral microbiome and body mass index among Black women [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C078.

Dirençli Egzersiz Eğitiminin Obez Bireylerde Vücut Kas ve Yağ Parametreleri Üzerine Etkisi

Obesity is a multifactorial disease with an increasing prevalence worldwide and is characterized by an increase in body weight. It poses a risk for diseases such as hypertension and diabetes, especially by causing an increase in fat in the abdominal area. Obesity can be managed through behavioral changes in energy intake or expenditure. Various nutrition and exercise strategies are used for this purpose. Exercise causes an increase in energy expenditure and contributes to a decrease in body weight, loss of fat mass and the maintenance of these effects. Exercise has the potential to mitigate the adverse health consequences of obesity even without weight loss in the body. Studies suggest that resistance exercise training can promote a negative energy balance, play a role in weight management by changing body fat mass. Increase in muscle mass with resistance exercise training provides a better metabolic control in the body. From the perspective of weight loss and control, recent exercise guidelines include resistance exercise training as part of an exercise prescription. Resistance exercise training can play an important role in body fat management, with an increase in energy expended during physical activity and an acute increase in basal metabolic rate. Resistance exercise training can increase lean body mass and cause changes in body composition by reducing visceral and total body fat. However, the effects of resistance exercise training on body fat composition still do not give definitive results. In this respect, this review aims to examine the effects of resistance exercise training on body fat mass and muscle.

Obesity: A Risk Factor for COVID-19.

Emerging data have demonstrated increased mortality of COVID-19 patients suffering from comorbid conditions such as Type II diabetes, hypertension, and cardiovascular diseases. Underlying risk in all these patients is an increase in bodyweight or obesity. The adverse health effects of obesity and how these factors enhance the risk of mortality in COVID-19 patients is still unexplored. The enhanced fat deposition might be a risk factor for increased mortality in COVID-19 patients. We have reviewed and collected the information from online databases: Pubmed, Google scholar, Researchgate, to highlight the systematic link between obesity with associated risks in COVID-19. We have reported the first study during the pandemic from France and New York, to a currently reported study in Mexico and found individuals with BMI ≥35kg/m2 or >40kg/m2 have greater risk of developing critical illness due to COVID-19, thereby increasing mortality. Our study suggests obesity in childhood, adolescence, and adulthood can be considered a profound risk factor for greater susceptibility and severity of COVID-19 and is associated with nutritional, lifestyle, cardiac, respiratory, renal, and immunological alterations, which may potentiate the complications of SARS-CoV-2 infection. Further suggesting to check on BMI during this pandemic situation.

The Multifaceted Actions of Curcumin in Obesity.

Obesity remains a pervasive health concern worldwide with concomitant comorbidities such as cardiovascular diseases, diabetes, inflammation, and other metabolic disorders. A wealth of data validates dietary and lifestyle modifications such as restricting caloric intake and increasing physical activity to slow the obesity development. Recently, the advent of phytochemicals such as curcumin, the active ingredient in turmeric, has attracted considerable research interest in tracking down their possible effects in protection against obesity and obesity-related comorbidities. According to the existing literature, curcumin may regulate lipid metabolism and suppress chronic inflammation interacting with white adipose tissue, which plays a central role in the complications associated with obesity. Curcumin also inhibits the differentiation of adipocyte and improves antioxidant properties. In the present review, we sought to deliberate the possible effects of curcumin in downregulating obesity and curtailing the adverse health effects of obesity.

The Effect of Aerobic and Resistance Training and Combined Exercise Modalities on Subcutaneous Abdominal Fat: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Subcutaneous abdominal adipose tissue (SAT), is the largest fat depot and major provider of free fatty acids to the liver. Abdominal fat is indirectly (via increased levels of low-grade inflammation) correlated with many of the adverse health effects of obesity. Although exercise is one of the most prominent components of obesity management, its effects on SAT are still unclear. The aim of this study was to investigate the independent effects of aerobic training (AT) and resistance training (RT) modalities and combined exercise modalities on SAT in adults. PubMed, SCOPUS, and Google Scholar were searched to find relevant publications up to November 2018. The effect sizes were represented as weighted mean difference (WMD) and 95% CIs. Between-study heterogeneity was examined using the I2 test. Overall, 43 identified trials that enrolled 3552 subjects (2684 women) were included. After removal of outliers, combining effect sizes indicated a significant effect of AT (WMD: -13.05 cm2; 95% CI: -18.52, -7.57; P < 0.001), RT (WMD: -5.39 cm2; 95% CI: -9.66, -1.12; P=0.01), and combined exercise training (CExT; WMD: -28.82 cm2; 95% CI: -30.83, -26.81; P < 0.001) on SAT relative to control groups. Pooled effect sizes demonstrated a significant effect of AT on SAT compared with a CExT group (WMD: 11.07 cm2; 95% CI: 1.81, 20.33; P=0.01). However, when comparing the AT and RT groups, no significant difference was seen in SAT (WMD: -0.73cm2; 95% CI: -4.50, 3.04; P=0.70). Meta-analysis of relevant trials indicated that AT, RT, and CExT lead to SAT reduction. Aerobic exercise was shown to produce greater efficacy in decreasing SAT.

Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging.

Diabesity is a term used to describe the combined adverse health effects of obesity and diabetes mellitus. The worldwide dual epidemic of obesity and type 2 diabetes is an important public health issue. Projections estimate a sixfold increase in the number of adults with obesity in40 years and an increase in the number of individuals with diabetes to 642 million by 2040. Increased adiposity is the strongest risk factor for developing diabetes. Early detection of the effects of diabesity on the cardiovascular system would enable the optimal implementation of effective therapies that prevent atherosclerosis progression, cardiac remodelling, and the resulting ischaemic heart disease and heart failure. Beyond conventional imaging techniques, such as echocardiography, CT and cardiac magnetic resonance, novel post-processing tools and techniques provide information on the biological processes that underlie metabolic heart disease. In this Review, we summarize the effects of obesity and diabetes on myocardial structure and function and illustrate the use of state-of-the-art multimodality cardiac imaging to elucidate the pathophysiology of myocardial dysfunction, prognosticate long-term clinical outcomes and potentially guide treatment strategies.

The association between obesity and sedentary behavior or daily physical activity among children with Down's syndrome aged 7–12 years in Japan: A cross-sectional study

BackgroundAn assessment of the adverse health effects of obesity in children with Down's syndrome (DS) is required to develop programs that facilitate the acquisition of healthy behaviors. Individuals with DS are often obese. These individuals must develop health related behaviors in childhood. For this reason, it is necessary to clarify the factors associated with obesity in children with DS. AimsThis study had two purposes. The first was to assess the obesity and to evaluate the sedentary behavior (SB) and physical activity of Japanese elementary school children with Down's syndrome. The second was to investigate the association between obesity and SB or moderate to vigorous physical activity (MVPA). Methods and proceduresNinety-three children (male/female: 51/42) with DS in elementary school grades 1 to 6 (aged 7–12 years) participated in this study in Japan. Physical characteristics were obtained from the questionnaire completed by their parents. The questionnaire provided information on regular school checkups. SB and MVPA were evaluated using a triaxial accelerometer. ResultsApproximately 20% of the children with DS were obese. Nearly half of the children with DS achieved 60 min of MVPA. SB time was significantly longer in the upper grades (aged 11–12 years) than in the lower grades (aged 7–8 years). Comparing weekdays and weekend days, the middle (aged 9–10 years) and upper grades had significantly shorter MVPA times on weekend days. The frequency of obesity was significantly associated with shorter MVPA times in the lower grades and longer SB time in the middle grades. Conclusions and implicationsChildren with DS may increase their SB time as their age group (grade category) increases. Increasing opportunities for MVPA during weekends may increase physical activity. The observed relationship between obesity and SB time or MVPA time may apply only to younger and middle grade children with DS. Further investigation is necessary to confirm these relationships.

Association of organic food consumption with obesity in a nationally representative sample.

The increased prevalence and adverse health consequences of obesity have made it one of the leading public health issues in recent years. Importantly, several epidemiological studies have revealed significant associations between BMI and organic food consumption. However, although these studies have suggested that this factor holds promise to prevent obesity, they all suffer from methodological limitations, including self-reporting methods to assess BMI, not controlling for potential confounding factors or using a non-representative sample. Moreover, all were restricted to an adult sample. We present the results of a cross-sectional epidemiological study assessing the association of organic food consumption with BMI and obesity in a representative lifespan French sample (INCA3 study). Objective methods were used to measure BMI, and several potentially confounding variables were controlled for. In total, 1775 children and adolescents and 2121 adults underwent anthropometric measurements and completed questionnaires concerning their dietary habits and lifestyle. Unadjusted models systematically revealed negative associations between organic food consumption and both BMI and obesity across all age groups. These associations tended to remain statistically significant even after controlling for several confounding variables concerning socio-economic status, quality of the diet and physical activity. The effect sizes were, however, small. These data confirm the association between organic food consumption and obesity during both childhood and adulthood. Evidence from randomised controlled trials is required to investigate causality between organic food consumption and lower BMI or obesity rate.

A Median Analysis of Factors Influencing Body Fatness in Urban School-Age Children in Cameroon.

Background Childhood overweight/obesity is a fast growing public health problem in developing countries. The adverse health consequences of obesity have been attributed to higher body fat levels and this has drawn overwhelming attention towards more accurate assessment of body fat. The goal of this study is to evaluate the relationships between selected behavioral factors and percentage body fat (%BF) estimated using bioelectrical impedance analysis in school-age children. Methods A cross-sectional analysis was carried out in randomly selected 6- to 11-year-old children (507 boys and 501 girls). Percentage body fat was assessed using bioelectrical impedance analysis. The behavioral factors were reported by parents using a structured questionnaire. Multiple quantile regression analysis was used to evaluate the relationship between the selected behavioral factors and %BF. Results With quantile regression, the daily consumption of fruits and vegetables, daily breakfast consumption, and high physical activity (>4–7 times/week) were significantly (p < 0.001) associated with a 4.95, 3.29, and 3.66 decrease in median %BF, respectively. Also, consumption of snacks (>3 times a day) (p < 0.001), high sedentary lifestyle (>3–6 hours/day) (p < 0.001), and motorization to school (p < 0.005) significantly increased the median %BF by 3.69, 3.01, and 1.39, respectively. The largest changes in median %BF were observed in girls. Conclusions Efforts are needed using longitudinal studies to clarify the effects of these behavioral factors on %BF in different regions and ethnic groups of Cameroon and also to assess whether any observed differences are of clinical relevance.

The Role of Lipids in the Pathogenesis of Metabolic Syndrome in Adolescents.

The increasing prevalence of childhood obesity is a driving force behind the increase in adolescent's metabolic syndrome (MetS). Although there is no clear consensus about the pediatric definition for MetS, this syndrome is becoming very common among adolescents. It is characterized by insulin resistance (IR), dyslipidemia, abdominal obesity and hypertension, and is associated with a high risk of type 2 diabetes mellitus and CVD in adulthood. Due to the increasing prevalence of obesity, there is strong incentive to reduce the impact of the adverse health effects associated with MetS. We explored the etiological role of nutrient-derived metabolic stressors, especially fatty acids, in the development of obesity and MetS. We also reviewed the evidence that pro-inflammatory stressors may predispose to obesity-induced insulin resistance. This article presents the opinion that reducing the impact of metabolic and inflammatory stressors may reduce the adverse health effects of obesity, and slow the progression towards MetS and CVD in adolescents. Evidence so far is limited from pediatric dietary epidemiological and interventional studies investigating the potential preventive and therapeutic effects of dietary fatty acid modification. This review will further investigate our understanding of the interaction between fatty acids in the pathogenesis and progression of MetS in adolescents.

Sirtuin 6 Builds a Wall Against Inflammation, Trumping Diabetes.

In 2014, more than two-thirds of U.S. adults were overweight or obese (1). These numbers have more than doubled over the past 50 years; ominously, obesity increasingly afflicts younger individuals, including children (2). Numerous deleterious health consequences are associated with obesity, including hypertension, dyslipidemia, type 2 diabetes, heart disease, and cancer (3,4). The costs associated with obesity in the U.S. are estimated to top $500 billion/year over the next two decades (5,6). Substantial literature has documented key roles for adipose tissue macrophages and hepatic Kupffer cells in driving chronic systemic inflammation and insulin resistance and their downstream sequelae in obesity (7). The sirtuins (SIRT1–7) are NAD+-dependent lysine deacetylases/deacylases critical for maintaining cellular and organismal homeostasis. A large body of work has demonstrated roles of sirtuins in regulating inflammatory responses and signaling through the insulin/IGF-1, mTOR, and AMPK pathways, all of which help mediate the adverse health consequences of obesity (8). SIRT6 is a chromatin-associated sirtuin implicated in metabolism, inflammation, stress responses, and genomic stability. Whole-body Sirt6 knockouts (KOs) die by a month of age …

Distribution of Sitting Height Ratio and its Association with Body Mass Index among Children and Adolescents in Shandong, China

Background: Sitting height ratio (SHR) is a useful parameter for assessing body proportion in clinical practice and other related fields. However, its association with body mass index (BMI) and obesity among children and adolescents is limited. Methods: Data for this study were obtained from a large cross-sectional survey of schoolchildren. A total of 42 348 students (21 248 boys and 21 100 girls) aged 7–18 years participated in this study. SHR was calculated as sitting height (SH) divided by total height. The BMI cutoff points recommended by the International Obesity Task Force (IOTF) were used to define overweight and obesity. Results: Children and adolescents aged 7–18 years in the ‘high SHR’ group (≥75th) had higher BMI than those in the ‘low SHR’ group (<25th) in all age groups (P<0.01), the range of differences being 1.28–1.55 kg/m2 for boys, and 1.06–1.90 kg/m2 for girls. The overall prevalence of overweight and obesity were 13.40% and 4.28% for boys, and 8.11% and 1.18% for girls in the ‘low SHR’ group, the corresponding figures were 19.69% and 9.45% for boys, and 14.06% and 3.68% for girls in the ‘high SHR’ group, the latter is significantly higher than the former (P<0.01). Conclusion: High SHR is associated with overweight and obesity, considering the adverse health effects of obesity, individuals with high SHR should be given special attention.

The Look AHEAD Trial: Implications for Lifestyle Intervention in Type 2 Diabetes Mellitus

Given the array of adverse health consequences of obesity, including increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the Look AHEAD trial (N=5145) was conducted to test the hypothesis that an intensive lifestyle intervention (ILI) for weight loss would achieve significantly greater reductions in CVD morbidity and mortality than a control condition of diabetes support and education (DSE) among participants with T2DM. A number of significant and long-term improvements were observed for ILI, including body weight, physical fitness and physical function, glucose control, quality-of-life (QoL), and healthcare costs. However, ILI did not significantly reduce CVD-related morbidity/mortality (i.e., CVD death, non-fatal MI, non-fatal stroke, hospitalized angina) after nearly 10 years of follow-up. There was a suggestion of heterogeneity of response based on the history of prior CVD at baseline (p=0.06). Despite the overall lack of CVD risk reduction, ILI remains important for care of patients with T2DM, particularly when accompanied by medication management. In particular, ILI may be an appealing option for patients wanting to minimize medication intensification. Also, ILI carries with it other potential benefits important to patients (e.g., improvements in physical functioning and QoL). Based on data from other trials, intensive medication management, such as tight glycemic control, is not without potential risks, which should be weighed in making treatment decisions. Future research is needed to determine if results observed in this trial would be replicated among younger patients, those without established T2DM, and/or those with no pre-existing CVD.

A double-blind, placebo-controlled trial related to the effects of melatonin on oxidative stress and inflammatory parameters of obese women.

Obesity, the global epidemic health problem, results in chronic disorders. Melatonin supplementation may prevent the adverse health consequences of obesity. The aim of this study was to assess the effects of melatonin supplementation on inflammatory and oxidative stress parameters in obese women. In randomized, double-blind, placebo-controlled trial, 44 obese women were randomly assigned to melatonin (n=22) and placebo (n=22) groups. Subjects were supplemented with a daily dose of 6 mg melatonin or placebo with low calorie diet for 40 days. Serum TNF-α, IL-6, hsCRP, TAC, and MDA levels were assessed before and after intervention. In the melatonin group, mean serum TNF-α, IL-6, hsCRP, and MDA levels decreased significantly (p<0.05) from 3.52±0.72 pg/ml, 27.12±6.32 pg/ml, 2.54±0.49 mg/l, and 3.81±0.29 nmol/l to 1.73±0.07, 16.34±6.32, 1.67±0.27, and 2.79±0.29, respectively. Whilst in the placebo group the decrease in values were not statistically significant. Mean TAC level increased slightly (from 1.11±0.30 to 1.14±0.45 mmol/l) in the melatonin group whereas it decreased slightly (from 1.13±0.15 to 1.08±0.21 nmol/l) in the placebo group. Significant differences were observed only for TNF-α (p=0.02) and IL-6 (p=0.03) between the 2 study groups. Considering the improvements in inflammatory and oxidative stress factors in obese women, it seems that melatonin supplementation may provide beneficial effects in obesity treatment by ameliorating some of its complications. However, further studies are needed to make concise conclusions.

Association of metabolically healthy obesity with depressive symptoms: pooled analysis of eight studies

The hypothesis of metabolically healthy obesity posits that adverse health effects of obesity are largely avoided when obesity is accompanied by a favorable metabolic profile. We tested this hypothesis with depressive symptoms as the outcome using cross-sectional data on obesity, metabolic health and depressive symptoms. Data were extracted from eight studies and pooled for individual-participant meta-analysis with 30,337 men and women aged 15-105 years (mean age=46.1). Clinic measures included height, weight and metabolic risk factors (high blood pressure, high triglycerides, low high-density lipoprotein cholesterol, high C-reactive protein and high glycated hemoglobin). Depressive symptoms were assessed using clinical interview or standardized rating scales. The pooled sample comprised 7673 (25%) obese participants (body mass index ⩾30 kg m(-2)). Compared to all non-obese individuals, the OR for depressive symptoms was higher in metabolically unhealthy obese individuals with two or more metabolic risk factors (1.45; 95% confidence interval (CI)=1.30, 1.61) and for metabolically healthy obese with ⩽1 metabolic risk factor (1.19; 95% CI=1.03, 1.37), adjusted for sex, age and race/ethnicity. Metabolically unhealthy obesity was associated with higher depression risk (OR=1.23; 95% CI=1.05, 1.45) compared with metabolically healthy obesity. These associations were consistent across studies with no evidence for heterogeneity in estimates (all I(2)-values<4%). In conclusion, obese persons with a favorable metabolic profile have a slightly increased risk of depressive symptoms compared with non-obese, but the risk is greater when obesity is combined with an adverse metabolic profile. These findings suggest that metabolically healthy obesity is not a completely benign condition in relation to depression risk.

Pediatric Obesity, Metabolic Syndrome, and Obstructive Sleep Apnea Syndrome

The prevalence of obesity in the pediatric population has dramatically increased in the last 30 years. While the adverse health effects of obesity have long been recognized in adults, many of these complications are now understood to begin in early childhood. Obese children and adolescents are significantly more likely than their peers of healthy weight to suffer from obstructive sleep apnea and metabolic syndrome. In turn, affected individuals may experience myriad serious clinical sequelae; neuro-cognitive, psychiatric, cardiovascular, and endocrinologic complications have each been extensively documented. Thus, the spectrum of obesity-related disease represents a serious but preventable threat to personal and family wellness; additionally, it is a source of considerable health care expenditure and represents a national and international health crisis. The optimal care of these patients will be best achieved through the pediatric health care provider's timely recognition of these clinical problems and knowledge of appropriate intervention strategies.

Fat Depots, Free Fatty Acids, and Dyslipidemia

Body fat deposition and excess free fatty acid (FFA) metabolism contribute to dyslipidemia and the adverse health consequences of obesity. Individuals with upper body obesity have impaired functioning of adipocytes, the primary fatty acid storage site. Excess visceral fat is strongly associated with impaired suppression of FFA release in response to insulin, as well as with hypertriglyceridemia and low concentrations of high density lipoprotein (HDL) cholesterol. High FFA concentrations can induce insulin resistance in muscle and liver. Furthermore, failure of hyperinsulinemia to normally suppress FFA is associated with impaired carbohydrate oxidation and muscle glucose storage, reduced hepatic insulin clearance and elevated triglycerides. Understanding the impact of body fat distribution on FFA metabolism and dyslipidemia is critical for determining the link between overweight and obesity and cardiovascular disease risk. In the current review, we will explore the relationship between adipose tissue, body fat depots, and FFA metabolism.

Curcumin and obesity

Turmeric has been long recognized for its anti-inflammatory and health-promoting properties. Curcumin is one of the principal anti-inflammatory and healthful components of turmeric comprising 2-8% of most turmeric preparations. Experimental evidence supports the activity of curcumin in promoting weight loss and reducing the incidence of obesity-related diseases. With the discovery that obesity is characterized by chronic low-grade metabolic inflammation, phytochemicals like curcumin which have anti-inflammatory activity are being intensely investigated. Recent scientific research reveals that curcumin directly interacts with white adipose tissue to suppress chronic inflammation. In adipose tissue, curcumin inhibits macrophage infiltration and nuclear factor κB (NF-κB) activation induced by inflammatory agents. Curcumin reduces the expression of the potent proinflammatory adipokines tumor necrosis factor-α (TNFα), monocyte chemoattractant protein-1 (MCP-1), and plasminogen activator inhibitor type-1 (PAI-1), and it induces the expression of adiponectin, the principal anti-inflammatory agent secreted by adipocytes. Curcumin also has effects to inhibit adipocyte differentiation and to promote antioxidant activities. Through these diverse mechanisms curcumin reduces obesity and curtails the adverse health effects of obesity.

Should I stay or should I go? Understanding families’ decisions regarding initiating, continuing, and terminating health services for managing pediatric obesity: the protocol for a multi-center, qualitative study

BackgroundAt least two million Canadian children meet established criteria for weight management. Due to the adverse health consequences of obesity, most pediatric weight management research has examined the efficacy and effectiveness of interventions to improve lifestyle behaviors, reduce co-morbidities, and enable weight management. However, little information is available on families’ decisions to initiate, continue, and terminate weight management care. This is an important knowledge gap since a substantial number of families fail to initiate care after being referred for weight management while many families who initiate care discontinue it after a brief period of time. This research aims to understand the interplay between individual, family, environmental, and systemic factors that influence families’ decisions regarding the management of pediatric obesity.Methods/DesignIndividual interviews will be conducted with children and youth with obesity (n = 100) and their parents (n = 100) for a total number of 200 interviews with 100 families. Families will be recruited from four Canadian multi-disciplinary pediatric weight management centers in Vancouver, Edmonton, Hamilton, and Montreal. Participants will be purposefully-sampled into the following groups: (i) Non-Initiators (5 families/site): referred for weight management within the past 6 months and did not follow-up the referral; (ii) Initiators (10 families/site): referred for weight management within the past 6 months and did follow-up the referral with at least one clinic appointment; and (iii) Continuers (10 families/site): participated in a formal weight management intervention within the past 12 months and did continue with follow-up care for at least 6 months. Interviews will be digitally recorded and analyzed using an ecological framework, which will enable a multi-level evaluation of proximal and distal factors that underlie families’ decisions regarding initiation, continuation, and termination of care. Demographic and anthropometric/clinical data will also be collected.DiscussionA better understanding of family involvement in pediatric weight management care will help to improve existing health services in this area. Study data will be used in future research to develop a validated survey that clinicians working in pediatric obesity management can use to understand and enhance their own health services delivery.