Higher Waist Circumference Research Articles

Dynapenic abdominal obesity and incident multimorbidity: findings from the English longitudinal study on ageing

BackgroundDynapenic abdominal obesity (DAO) (i.e., impairment in muscle strength and high waist circumference) is gaining interest, as it is associated with several important adverse health outcomes. However, the association between DAO and multimorbidity is largely unclear. Thus, the aim of the present study was to investigate the association between DAO at baseline and new onset multimorbidity over ten years of follow-up.MethodsPeople participating in the English Longitudinal Study of Ageing were included. DAO was defined as waist circumference > 102 cm in men and > 88 cm in women, and a concomitant presence of dynapenia (handgrip strength defined as < 27 kg for men and < 16 kg for women). Multimorbidity was defined as having two or more chronic conditions. The association between DAO and incident multimorbidity was assessed using a multivariable logistic regression analysis, reporting the data as odds ratios (ORs) and their 95% confidence intervals (CIs).ResultsOverall, 3302 participants (mean age: 63.4 years, males: 50.3%) without multimorbidity at baseline were followed-up for ten years. After adjusting for several variables, compared to participants without dynapenia nor abdominal obesity, the presence of abdominal obesity (OR = 1.505; 95%CI: 1.272–1.780; p < 0.0001) and DAO (OR = 1.671; 95%CI: 1.201–2.325; p = 0.002) significantly increased the risk of multimorbidity. Compared to no dynapenia nor abdominal obesity, DAO was associated with significantly higher risk for arthritis and diabetes.ConclusionsDAO was significantly associated with a higher risk of incident multimorbidity, over 10 years of follow-up. The results of our study suggest that addressing DAO can potentially decrease risk for multimorbidity.

METABOLIC PREDICTORS OF TARGET ORGAN DAMAGE IN ESSENTIAL HYPERTENSION

Objective: First, to verify the relationship between hypertension-mediated organ damage (HMOD) and measures of abdominal obesity in essential hypertension. Secondly, to evaluate which condition between overweight (BMI&gt;25 kg/m2), high waist circumference (WC&gt;80/94 cm in females/males) and waist-to-height ratio (WHtR&gt;0.54) is more predictive of HMOD. Design and method: We selected a cohort of adult treated essential hypertensive subjects followed at our Hypertension Center. Blood pressure (BP), height, weight and WC were measured in all subjects. Various investigations were also performed to identify HMOD, such as echocardiography, carotid ultrasound, carotid-femoral pulse wave velocity (PWV) and fundoscopy. Results: 114 subjects were enrolled (46/68 females/males, mean age 69±2 years, mean BP 135/77±3/2 mmHg). WC and WHtR were higher in patients with all expressions of HMOD except for hypertensive retinopathy. In particular, left ventricular mass index (LVMi/BSA) correlates with WHtR (p&lt;0.05), while in obese subjects, in which ventricular mass was indexed as LVMi/h2.7, both WC and WHtR significantly correlate (p&lt;0.05). In subjects with WHtR&gt;0.54, there was a significant risk of increased arterial stiffness by PWVs (OR = 2.479, p = 0.04). This data is confirmed in subjects with BMI&gt;25 kg/m2 (OR = 2.888, p = 0.04) but not in subjects with BMI&lt;25 kg/m2, while no significance was observed for high WC. In the presence of HMOD, a significantly higher number of metabolic syndrome factors (MetS) was observed (3.1 vs. 2.06, p = 0.0008). An OR of 7.55 (p = 0.01) for the presence of HMOD was observed in subjects diagnosed with MetS. Conclusions: In our population, the presence of abdominal obesity may indicate a greater risk of developing HMOD (especially left ventricular hypertrophy and increased arterial stiffness) in essential hypertensive patients. WHtR may be a more sensitive indicator than WC. Furthermore, the significant increase in the risk of HMOD in the presence of MetS may indicate that the synergy between multiple risk factors correlates more strongly with the development of HMOD. Therefore, in the management of essential hypertension, it is of great importance to combine drug therapy with a strategy of reduction of abdominal adipose tissue and the other MetS factors.

RELATION BETWEEN WAIST CIRCUMFERENCE AND THE RENAL HEMODYNAMIC IN PATIENTS WITH UNCOMPLICATED HYPERTENSION GRADE 1-2

Objective: Abdominal adiposity, measured by waist circumference (WC), is associated with increased mortality in patients with hypertension. Little is known about the impact of abdominal obesity on the renal perfusion and function in patients with hypertension. We analyzed whether abdominal adiposity changes renal hemodynamics in 36 patients with uncomplicated hypertension grade 1-2 without other cardiovascular (CV) disease. Design and method: We analysed the renal hemodynamic using steady state input clearance with infusion of para-aminohippuric acid and inulin, respectively. Intraglomerular pressure and resistances of the afferent (RA) and efferent (RE) arterioles were calculated according to the Gomez equation. The study population was divided in into two groups based on median of WC of the total study population. Results: The study cohort consisted of 36 male, non-smoking individuals, aged 36 ± 10 years with mean WC of 96.1 ± 10.4 cm and mean BMI of 27 ± 3.8 kg/m2. True hypertension was confirmed using 24-hour ambulatory blood pressure (BP) measurement. Patients in the high WC group (19 patients) showed mean office BP of 145/ 90 mmHg and mean 24-hour ambulatory BP of 139/ 86 mmHg, whereas patients in the low WC group (17 patients) showed mean office BP of 144/ 88 mmHg and mean 24-hour-ambulatory BP of 140/ 86 mmHg (office BP: p = 0.895/ p = 0.662, 24-hour-ambulatory BP: p = 0.645/ p = 0.918). Renal vascular resistance and RA were higher in the high WC compared to the low WC group, whereas glomerular filtration rate and renal plasma flow were lower in the high WC compared to the low WC group (table 1). Conclusions: Higher WC in young, male patients with hypertension grade 1-2 without other cardiovascular disease was associated with increased renal vascular resistance predominantly at the afferent site leading to reduced glomerular filtration rate.

0244 The Relationship between Sleep and Metabolic Syndrome in Late Adolescents: Racial Differences

Abstract Introduction Disparities in sleep health and metabolic syndrome (MetS) components co-exist in ethnic/racial minorities. Late adolescents (18-21 y.o.) are a high-risk, yet overlooked population to study sleep disparities and the associated metabolic health. This study aimed to examine the interaction between race and sleep health metrics on MetS components in late adolescents. Methods In this cross-sectional study, we enrolled a convenience sample of 60 college students (19.22±1.06 y.o.). Actigraph accelerometers assessed total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO) over one week. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and questions about demographic/socioeconomic information and risk behaviors. A point-of-care test provided the fasting glucose and cholesterol panel. The number (0 vs. &amp;gt;1) of MetS components, including high waist circumference, blood pressure, fasting triglycerides and glucose, and low High-Density Lipoprotein, indicated metabolic health. Logistic regression tested interaction terms controlling for adolescents’ age, sex, alcohol consumption, and parents’ education, marital status, and family income. Results Most participants (n=55; 92%) slept &amp;lt; 7 hours and 43% reported poor sleep (PSQI&amp;gt;5). More than half (n=33; 55%) had at least one MetS component. On average, White (non-Hispanic) participants had higher TST (6.07 vs. 5.63, t=1.93, p=0.06) and SE (84.89% vs. 81.07%, t=2.31, p=0.02) than their racial/ethnic minority (Black/Hispanic/Asian American/other) peers. Race significantly interacted with TST (OR=0.24, p=0.04), SE (OR=0.69, OR=0.10), and WASO (OR=1.08, p=0.02), such that associations of decreasing odds of MetS with increasing TST and SE and decreasing WASO were significant only in the racial/ethnic minority group. Furthermore, racial/ethnic minority adolescents (vs. White) had a greater MetS risk, when TST hours were at low levels (i.e., &amp;lt; 6 hours). Similarly, low SE (&amp;lt; 85%) and high WASO (&amp;gt;60 min) were associated with greater odds of MetS in racial/ethnic minority (vs. White) adolescents. PSQI scores were not independently associated with MetS or interacted with race in the association with MetS. Conclusion Unhealthy sleep is associated with increased MetS risk, particularly for racial/ethnic minority adolescents. Given the greater sensitivity to sleep health, improving sleep quantity and quality may be candidate targets for MetS interventions in at-risk populations who experience health disparities. Support (if any) American Nurses Foundation (18A01422). Center of Biomedical Research Excellence (COBRE) in cardiovascular health (P20GM113125)

Food insecurity is associated with glycemic markers, and socioeconomic status and low-cost diets are associated with lipid metabolism in Mexican mothers

The association between socioeconomic status (SES) and chronic disease has recently become more evident in middle- and low-income countries. We hypothesized that poor socioeconomic conditions, such as food insecurity, low educational level, or low SES, may restrict access to a healthy diet and may be associated with cardiometabolic risk independently of body fat. This study examined the relation between socioeconomic indicators, body fat, and cardiometabolic disease risk markers in a random sample of mothers living in Queretaro, Mexico. Young and middle-aged mothers (n = 321) answered validated questionnaires to determine SES, food insecurity, and educational level and a semiquantitative food frequency questionnaire to determine dietary patterns and the cost of individual diet. Clinical measurements included anthropometry, blood pressure, lipids profile, glucose, and insulin. Obesity was present in 29% of the participants. Women with moderate food insecurity had higher waist circumference, glucose, insulin, and homeostasis model assessment of insulin resistance than women with food security. High triglyceride concentration and lower levels of high-density lipoprotein and low-density lipoprotein cholesterol were associated with lower SES and lower educational level. Women who consumed a lower carbohydrate diet had higher SES, higher education, and better cardiovascular risk markers. The higher carbohydrate diet profile was the least expensive diet. There was an inverse association between the cost and energy-density of foods. In conclusion, food insecurity was associated with glycemic control markers, and lower SES and education were related to a low-cost, higher carbohydrate diet and to a greater cardiovascular risk. The influence of the social environment on obesity and cardiovascular diseases needs to be further explored.

A novel criterion of metabolically healthy obesity could effectively identify individuals with low cardiovascular risk among Chinese cohort.

Obesity has become a serious public health problem and brings a heavy burden of cardiovascular disease. Metabolically healthy obesity (MHO) is defined as individuals with obesity with no or only minor metabolic complications. Whether individuals with MHO have a lower cardiovascular risk remains controversial. In this study, a new criterion was used to define MHO and assess its predictive value for cardiovascular events and death. At the same time, the new criterion and the traditional criterion are compared to analyze the differences between different diagnostic criteria. A prospective cohort was established in northeast rural China from 2012 to 2013. Follow-up was conducted in 2015 and 2018 to investigate the incidence of cardiovascular events and survival. Subjects were grouped according to the metabolic health and obesity status. Kaplan-Meier curves were drawn to describe the cumulative risk of endpoint events in the four groups. Cox regression analysis model was constructed to evaluate the risk of endpoint events. Analysis of variance and post hoc analyses were used to calculate and compare differences in metabolic markers between MHO subjects diagnosed by novel and traditional criteria. A total of 9345 participants 35 years of age or older without a history of cardiovascular disease were included in this study. After a median follow-up of 4.66 years, the data showed that participants in the MHO group had no significant increase in the risk of composite cardiovascular events and stroke, but had a 162% increase in the risk of coronary heart disease (HR: 2.62; 95%CI: 1.21-5.67). However, when using conventional criteria for metabolic health, mMHO group had a 52% increase in combined CVD risk (HR: 1.52; 95%CI: 1.14-2.03). By comparing the differences of metabolic indicators between MHO subjects diagnosed by the two criteria, MHO subjects diagnosed by the new criterion had higher WC, WHR, TG, FPG, and lower HDL-C levels except for lower blood pressure, showing more exposure to cardiovascular risk factors. The risk of combined CVD and stroke was not increased in MHO subjects. The new metabolic health criterion is superior to the traditional criterion and can effectively identify individuals with obesity with a lower risk of combined CVD. Blood pressure levels may be responsible for the inconsistent risk of combined CVD in MHO subjects diagnosed with both criteria.

Association between markers of adiposity during childhood and puberty onset in Latino girls.

Prepubertal adiposity is associated with earlier puberty. It is unclear when this association starts, if all adiposity markers are similarly associated, and whether all pubertal milestones are similarly affected. To evaluate the association between different adiposity markers during childhood and the timing of different pubertal milestones in Latino girls. Longitudinal follow-up of 539 female participants of the Chilean Growth and Obesity Cohort (GOCS) recruited from childcare centers (mean age 3.5y) from the South East area of Santiago, Chile. Participants were singletons born between 2002-2003 within the normal birthweight range. Since 2006, a trained dietitian measured weight, height, waist circumference (WC) and skinfolds to estimate BMI CDC percentiles, central obesity, fat mass (%FM) and fat mass index (FMI = fat mass/height2). since 2009, sexual maturation was assessed every 6 months to assess age at: i) thelarche, ii) pubarche, iii) menarche, and iv) age at peak height velocity (PHV). At thelarche, 12.5% were obese and 2% had central obesity. The median age of pubarche, menarche, and PHV were all associated with markers of adiposity at different time points during childhood; whereas thelarche only with %FM and FMI. Adiposity clusters models showed that children with trajectories of high WC, %FM and FMI during childhood were related with earlier thelarche, pubarche, menarche and PHV; BMI trajectories only with menarche and PHV. Higher WC, %FM and FMI were associated with earlier age at thelarche, pubarche, menarche, and PHV. The effect of BMI was less consistent.

Gender differences in the impact of 3-year status changes of metabolic syndrome and its components on incident type 2 diabetes mellitus: a decade of follow-up in the Tehran Lipid and Glucose Study.

The aim of this study was to examine the gender differences in the association between status changes of metabolic syndrome (MetS) and its components, using Joint Interim Statement (JIS) criteria, with the risk of type 2 diabetes mellitus (T2DM) among an urban population. The study included 4,463 Iranian adult participants (2,549 women) aged ≥20 years. Based on status changes of MetS and its components during 3 years, subjects were categorized into four groups: MetS-free (reference), MetS-developed, MetS-recovery, and MetS-stable. A similar categorization was applied to MetS components. Multivariable Cox regression models were used for estimating hazard ratios (HRs) and women-to-men ratios of HRs (RHRs). During a median follow-up of 9.3 years, 625 T2DM events (351 women) occurred. Compared with the reference, the HRs of the MetS-developed, -recovery, and -stable groups among men for incident T2DM were 2.90, 2.60, and 4.92; the corresponding values for women were 2.73, 2.88, and 5.21, respectively (all p-values < 0.01), without significant gender difference in these relationships. In both genders, the fasting plasma glucose (FPG) component, regardless of the change in status, was strongly and significantly associated with incident T2DM with HRs ranging from 2.49 to 9.42; a similar association was also found for high waist circumference (WC)-recovery and -stable groups, with HRs ranging from 1.58 to 2.85 (p-values ≤ 0.05). Regarding gender differences, the development and persistence of high blood pressure (BP) status exposed men to greater T2DM risk than women with women-to-men RHRs of 0.43 (0.26-0.72) and 0.58 (0.39-0.86), respectively. Moreover, stable low levels of high-density lipoprotein cholesterol (HDL-C) and high triglyceride (TG) levels conferred higher T2DM risk in women than in men, with women-to-men RHRs of 1.67 (0.98-2.86) and 1.44 (0.98-2.14), respectively (both p-values = 0.06). Among Tehranian adults, in both genders, all status changes of MetS, even those recovered from MetS, have a higher risk of T2DM compared to those who never had MetS. Also, all statuses of high FPG, in addition to recovered and stable high WC, were strongly associated with T2DM risk. Specifically, men with stable or developed high BP and women with stable dyslipidemic status were at differentially increased risk of incident T2DM.

High sweet foods and low life satisfaction can act as risk factors for acute coronary syndrome through synergistic interaction

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health &amp; Welfare, Republic of Korea. Background Dietary and psychological factors contribute to development of coronary artery disease (CAD). However, contributing components of these lifestyle factors may vary depending on ethnic and cultural background, and secondary prevention programs dealing with these factors in specific population are not well established. Aims We aimed to analyze dietary and psychological characteristics and independent risk factors in Korean patients with acute coronary syndrome (ACS). Methods Ninety-two patients with ACS (29 acute myocardial infarction, 63 unstable angina) and 69 controls were subject to analysis of lifestyle factors focused on dietary and psychological status. Dietary intake was assessed by a food frequency questionnaire (FFQ) using the KoGES software and Can-Pro 4.0. Psychological depression and perceived stress were measured with the Patient Health Questionnaire 9 (PHQ-9) and the Korean version of Perceived Stress Scale (K-PSS), respectively. In additions, eight domains of life satisfaction was assessed with the Domain Satisfaction Questionnaire (DSQ). Results ACS group had more men (79% vs 61%) and was older (53 yr vs. 49 yr), less physically active, and higher waist circumference and BMI than controls. Dietary analyses showed that ACS group had more intakes of sweets and fish/seafood in both men and women compared to controls. Psychological analyses showed that ACS group had higher depressive symptom (5.4 vs. 4.2, p&amp;lt;0.05) and less total DSQ scores (average satisfaction scores across the 8 life domains: 4.2 vs. 4.7, p&amp;lt;0.001) along with the lower DSQ scores of all 8 individual domains (love relationship, leisure, standard of living, job, health, family life, sex life, and self). There was a modest but significant linear inverse correlation between daily sweet intakes and total DSQ score (r = -0.23, p=0.01). Sweets (OR: 4.57, 95% CI: 1.94-11.40) and total DSQ scores (OR: 0.34, 95% CI: 0.14-0.81) were identified, by multivariate logistic regression analysis, as independent risk factors that synergistically as well as individually contribute to development of ACS. Conclusions High sweet food intake and low life satisfaction can act as independent risk factors for ACS through interactive mechanism. These data also highlight the importance of the role of positive psychological factor in cardiovascular health.

Field Synopsis of Environmental and Genetic Risk Factors of Sporadic Early-Onset Colorectal Cancer and Advanced Adenoma.

To systematically appraise and synthesize available epidemiologic evidence on the associations of environmental and genetic factors with the risk of sporadic early-onset colorectal cancer (EOCRC) and early-onset advanced colorectal adenoma (EOCRA). Multiple databases were comprehensively searched to identify eligible observational studies. Genotype data from UK Biobank were incorporated to examine their associations with EOCRC in a nested case-control design. Meta-analyses of environmental risk factors were performed, and the strength of evidence was graded based on predefined criteria. Meta-analyses of genetic associations were conducted using the allelic, recessive, and dominant models, respectively. A total of 61 studies were included, reporting 120 environmental factors and 62 genetic variants. We found 12 risk factors (current overweight, overweight in adolescence, high waist circumference, smoking, alcohol, sugary beverages intake, sedentary behavior, red meat intake, family history of colorectal cancer, hypertension, hyperlipidemia, and metabolic syndrome) and three protective factors (vitamin D, folate, and calcium intake) for EOCRC or EOCRA. No significant associations between the examined genetic variants and EOCRC risk were observed. Recent data indicate that the changing patterns of traditional colorectal cancer risk factors may explain the rising incidence of EOCRC. However, research on novel risk factors for EOCRC is limited; therefore, we cannot rule out the possibility of EOCRC having different risk factors than late-onset colorectal cancer (LOCRC). The potential for the identified risk factors to enhance the identification of at-risk groups for personalized EOCRC screening and prevention and for the prediction of EOCRC risk should be comprehensively addressed by future studies.

Area-level associations of travel behaviour metrics with waist circumference: findings from linkage of travel and health surveys

Individual-level analyses have consistently shown associations of travel behaviours with obesity-related measures. However, transport planning policies often target areas rather than individuals. To better inform transport-related policies and initiatives for obesity prevention, area-level relationships need to be investigated. This study linked data from two travel surveys with data from the Australian National Health Survey at the level of Population Health Areas (PHAs) and examined to what extent area-level travel behaviours metrics (prevalence of active travel, mixed travel and sedentary travel, diversity of travel modes) were associated with the rate of high waist circumference. Data from 51,987 travel survey participants were aggregated into 327 PHAs. Bayesian conditional autoregressive models were used to account for spatial autocorrelation. It was found that statistically replacing participants who relied on cars for travel (without walking/cycling) with those engaging in 30+ min/d of walking/cycling (without car use) was associated with a lower rate of high waist circumference. Areas with greater diversity of travel modes (mix of walking/cycling, car use, public transport use) also had lower prevalence of high waist circumference. This data-linkage study suggests that area-level transport planning strategies addressing car dependency, shifting car use to walking/cycling over 30 min/d, may help to reduce obesity.

The impact of general and central obesity for all-cause hospitalization among Iranian adults: a 20 year follow-up-results from the TLGS cohort

BackgroundFew studies have examined the effect of obesity indices on total number of hospitalizations. We examined the associations between body mass index (BMI) and waist circumference (WC) and rate of all-cause hospitalizations among Iranian adult participated in the Tehran Lipid and Glucose Study cohort.MethodsThis study included 8202 individuals (3727 men) aged ≥ 30 years, who were followed for a median of 18 years. Participants were categorized into three groups according to their baseline BMI: normal weight, overweight and obese. In addition, they were classified according to WC in two categories: normal WC and high WC. Negative Binomial regression model was used to estimate the incidence rate ratios (IRRs) and 95% confidence interval (95% CI) of all-cause hospitalizations in relation to obesity indices.ResultsThe overall crude rate of all-cause hospitalizations were 77.6 (95% CI, 73.9–81.2) and 76.9 (73.4–80.3) per 1000 person-year in men and women, respectively. The covariate adjusted rate of all-cause hospitalizations was 27% higher in obese men than normal weight men (IRR (95% CI): 1.27 (1.11–1.42)). Among women, overweight and obese individuals had 17% (1.17 (1.03–1.31)) and 40% (1.40 (1.23–1.56)) higher rate of hospitalization compared to normal weight women. Having high WC was associated with 18% (1.18 (1.08–1.29)) and 30% (1.30 (1.18–1.41)) higher rate of all-cause hospitalization in men and women, respectively.ConclusionsObesity and high WC were associated with increased hospitalization rates during long-term follow-up. Our findings suggests that successful obesity prevention programs may decrease the number of hospitalizations, particularly, in women.

High fat in blood and body and increased risk of clinically diagnosed non-alcoholic fatty liver disease in 105,981 individuals

Background and aimsHigh caloric diets rich in fat and carbohydrates lead to increased fat accumulation in adipose tissue and blood. This may lead to increased risk of non-alcoholic fatty liver disease. We hypothesized that baseline high nonfasting plasma triglycerides, body mass index (BMI), and waist circumference, individually and combined, associate with increased risk of clinically diagnosed non-alcoholic fatty liver disease during follow-up. MethodsCohort of 105,981 white Danish individuals recruited in 2003–2015 with end of follow-up on December 13th, 2018. Mean follow-up was 9.2 years during which time 418 were clinically diagnosed at hospitals with non-alcoholic fatty liver disease. ResultsRisk of clinically diagnosed non-alcoholic fatty liver disease increased with higher plasma triglycerides, higher BMI, and with higher waist circumference, continuously and stepwise using multivariable adjusted hazard ratios and cumulative incidences. Combining clinical categories of plasma triglycerides with BMI or waist circumference categories, illustrated an almost additive risk with increasing categories. Compared with plasma triglycerides of <1 mmol/L and BMI <25 kg/m2, the multivariable adjusted hazard ratio was 5.2(95% confidence interval: 1.3–21.6) for individuals with both plasma triglycerides of ≥5 mmol/L and BMI ≥35 kg/m2. The corresponding hazard ratio for individuals with plasma triglycerides ≥5 mmol/L and waist circumference was >88 cm for women and >102 cm for men was 4.8(2.3–9.7). Triglyceride results were more pronounced in women versus men. ConclusionsHigh fat in blood and body measured by plasma triglycerides, BMI, and waist circumference, individually and especially combined, are associated with up to a 5-fold increased risk of clinically diagnosed non-alcoholic fatty liver disease.

Predictability of the Development of Insulin Resistance Based on the Risk Factors Among Female Medical Students at a Private College in Saudi Arabia.

Insulin resistance (IR) is currently an underlying phenomenon in the etiology of mostnon-communicable diseases. IR has been proposed as the key linking factor for the metabolic syndrome disease cluster of glucose intolerance. This study's target was to assess the predictability of risk factors for IR among female medical students Methods: A cross-sectional study involving female medical students was carried out. The sample size was 272, and a suitable non-probability sampling method was employed. A correlation test was done, and a P value less than 0.05 is considered statistically significant.Each participant underwent assessment of anthropometric measurements and biochemical testing. For assessing lifestyle, validated questionnaires on physical activity, sleep pattern, dietary pattern, and stress were adopted. The anthropometric data such as height, weight, and waist circumference were collected. Biochemical testing involved estimation of the postprandial capillary blood glucose level on campus. Additionally, systolicblood pressure and diastolic blood pressurewere measured. The association of lifestyle risk factors with waist circumference as an indicator of IR was done wherethe majority of those with high waist circumference were physically inactive and more prone to stress which was statistically significant when compared to those with normal waist circumference. However, poor sleep and unhealthy diet were high among those with high waist circumference, but they were not statistically significant. The correlation of waist circumference as an indicator of IR was highly significant with body mass index, postprandial blood sugar, systolic blood pressure, and diastolic blood pressure. A series of unhealthy lifestyle habits was contributable to developing obesity and therefore IR among medical students in Saudi Arabia.

Association between plant-based diets and metabolic syndrome in obese adults from Iran: a cross-sectional study

BackgroundMetabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity.MethodsIn Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed.ResultsThe average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m2. There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54–1.47), hPDI (OR: 0.82; 95% CI: 0.48–1.40), and uPDI (OR: 0.83; 95% CI: 0.87–2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13–5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04–6.04) and second (OR: 2.58; 95% CI: 1.05–6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass.ConclusionWe found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings.

Prevalence of persistent symptoms after having COVID-19 in a cohort in Suriname.

To determine the prevalence of persistent symptoms after having coronavirus disease 2019 (COVID-19) in a cohort in Suriname, and assess the factors associated with long COVID. A sample of adults 18 years and older who were registered 3-4 months previously in a national database because of a positive COVID-19 test were selected. They were interviewed about socioeconomic characteristics, pre-COVID-19 health status and lifestyle, and symptoms during and after COVID-19. A subset of participants underwent a physical examination to determine body mass index, waist circumference, cardiovascular parameters, lung function, and functionality. A total of 106 participants (mean age 49 (standard deviation 15) years; 62.3% female) were interviewed, of whom 32 were physically examined. The greatest proportion of participants was of Hindustani descent (22.6%). Overall, 37.7% of participants were physically inactive, 26.4% had hypertension or diabetes mellitus, and 13.2% had been previously diagnosed with heart disease. Most participants (56.6%) had experienced mild COVID-19 and 14.2% had experienced severe COVID-19. A large proportion (39.6%) had experienced at least one persistent symptom after recovery from acute COVID-19 and more women were affected (47.0% of women versus 27.5% of men). Fatigue and alopecia were the most common symptoms, followed by dyspnea and sleep disturbance. Differences were observed between ethnic groups. Based on physical examination, 45.0% of the subset was obese and 67.7% had very high waist-circumference. About 40% of the cohort had at least one persistent symptom 3-4 months after having had COVID-19, with differences observed by sex and ethnic group.

Association of Body Mass Index and Cardiometabolic Factors With Elderly Suicide: A Cohort Study of 101,518 Older Taiwanese

Older people have the highest suicide rate across age groups in most countries. The prevalence of cardiometabolic risk factors also increases with age. We investigated the association between body mass index (BMI), cardiometabolic risk factors, and suicide in a large cohort of older people in Taiwan. We conducted a cohort study using data from an elderly health examination program in Taipei City, Taiwan (2005-2010), linked to the national cause-of-death data files. We used competing risk Cox regression models to investigate the associations of BMI (kg/m2) and cardiometabolic factors with suicide after adjusting for sex, age, socioeconomic variables, chronic diseases, psychological distress, and cognitive function. Among 101,518 individuals aged ≥ 65 years, 92 died by suicide during an average follow-up of 3.9 years. Underweight (BMI<18.5) was associated with increased suicide risk (adjusted hazard ratio [aHR]=2.33, 95% confidence interval [CI] 1.20-4.52) (reference: normal weight). Low diastolic blood pressure was associated with increased suicide risk - aHR was 0.51 (95% CI 0.29-0.91) and 0.55 (95% CI 0.31-0.99) for the third and fourth quartiles of diastolic blood pressure (reference: the lowest quartile), respectively. Older people with a higher waist circumference (aHR per 1-standard-deviation increase=0.60 [95% CI 0.37-0.98]) and a higher number of metabolic syndrome criteria (aHR per 1-criterion increase=0.65 [95% 0.46-0.92]) had lower suicide risk. Systolic blood pressure, pulse rate, fasting blood glucose, and lipid profiles were not associated with suicide risk. Underweight, low diastolic blood pressure, and low waist circumference may be markers of increased suicide risk in older people.

The correlation between Body Mass Index and histological features of Nonalcoholic Fatty Liver Disease.

Introduction: NAFLD is strongly associated with metabolic syndrome, and for many years, fatty liver was an exclusive feature of obese patients. The study tries to assess whether the body mass index (BMI) and body circumference is correlated to steatosis, fibrosis, or inflammatory activity of the liver. Methods: 81 patients with recent hepatic biopsy were included in the study and were weighed and measured. The biopsy results were compared to the measurements. Results: The average BMI overall for the whole lot was 30.16. There was a significant difference in BMI across the inflammatory activity categories (p=0.009): groups with higher necro inflammatory activity tended to have higher BMI values (average values per grade: 0 - 28, 1 - 29, 2 - 33, 3 - 32, 4 - 29). There was no significant difference for grades of steatosis (p=0.871). With regards to waist circumference, the overall average was 90.70cm/35.70in. There was a significant difference across the steatosis categories (p<0.001): groups with higher steatosis scores had higher waist circumferences (average values per grade: 1 - 77cm / 30 in, 2 - 95 cm / 37 in, 3 - 94 cm / 37 in). There was no significant difference for grades of activity (p=0.058). Conclusion: BMI and waist circumference are easy to measure, non-invasive parameters, which could be useful in screening patients at higher risk for necro inflammatory activity or severe steatosis.

Prevention and Interventional Strategies of Adolescent Obesity / Overweight - Systematic Review and Meta-analysis of 10 Years Research

The purpose of this review was to reach a consensus on the evidence of the literature investigating multiple school-based interventions (physical activity, diet, and sedentary behavior) to prevent or reduce high body mass index z-score and waist circumference among adolescents. A systematic search of five electronic databases: Pubmed, MEDLINE, Science Direct Index, HINARI, and Google Scholar were conducted to identify published studies between January 2010 and December 2020. Only studies that used randomized controlled trials to assess the effects of physical activity and/or physical education, nutritional education and/or dietary behavior, and sedentary behavior on adolescents’ body mass index z-score and waist circumference were included. The risk of bias in credible studies was evaluated using the Standard Cochrane tool. A random effects model was used to assess the impact of the interventions included on the waist circumference and body mass index z-score. Of the 2,090 citations reviewed, n = 1,954 (789 interventions, 1,165 controls) from five studies were included. Overall, a minimally significant reduction was found in BMI z-score MD -0.05 [95% CI: -0.20, 0.11, p-value &lt; 0.0001, I2 = 87%] and waist circumference MD -0.97 [95% CI: -1.53, -0.42, p-value = 0.26, I2 = 25%] between 3 to 12 months than 12 to 24 months. Multiple school-based interventions for adolescents that last between three and twelve months are more successful. Further study should focus on the effect of coupled components on the efficacy of multicomponent therapies integrated with theoretical/conceptual aspects.

Investigation of the relationship between sleep-related parameters and metabolic syndrome (MetS) among youths in the Southeast of Iran

Background and aimThere are few studies and inconsistent findings on the role of sleep-related parameters in the development of metabolic syndrome (MetS) among youths. In this study, we aim to investigate the relationship between sleep-related parameters and MetS among youths in a large sample size in Rafsanjan, a region in the southeast of Iran.MethodsThe current cross-sectional study was performed on 3,006 young adults aged 15–35, who registered for Rafsanjan Youth Cohort Study (RYCS), as part of Rafsanjan Cohort Study (RCS)). In fact, RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, we included 2,867 youths after excluding some subjects with missing information on MetS components. MetS was diagnosed based on Adult Treatment Panel III (ATP III) criteria. Besides, data on sleep-related parameters were collected by self-report questionnaires.ResultsThe overall prevalence of MetS was 7.74% among the participants. In addition, bedtime, wake time, napping, night shift work, and sleep duration per night and day had no association with the higher odds of having MetS. In contrast, long sleep duration at night was associated with the lower odds of high waist circumference (WC) (OR: 0.82,95% CI :0.67–0.99).ConclusionIn the present study, long sleep duration at night was associated with lower odds of central obesity. However, more longitudinal studies with the objective measurement of sleep-related parameters are needed to verify the associations reported in the current study.