Increasing Prevalence Of Obesity Research Articles

Causes of obesity: a review

Obesity research is advancing swiftly, but the increase in obesity prevalence is faster. Over the past three decades, researchers have found that biopsychosocial factors determine weight gain much more than personal choices and responsibility. Various genes have found to predispose people to obesity by interacting with our obesogenic environment. In this review, we discuss the impact of physical inactivity, excessive caloric intake, intrauterine environment, postnatal influences, insufficient sleep, drugs, medical conditions, socioeconomic status, ethnicity, psychosocial stress, endocrine disrupting chemicals and the gastrointestinal microbiome, on the occurrence of obesity.

Impact of Food Environments on Obesity Rates: A State-Level Analysis.

Limited access to healthy food in areas that are predominantly food deserts or food swamps may be associated with obesity. Other unhealthy behaviors may also be associated with obesity and poor food environments. We calculated Modified Retail Food Environment Index (mRFEI) to assess food retailers. Using data collected from the Behavioral Risk Factor Surveillance System (BRFSS) survey, the NJ Department of Health (NJDOH), and the US Census Bureau, we conducted a cross-sectional analysis of the interaction of obesity with the food environment and assessed smoking, leisure-time physical activity (LPA), and poor sleep. There were 17.9% food deserts and 9.3% food swamps in NJ. There was a statistically significant negative correlation between mRFEI and obesity rate (Pearson's r -0.13, p < 0.001), suggesting that lack of access to healthy food is associated with obesity. Regression analysis was significantly and independently associated with increased obesity prevalence (adjusted R square 0.74 and p=0.008). Obesity correlated positively with unhealthy behaviors. Each unhealthy behavior was negatively correlated with mRFEI. The mean prevalence for smoking, LPA, and sleep <7 hours was 15.4 (12.5-18.6), 26.5 (22.5-32.3), and 37.3 (34.9-40.4), respectively. Obesity tracks with food deserts and especially food swamps. It is also correlated with other unhealthy behaviors (smoking, LPA, and poor sleep).

Obesity Severity Predicts Patient Dissatisfaction After Total Knee Arthroplasty

BackgroundPatient dissatisfaction has been reported in 15 to 20% of traditional total knee arthroplasty (TKA) procedures. While contemporary improvements may have positive effects on patient satisfaction, these may be offset by increasing obesity prevalence among patients who have knee osteoarthritis. We performed this study to determine whether obesity severity impacts patient-reported TKA satisfaction. MethodsWe compared patient demographic characteristics, preoperative expectations, preoperative and minimum 1-year postoperative patient-reported outcome measures as well as postoperative satisfaction level among 229 patients (243 TKAs) who had World Health Organization (WHO) Class II or III obesity (group A), and 287 patients (328 TKAs) who had WHO classifications of normal weight, overweight, or Class I obesity (group B). ResultsGroup A patients were younger and had more severe preoperative back and contralateral knee pain, more frequent preoperative opioid medication use, and lower preoperative and postoperative patient-reported outcome measures (P < .01). A similar proportion of patients in both groups expected at least 75% improvement (68.5 versus 73.2%, P = .27). While satisfaction was higher than traditional reporting for both groups (89.4 versus 92.6%, P = .19), group A patients were less likely to be highly satisfied (68.1 versus 78.5%, P = .04) and were more likely to be highly dissatisfied (5.1 versus 0.9%, P < .01). ConclusionsPatients who have Class II and III obesity report greater TKA dissatisfaction. Additional studies should help determine whether specific implant designs or surgical techniques may improve patient satisfaction or whether preoperative counseling should incorporate lower satisfaction expectations for patients who have WHO Class II or III obesity.

THE RISK OF DEGENERATIVE DISEASES BASED ON ENERGY CONSUMPTION AND EXERCISE HABITS

Obesity triggers the risk of degenerative diseases. An unhealthy diet and insufficient physical activity have been contributing to the rapid increase in obesity prevalence. This study aims at determining the differences in the risk of degenerative diseases based on energy consumption and exercise habits of City Disaster Management Board/DMB members, especially in Denpasar City. This research is an observational study, targeting all members of Denpasar DMB as a population. Samples were taken purposively with a total of 126 people. The risk difference was tested using chi-square, and the estimated risk of degenerative diseases was analyzed using the Mantel-Haentzel odds ratio. The risk of degenerative diseases based on energy consumption shows a significant risk only in the group of people who did not have exercise habits (Q-suare=4.53; p=0.03), with an estimated risk that is also significant (OR=2.48; 95% CI= 1.07 - 5.74). The estimated risk results indicated that exercise habit is a potential confounding variable in the risk of degenerative diseases based on energy consumption. Lowering energy consumption is not effective enough to prevent the increase of degenerative disease risk, and prevention of new risks of degenerative diseases must include regular exercise.

SAT-436 - The impact of projected increases in obesity prevalence on incident liver disease in the UK: insights from bayesian-network modelling

SAT-436 - The impact of projected increases in obesity prevalence on incident liver disease in the UK: insights from bayesian-network modelling

Developing Effective Strategies for Obesity Prevention.

Nutrition policies can work with clinical treatments to address the obesity epidemic. The United States has passed beverage taxes at the local level and calorie labeling mandates at the federal level to encourage healthier consumption. Nutritional changes to federal nutrition programs have been either implemented or suggested; evidence shows that the changes that have been implemented have resulted in improvements in diet quality and are cost-effective in decreasing the increase in obesity prevalence. A comprehensive policy agenda that addresses risk of obesity on multiple levels of the food supply will have meaningful long-term effects on obesity prevalence.

PREVALENCE CHANGE IN THE PREVALENCE OF HYPERTENSION AND CARDIOMETABOLIC RISK FACTORS IN PURE COLOMBIA COHORT (2005-2021)

Objective: Describe the change in the prevalence of hypertension (HTA) and cardiometabolic risk factors (RF's) in PURE Colombia cohort during the period 2005-2021. Design and method: Design: Cohort study. Methods: 7552 adults participants of the PURE Colombia cohort from 11 departments (Atlántico, Bolívar, Caldas, Casanare, Cauca, Cesar, Cundinamarca, Nariño, Quindío, Santander, Tolima) followed up for a mean of 13 years (SD 2.3). A descriptive analysis was used to document the changes in prevalence of HTA and associated RF's such as body mass index (BMI), waist-hip ratio (WHR), and level of physical activity (PA) in the follow-up period 2005-2021. PA is divided into three levels and measured in metabolic equivalent of task (METs). Results: Of the participants, 64% were women, with a mean age at follow-up of 65 years (SD 9.7). Overall, the prevalence of HTA increased by 12% (p&lt;0.001), reaching values of 47.5% and 51.5% in men and women, respectively. In addition, there was an increase in obesity prevalence (BMI &gt; 30) in both men and women (increases of 6.8 and 5.8 %, respectively, p&lt;0.001,), reaching an overall prevalence of 25% in the population. Consist with this, WHR increased from 0.93 to 0.95 in men (p&lt;0.001) and from 0.86 to 0.89 in women (p&lt;0.001Finally, we found that there was a global increase in the number of people with a low level of PA (17.7 to 43.8% p&lt;0.001). Conclusions: We observed a significant increase in the prevalence of cardiometabolic RF's and HTA after over a decade of follow-up of adults in a middle-income American country. Increases in modifiable RF's such as higher BMI and WHR and reduced numbers with adequate PA concurrent with the trends in HTA suggest a positive relationship between them and reaffirm the necessity to emphasize strategies focused on potentially modifiable lifestyle RF's.

Obesity as a causal risk factor for depression: Systematic review and meta-analysis of Mendelian Randomization studies and implications for population mental health

Background/objectivesObesity has been associated with elevated risk of depression. If this association is causal, the increasing obesity prevalence might lead to worsening population mental health, but the strength of the causal effect has not been systematically evaluated. Subjects/methodsThe current study provides a systematic review and meta-analysis of studies examining associations between body mass index and depression using Mendelian randomization with multiple genetic variants as instruments for body mass index. We used this estimate to calculate the expected changes in prevalence of population psychological distress from the 1990s–2010s, which were compared with the empirically observed trends in psychological distress in the Health Survey for England (HSE) and U.S. National Health Interview Surveys (NHIS). ResultsMeta-analysis of 8 Mendelian randomization studies indicated an OR = 1.33 higher depression risk associated with obesity (95% confidence interval 1.19, 1.48). Between 15% and 20% of the participants of HSE and NHIS reported at least moderate psychological distress. The increase of obesity prevalence from the 1990s–2010s in HSE and NHIS would have led to a 0.6 percentage-point increase in population psychological distress. ConclusionsMendelian randomization studies suggest that obesity is a causal risk factor for elevated risk of depression. The increasing obesity rates may have modestly increased the prevalence of depressive symptoms in the general population. Mendelian randomization relies on methodological assumptions that may not always hold, so other quasi-experimental methods are needed to confirm the current conclusions.

Association Abdominal Obesity with Dietary Habits and demographic Variables among Students at Southern Technical University

Obesity and overweight are still very common diseases affecting most regions of the world. According to studies, the increasing obesity prevalence in both adults and children of all ages, regardless of geography, race, or socioeconomic status. The Abdominal obesity is featured by fat accumulation in abdomen or atrophy of the large muscle group or both. So, the waist circumference (WC) is greater than the hip circumference (higher WHR) because of the accumulation of fat inside the abdomen. This study aims to find an association between abdominal obesity and dietary habits. Materials and methods: A cross-sectional survey; of 384 participants randomly selected from the formations of the Southern Technical University in Basra Governorate southern Iraq from (The College of Health and Medical Technologies, Technical College Administrative. Technical College of Engineering and Technical Institute in Basra) the data was gathered by conducting in-person interviews with the participants and utilizing thorough self-reporting survey questionnaires. Results: The present study reveals that more than half (51.0%) of students rest in the normal range. While 49.0% of them have abdominal obesity. Conclusion: With the exception of rice and soft drinks, the results of the current study showed no significant correlation between dietary habits and WC. To address the high incidence of abdominal obesity, among university students who need health education programs.

Impact of cuts to local authority spending on cultural, environmental and planning services on inequalities in childhood obesity in England: A longitudinal ecological study.

Almost 20% of children in England are living with obesity by the end of primary school, with marked and growing inequalities driven by increasing prevalence in more deprived areas. Neighbourhood environments are upstream determinants of childhood weight status. Cultural, Environmental and Planning (CEP) services delivered by local authorities (LAs) in England include various services that contribute to these local environments, e.g. leisure centres, parks, playgrounds, libraries, community safety and environmental protection. Children in deprived areas potentially benefit most from the provision of these universal services. Spending on CEP services has been cut dramatically over the past decade, especially in more deprived areas. Given the potential link between these services and childhood obesity, we examined whether recent cuts in LA spending on CEP services are associated with trends and inequalities in obesity. We compiled annual data (2009-2017) on CEP spending in 324 LAs in England, from Ministry of Housing, Communities and Local Government reports. Obesity prevalence data for Year 6 children were obtained from the National Child Measurement Programme, for LAs and Middle-layer Super Output Areas (MSOAs). Following descriptive and pooled OLS analyses, we used fixed effects panel regression to estimate associations between CEP spending and obesity prevalence, within LAs over time, adjusting for potential confounding by local economic conditions and spending on other public services. Final models included an interaction term between area deprivation (2015 IMD) and year to account for differential background trends in obesity across deprivation levels. We tested for effect modification by deprivation and, using MSOA-level obesity data, explored associations between spending and within-LA obesity inequalities. In unadjusted pooled OLS analyses, areas with higher CEP spending had higher prevalence of obesity, reflecting the strong social gradient in childhood obesity and the higher levels of central government funding allocated to more deprived areas. Deprivation, other spend, and local economic conditions explained this relationship. In the fixed effects analysis, designed to isolate average within-area change in obesity associated with changing spend, we observed a 0.10 percentage point increase in obesity prevalence for each 10% reduction in spend (95%CI: 0.04,0.15; p<0.001), but this disappeared after accounting for differential background trends in obesity across deprivation levels (-0.02; 95%CI: 0.07,0.03; p=0.39). Similar results were observed for obesity inequalities, although sensitivity analyses suggest spending on Environmental Services in particular may affect inequalities in urban local authorities. CEP spending levels may influence local childhood obesity risk, but the increasing prevalence and widening inequalities in obesity of the past decade seem to have been driven mainly by factors other than CEP spending cuts, that are also unevenly distributed across deprivation levels. The influence of specific services might be obscured by grouping CEP services for analysis.

Laboratory Findings in Children with Excess Body Weight in Romania.

Background and Objectives: Childhood obesity has been increasing at a worrisome pace and emerging as a non-infectious pandemic in the pediatric population in recent years. Raising awareness on this problem is of utmost importance, in order to take action to control body weight from an early age. Materials and Methods: We performed a retrospective study among overweight or obese children evaluated on an outpatient basis in the Department of Pediatric Endocrinology of a tertiary care hospital in Bucharest Romania in 2021 in order to identify laboratory changes occurring according to age and sex. Results: A total of 268 children were included in the analysis, with a median age of 10.9 years (IQR: 8.3, 13.3 years); 61.8% were obese and 38.2% overweight. We identified a subclinical pro-inflammatory status characterized by increased neutrophil count (12.7%) and increased C-reactive protein (16.4%). Biochemically, we identified the highest increases for uric acid (35.4%). More than half of the children included in the study had dyslipidemia-specific changes: high low-density lipoprotein cholesterol (LDL) (50.0%), low high-density lipoprotein cholesterol (HDL) (58.9%) and increased triglyceride levels (12.7%), especially children with a body mass-index (BMI) percentile above 95%. Increased thyroid stimulating hormone (TSH) was identified in 20.3% and low thyroxine (T4) level in 13.4%, especially in females. Conclusions: Early measures to control excess body weight are needed since preventing obesity is easier than treating it. However, this is often difficult to do in our country because parents frequently do not recognize the problem until it is advanced. Furthermore, doctors are not always adequately prepared and sometimes they do not have the support of the health systems to provide children in need with the adequate care. Educational strategies and awareness of issue should be revisited in current post-pandemic context that facilitates increase of obesity prevalence in children. Increase of efficient communication could be achieved by pointing to these objective findings.

An age-period-cohort approach to studying long-term trends in obesity and overweight in England (1992-2019).

This study aims to understand long-term trends in obesity and overweight in England by estimating life-course transitions as well as historical and birth cohort trends for both children and adults. Data on individuals aged 5 to 85 years old from the Health Survey for England were used, covering the period 1992 to 2019 and birth cohorts born between 1909 and 2013. Individual BMI values were classified as healthy weight, overweight, or obesity. Trends were compared, and an age-period-cohort model was estimated using logistic regression and categorical age, period, and cohort groups. There was significant variation in age trajectories by birth cohorts for healthy weight and obesity prevalence. The odds of having obesitycompared with a healthy weight increased consistently with age, increased throughout the study period (but faster between 1992 and 2001), and were higher for birth cohorts born between 1989 and 2008. The odds of having overweight showed an inverted U-shape among children, increased through adulthood, have been stable since 2012, and were considerably higher for the youngest birth cohort (2009-2013). Younger generations with higher overweight prevalence coupled with increasing obesity prevalence with age suggest that obesity should remain a high priority for public health policy makers in England.

Prediction of fat mass from anthropometry at ages 7 to 9 years in Samoans: a cross-sectional study in the Ola Tuputupua'e cohort.

With increasing obesity prevalence in children globally, accurate and practical methods for quantifying body fat are critical for effective monitoring and prevention, particularly in high-risk settings. No population is at higher risk of obesity than Pacific Islanders, including children living in the independent nation of Samoa. We developed and validated sex-specific prediction models for fat mass in Samoan children. Dual X-ray absorptiometry (DXA) assessments of fat mass and weight, height, circumferences, and skinfolds were obtained from 356 children aged 7-9 years old in the Ola Tuputupua'e "Growing Up" study. Sex-specific models were developed from a randomly selected model development sample (n = 118 females, n = 120 males) using generalized linear regressions. In a validation sample (n = 59 females; n = 59 males), Lin's concordance and Bland-Altman limits-of-agreement (LoA) of DXA-derived and predicted fat mass from this study and other published models were examined to assess precision and accuracy. Models to predict fat mass in kilograms were: e^[(-0.0034355 * Age8 - 0.0059041 * Age9 + 1.660441 * ln (Weight (kg))-0.0087281 * Height (cm) + 0.1393258 * ln[Suprailiac (mm)] - 2.661793)] for females and e^[-0.0409724 * Age8 - 0.0549923 * Age9 + 336.8575 * [Weight (kg)]-2 - 22.34261 * ln (Weight (kg)) [Weight (kg)]-1 + 0.0108696 * Abdominal (cm) + 6.811015 * Subscapular (mm)-2 - 8.642559 * ln (Subscapular (mm)) Subscapular (mm)-2 - 1.663095 * Tricep (mm)-1 + 3.849035]for males, where Age8 = Age9 = 0 for children at age 7 years, Age8 = 1 and Age9 = 0 at 8 years, Age8 = 0 and Age9 = 1 at 9 years. Models showed high predictive ability, with substantial concordance (ρC > 0.96), and agreement between DXA-derived and model-predicted fat mass (LoA female = -0.235, 95% CI:-2.924-2.453; male = -0.202, 95% CI:-1.977-1.572). Only one of four existing models, developed in a non-Samoan sample, accurately predicted fat mass among Samoan children. We developed models that predicted fat mass in Samoans aged 7-9 years old with greater precision and accuracy than the majority of existing models that were tested. Monitoring adiposity in children with these models may inform future obesity prevention and interventions.

Third trimester HbA1c as a prognostic indicator in the prediction of large-for-gestational age babies in South Indian women with gestational diabetes mellitus: A cross-sectional study

Background: The prevalence of hyperglycemia first detected during pregnancy is showing an escalating increase in recent years contributed by the increasing obesity prevalence, advanced maternal age at delivery, and the universal screening protocol during the first antenatal visit. There exists a very little data on the role of HbA1c in pregnancy and the results remain inconsistent. There is a need to define diagnostic criteria to predict the adverse perinatal outcomes in gestational diabetes mellitus (GDM). Aims and Objectives: This study was aimed to assess the role of HbA1c as a prognostic indicator of third trimester mean blood glucose in GDM pregnancies and in predicting the birth of large for gestational age (LGA) babies. Materials and Methods: 200 pregnant women with GDM and 200 pregnant women without GDM and their neonates participated in this analytical cross-sectional study. Maternal age, height, weight, BMI, and neonatal birth weight were recorded. Third trimester maternal HbA1c level was analyzed by high-performance liquid chromatography. The association between HbA1c and LGA births was analyzed. Results: The mean HbA1c levels and percentage of LGA births were high in GDM group. Multiple logistic regression analysis showed association between high HbA1c values and LGA births in GDM. A Receiver operating characteristic curve was drawn to derive the optimal cut-off value, sensitivity, and specificity of HbA1c in predicting birth of LGA neonates in GDM. Conclusion: This study shows that high third trimester HbA1c levels in GDM increase the risk of LGA births. Further studies are needed to define standard cut-off values of glycated Hb in each trimester of pregnancy.

Current Practices and Guidelines for Perioperative Blood Management in Post-Bariatric Body Contouring Surgery: A Comprehensive Review of Literature.

With the increase in obesity prevalence, a noticeable increase in bariatric surgeries has been reported in national and international statistics. Therefore, body contouring surgeries have increased to help individuals achieve their desired body shape. Plastic surgeons need to consider potential hematologic complications that may occur in this specific group of patients before performing body contouring surgery. This review illustrates the perioperative medical, laboratory, and management strategies needed to minimize blood loss and blood transfusion requirements during body contouring. Using Google Scholar and PubMed, a comprehensive literature review was conducted to identify articles discussing post-bariatric body contouring perioperative blood management strategies, including the effects of bariatric surgery on hemostasis as well as basic hematology and coagulation. In preoperative blood management, blood investigations aid in the early detection of electrolytes, protein, and vitamin deficiencies and anemia, resulting in the early correction of nutritional deficiencies. In order to reduce postoperative complications, surgical and anesthesia techniques, as well as intraoperative pharmacological therapy, play an essential role. Postoperative blood transfusion and restrictive transfusion thresholds are tailored to the patient's needs and depend on various physiological indicators, such as heart rate, blood pressure, urine output, and laboratory findings, such as acidosis and hematocrit level. Generally, post-bariatric body contouring blood management measures are still lacking, and more research is required to develop standardized guidelines for optimizing patient safety and satisfaction.Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Validity of anthropometric equation-based estimators of fat mass in Samoan adults.

In 1999, a set of highly accurate Polynesian-specific equations to estimate adult body fat from non-invasive field measures of age, sex, height, and weight (Equation 1), age, sex, height, weight, and bioelectrical impedance analysis (BIA) resistance (Equation 2), and age, sex, height, weight, and the sum of two skinfold thicknesses (Equation 3) were published. The purpose of this study was to evaluate the performance of the equation-based estimators in a sample of Samoan adults recruited 20 years later between 2017 and 2019. Age, sex, height, weight, BIA resistance, skinfold thickness, and fat mass as measured using dual energy x-ray absorptiometry (DXA) were available for 432 Samoan adults (mean age 50.9 years, 56% female) seen in 2017/2019. We compared equation-derived fat mass and DXA-derived fat mass using scatterplots and Pearson correlation coefficients. We then updated the equation coefficient estimates in a training set (2/3 of the sample) and evaluated the performance of the updated equations in a testing set (the remaining 1/3 of the sample). Equation-derived fat mass was strongly correlated with DXA-derived fat mass for Equation (1) (r2 =0.95, n=432), Equation (2) (r2 =0.97, n=425), and Equation (3) (r2 =0.95, n=426). Updating the equation coefficient estimates resulted in mostly similar coefficients and nearly identical testing set performance for Equation (1) (r2 =0.96, n=153), Equation (2) (r2 =0.98, n=150), and Equation (3) (r2 =0.96, n=150). The Polynesian-specific body fat estimation equations remained stable despite changing social and environmental factors and marked increase in obesity prevalence in Samoa.

Excessive Weight Gain: the Problems and Solutions

According to the data of the World Health Organization a prevalence of obesity has increased since 1975. Almost 2 billion adults are overweight, among them over 650 million are obese. It is also known that overweight and obesity kill more people than underweight. Currently, it is estimated that about 3 billion adults will be overweight and over 1 billion will be obese by 2025. Moreover, among 13 biggest health problems facing people in their country an obesity takes the fifth place. The purpose of the study was to analyze the new data of the scientific publications of recent years explaining new concepts of physiological mechanism of hunger and satiety balance, the causes of excessive weight or obesity, and suggestions for mindful eating, avoiding overeating and food temptation. Results and discussion. The obesity epidemic is now one of the most important public health problems in the world. However, overweight and obesity are preventable. Being overweight increases the risk of death. The results of recent researches suggest that weight gain itself, even if a person stays within the “normal” weight range, also increases the risk of disease and premature death. There are studies that showed that a weight gain even less than 5 kg and within a healthy body mass index range, is associated with an increased risk of disease. Results of other research findings showed that biological indicators of health risk are strongly related to body weight from the lowest body mass index to the highest body mass index, with higher body mass associated with greater health risk. Obesity becomes global health problem. Obese people are at high risk of developing a number of comorbidities, including disorders of gastrointestinal tract, type 2 diabetes mellitus, joint and muscle diseases, respiratory problems and psychological problems, which can significantly affect the quality of their daily life and increase the risk of mortality. The conditions associated with obesity are diverse, but even modest weight loss can reduce the risk of development of cardiovascular disease, diabetes mellitus, obstructive sleep apnea, and arterial hypertension, among many other comorbidities. Even relatively small weight loss can improve patient condition and can act as a trigger for further change, with sustained weight loss achieved through a series of gradual weight loss steps. Conclusion. The increase in obesity prevalence has an essential influence on the global morbidity of many diseases, moreover obesity and overweight affect quality and quantity of health thus being the causes of disability and significantly affect quality of life. Prevention of weight gain has been the focus of much discussion and debate, with many theories about the causes and solutions of the problem. However, prevention programs, which take in account the causes and risks factors, are more effective than weight-loss programs

Abstract 11610: Obesity and Metabolic Syndrome Among Heart Failure With Preserved Ejection Fraction Patients

Introduction: Recent data show a relative increase of HFpEF in heart failure. Additionally, an increase in prevalence of obesity and metabolic syndrome (MetS) in the population have been reported. Obesity and MetS differ across race, ethnicity, and sex. We sought to examine characteristics of patients with HFpEF by both obesity and MetS status to characterize differences in patient profiles for HFpEF. Methods: We examined data from the Practice Innovation and Clinical Excellence (PINNACLE) Registry® (American College of Cardiology and Veradigm) for HFpEF patients (LVEF ≥ 50%) and receiving care in a cardiologist clinic from 2016 thru 2019. Obesity is defined as BMI ≥ 30 kg/m 2 and MetS is approximated among patients with no history of myocardial infarction by presence of three of the four conditions (dyslipidemia, hypertension, obesity, and diabetes) at baseline. Results: Among 218,843 HFpEF patients, 56.7% had obesity, 50.4% had MetS, 34.8% had neither, and 41.8% had both. Obese patients were younger than non-obese (69.9 vs 74.9 years) and MetS patients were somewhat younger than non-MetS (71.7 vs 72.5 years). Over half of non-obese (62.7%) and non-MetS (53.8%) patients were 80+ years old. A higher proportion of women were obese than non-obese (57.8 vs 47.3%), while the proportion of women with and without MetS was similar (54.7 and 54.1%). Blacks have higher proportions of both obese and MetS than without (9.8 vs 5.2% and 9.6 vs 6.5%). Hispanics also have a higher proportion of MetS than without (4.9 vs 3.9%). MetS group exhibited a higher rate of all other cardiovascular comorbidities than the obesity group except for atrial fibrilation. Conclusions: In this large cohort of HFpEF patients in the ambulatory specialist care setting, nearly 2/3 of the HFpEF patients had obesity or MetS. MetS patients reflect an older more minority population with a higher proportion of comorbidities than obese patients.

Twelve-Year Trajectory of Disease Burden and Mortality by Obesity Level in Korea: Analysis of the National Health Insurance Service Database.

Despite increases in obesity prevalence, awareness of obesity as a disease requiring active treatment remains lacking in Korea. We investigated differences in medical problems and expenditures and mortality across obesity categories using 12-year data from the National Health Insurance Service. Individuals aged 40-79years who underwent medical examinations during 2003-2004 (n = 415,201) were divided based on Asian body mass index (kg/m2) criteria: normal weight (18.5 to < 23.0, 36.4%), overweight (23.0 to < 25.0, 28.3%), obesity (25.0 to < 30.0, 32.5%), and severe obesity (≥ 30.0, 2.8%). Medical problems and expenditures were fitted to linear mixed models. Mortality was analyzed via Cox proportional-hazards model. More severe obesity was associated with a higher rate of medical problems, relative to normal weight: coefficient = 0.31 (95% confidence interval [CI], 0.30-0.32) for overweight, 0.61 (0.60-0.61) for obesity, and 1.07 (1.04-1.09) for severe obesity. A similar association was observed for medical expenditure: coefficient = 8.85 (95%CI, 6.80-10.89) for overweight, 20.04 (18.07-22.01) for obesity, and 48.76 (43.66-53.86) for severe obesity. Relative to overweight participants, those with normal weight and severe obesity exhibited a higher mortality risk (hazard ratio [HR] 1.21 [95%CI, 1.18-1.25] for normal; 1.27 [1.19-1.36] for severe obesity). In age-specific analyses, mortality risk was the highest for participants with severe obesity, aged < 60years (HR, 1.58 [95%CI, 1.41-1.77]). Disease burden including medical problems and expenditure, and mortality in middle-aged adults, increased proportionally to the degrees of obesity. Health policies and medical systems aimed at reducing the burden of obesity may help reduce the burden of disease on society.

Trends and Factors Associated with Obesity Prevalence in Rural Australian Adults-Comparative Analysis of the Crossroads Studies in Victoria over 15 Years.

This study examined the changes in the prevalence of obesity and associated lifestyle factors using data from repeated cross-sectional, self-reported surveys (Crossroads I: 2001-2003 and Crossroads II: 2016-2018, studies) and clinic anthropometric measurements collected from regional and rural towns in the Goulburn Valley, Victoria. Given that past community studies have only focused categorically on dietary intake, or assessed caloric energy intake, we examined the difference in broad dietary practices at two different times. Clinical assessments from randomly selected household participants aged ≥18 years were analyzed. Differences in obesity prevalence were calculated for each individual variable. Logistic regression was used to determine the odds ratios (95% confidence intervals (CI)) with and without adjustment for key lifestyle factors. There were 5258 participants in Crossroads I and 2649 in Crossroads II surveys. Obesity prevalence increased from 28.2% to 30.8% over 15 years, more among those who ate fried food, but decreased significantly among rural dwellers (31.7: 27.0, 36.8% versus 25.1: 22.9, 27.5%) and those who had adequate fruit intake (28.5: 25.0, 32.3% to 23.9: 21.8, 26.2%). Obesity was associated with older age (≥35 years), use of fat-based spreads for bread (adjusted odds ratio, aOR:1.26: 1.07, 1.48) and physical inactivity. The increase in obesity prevalence especially in the rural towns, was associated with unhealthy dietary behaviour which persisted over 15 years. Understanding and addressing the upstream determinants of dietary intake and choices would assist in the development of future health promotion Programs.