Lower Rates Of Obesity Research Articles

A Quantitative Study on Parental Influence and Lifestyle Factors in Child Obesity

Child obesity is a growing global health concern, significantly impacting both developed and developing countries. This study examines the influence of parental behaviors and lifestyle factors on child obesity in Keyouqianqi, Inner Mongolia, China. Employing a quantitative research design, data was collected from 50 parents of obese children through structured questionnaires. Statistical analyses revealed significant associations between parental promotion of healthy eating, physical activity encouragement, and lower obesity rates, whereas restrictive feeding practices were linked to higher obesity rates. Lifestyle factors such as high-calorie food consumption, sugary beverage intake, insufficient physical activity, and excessive screen time were also significantly associated with child obesity. The findings underscore the importance of comprehensive interventions addressing both parental behaviors and children's lifestyle choices to combat child obesity effectively.

Increases in Psychological Stress Are Associated With Higher Fasting Glucose in US Chinese Immigrants.

The majority of Chinese Americans is foreign-born, and it is well-documented that immigration to the United States (US) leads to increased risk for chronic diseases including type 2 diabetes. Increased disease risk has been attributed to changes in lifestyle behaviors following immigration, but few studies have considered the psychosocial impact of immigration upon biomarkers of disease risk. To examine associations ofpsychological stress and social isolation with markers of type 2 diabetes risk over time among US Chinese immigrants. In this longitudinal study of 614 Chinese immigrants, participants completed assessments of perceived stress, acculturative stress, negative life events, and social isolation annually atthree time points. Fasting blood samples were obtained at each time point to measure blood glucose, glycated hemoglobin, and insulin resistance. Mean duration between baseline and follow-up assessments was approximately 2 years. Increases in migration-related stress, perceived stress and social isolation were associated with significant increases in fasting glucose at follow-up independent of age, body mass index, length of US residence, and other potential covariates. Moreover, increases in glucose varied depending on perceived stress levels at baseline, such that those with higher baseline stress had a steeper increase in glucose over time. Psychological stress and social isolation are associated with increases in fasting glucose in a sample of US Chinese immigrants. Findings suggest that the unique experiences of immigration maybe involved in the risk of developing type 2 diabetes, a condition that is prevalent among US Chinese despite relatively low rates of obesity.

Lasting Legacy: The Enduring Relationship Between Racially Restrictive Housing Covenants and Health and Wellbeing.

Racially restrictive covenants in housing deeds, commonplace in Minnesotafor houses built from the 1910s to the 1950s, provided a foundation for the myriad of policies that made it difficult for people of color to obtain housing. Though covenants were ruled illegal in 1968, their legacy continues to shape neighborhoods. The Mapping Prejudice Project's efforts in Hennepin County, Minnesota, produced the first systematic documentation of racially restrictive covenants. We use this novel data set to explore the relationship between historic covenants and current health and wellbeing outcomes. Using regression analysis to control for neighborhood level covariates, we compare previously covenanted neighborhoods to neighborhoods without covenants. Today, previously covenanted neighborhoods have higher life expectancy and lower rates of obesity, diabetes, coronary heart disease, and asthma than neighborhoods without racially restrictive covenants. Additionally, previously covenanted neighborhoods have less upward mobility for children from poorer households, and there are larger gaps in upward mobility between white and Black children. These findings contribute to a growing literature that shows racist policies, even decades after they are legally enforceable, leave an imprint on neighborhoods. Using the novel data from the MappingPrejudiceProject, we provide statistical analysis that confirms qualitative and anecdotal evidence on the role of racial covenants in shaping neighborhoods.

Tweeting environmental pollution: Analyzing twitter language to uncover its correlation with county-level obesity rates in the United States

BackgroundEnvironmental pollution has been linked to obesogenic tendencies. Using environmental-related posts from Twitter (now known as X) from U.S. counties, we aim to uncover the association between Twitter linguistic data and U.S. county-level obesity rates. MethodsAnalyzing nearly 300 thousand tweets from January 2020 to December 2020 across 207 U.S. counties, using an innovative Differential Language Analysis technique and drawing county-level obesity data from the 2020 Food Environment Atlas to identify distinct linguistic features in Twitter relating to environmental-related posts correlated with socioeconomic status (SES) index indicators, obesity rates, and obesity rates controlled for SES index indicators. We also employed predictive modeling to estimate Twitter language's predictive capacity for obesity rates. ResultsResults revealed a negative correlation between environmental-related tweets and obesity rates, both before and after adjusting for SES. Contrarily, non-environmental-related tweets showed a positive association with higher county-level obesity rates, indicating that individuals living in counties with lower obesity rates tend to tweet environmental-related language more frequently than those living in counties with higher obesity rates. The findings suggest that linguistic patterns and expressions employed in discussing environmental-related themes on Twitter can offer unique insights into the prevailing cross-sectional patterns of obesity rates. ConclusionsAlthough Twitter users are a subset of the general population, incorporating environmental-related tweets and county-level obesity rates and using a novel language analysis technique make this study unique. Our results indicated that Twitter users engaging in more active dialog about environmental concerns might exhibit healthier lifestyle practices, contributing to reduced obesity rates.

O-244 AMH levels in infertile women in APAC region - prospective study in multiple countries, ethnicities and centres

Abstract Secretary General, Asia Pacific Initiative on Reproductive (ASPIRE) President, Taiwan Endometriosis Society Founder & CEO, Taipei Fertility Center AMH is produced by granulosa cells of small growing follicles in the ovary and serum AMH levels strongly correlate with the number of growing follicles, AMH has been used clinically as a marker for ovarian reserve. Despite being of similar ages, with similar AMH levels, durations of ovarian stimulation, and gonadotropin doses, Asian women have been documented as having decreased AFCs and lower yields of total and mature oocytes after ovarian stimulation compared to their Caucasian counter- parts. These earlier data suggested that the effect of ethnicity was as an independent marker of ovarian reserve and potentially subsequent reproductive outcomes. We conducted the first multi-nation, multi-centre, and multi-ethnicity prospective cohort study from January 2020 to May 2021 to investigate serum AMH profiles among infertile Asian women. A total of 4613 women who visited fertility clinics at 12 IVF centres in 11 regions throughout Asia were recruited from Taiwan, China, Hong Kong SAR, India, Indonesia, Japan, Korea, Malaysia (2 centres), Thailand, Vietnam, and Singapore. The inclusion criteria were female partners aged 20–43years and naive to any ovarian stimulation cycle. The AMH measurement was performed using an AMH automated assay on a clinically validated platform. Among the 12 centres that joined the study, most demonstrated racial homogeneity except for Singapore and Malaysia which presented a highly diverse ethnic profile, while others were supposedly monoethnic communities. Unexplained or male infertility is the most common infertility cause in most countries, except for China with a notably high incidence of tubal disease. Age, ethnicity, obesity, and PCOS are significantly associated with ovarian reserve. The highest rates of PCOS were found in Indians (18.6%), Malays (18.9%), and Vietnamese (17.7%), yet remarkably lean with lower obesity rate was found in Vietnamese. Serum AMH levels are not affected by smoking or GnRHa and OCPs pretreatment but are affected by endometrioma surgery. Moreover, the assay can be conveniently conducted on any day of the menstrual cycle and is not influenced by the use of fresh or frozen samples. The rate of decline in ovarian reserve increases with age in Asian women, at 0.13ng/ml/year at 25–33years old and 0.31ng/ ml/year at 33–43 years old. We also found that a cut-off at 4.0 ng/ml could be considered for PCOS diagnosis in the Asian region. Despite limitations, the results can help guide clinicians for personalized infertility treatment, and call for further investigation into the effects of genetic, environmental and lifestyle factors on ovarian reserve.

Neighbourhood walkability and body mass index in children: Evidence from the Millennium Cohort Study in Wales

BackgroundOverweight and obesity in children continues to increase. Yet, the role of active transport, namely walking, in mitigating these trends remains unclear. This study examined the cross-sectional association between walkability and children's Body Mass Index (BMI) and how this varies by socio-economic and lifestyle characteristics. MethodsWe analysed BMI for 14-year-old children living in Wales from the UK Millennium Cohort Study. Children were categorised as healthy weight, overweight or obese using the British 1990 cut-off points. Walkability was assessed using the Wales Active Living Environments (Wal-ALE) database, categorised as 1 (least walkable environments) to 5 (most walkable environments). We applied multinomial logistic regression analysis and adjusted for ethnicity, having a limiting longstanding illness, parental BMI, socio-economic circumstances, and lifestyle characteristics. ResultsChildren were more likely to be obese if they lived in areas classed as more walkable in unadjusted analysis [Relative Risk Ratio (RRR) = 1.72 (95%CI = 1.15–2.58)] and following adjustment for ethnicity, limiting longstanding illness and parental BMI [RRR = 1.83 (95%CI = 1.12–3.00)]). Significant associations remained even after further adjustment for lifestyle characteristics and socio-economic circumstances [RRR = 1.76 (95%CI = 1.05–2.96)]. Further, children were more likely to be obese if their parents were overweight or obese and if they were living in poverty. Children were less likely to be obese if they spent 3 or more days per week in moderate-to-vigorous physical activity (MVPA) and if they ate breakfast every day vs. some days or never. ConclusionFindings demonstrate that walkable environments are not associated with lower rates of obesity in children, indicating that the relationship between the built environment and child health is complex and requires further study.

Impact of Breakfast Skipping and Choices on The Nutrient Intake and BMI of University Hostel Students of Lahore

This longitudinal study aimed to investigate the food choices of university hostel students and explore the relationship between breakfast skipping, food choices, nutrient intake, and BMI. Data were collected from students residing in university hostels over a three-month period, with monthly assessments. The study included 306 students divided into breakfastskippers and breakfast-eaters (control group), each comprising 153 students. Further categorization was performed among the breakfast eaters. A valid assessment questionnaire was used, encompassing social demographic characteristics, anthropometric measures, lifestyle assessment, dietary assessment through 24-hour dietary recall, and food composition table analysis. Among breakfast skippers, 15% were classified as obese and 13.7% as overweight, which was higher compared to other groups. Among the non-cereal-based breakfast eaters, 14.4% were obese, and 21% were overweight. The cereal-based breakfast eaters had the lowest rates of obesity and overweight, with 6.4% falling into each category. Significant differences were observed in calorie consumption and the intake of micronutrients across different breakfast categories. This study provided strong evidence linking breakfast skipping to a higher BMI (26.2 vs 24.1) and age-related patterns, with more breakfast skippers among younger individuals. Non-cereal-based breakfasts had a superior nutrient intake, while breakfast skippers had more screen time and insufficient sleep. Emotional states as triggers for binge eating were reported

Rapid Increase of Female but not Male Obesity: Analysis of the 2023 Vanuatu Health Transition Project Survey on Aneityum

Globally, obesity rates are continuing to increase and countries in the midst of modernization are most vulnerable. Developing nations are undergoing a health transition alongside rapid economic modernization. The nation of Vanuatu, like other Pacific island countries, is experiencing such a transition marked by decreased cases of infectious disease and increased incidence of chronic and non-communicable diseases. Aneityum is a small and sparsely populated island in Vanuatu and is behind more developed islands in its transition. This present study is the latest in a multi-year project examining health in Vanuatu as it undergoes a health transition with an increased prevalence of chronic disease, namely cardiovascular diseases and type 2 diabetes. In this study, we sought to continue tracking the population health on Aneityum, to analyze health differences between men and women, and to compare findings to previous data in Vanuatu. In July and August of 2023, adult males [n=41] and females [n=62] were surveyed and had their anthropometric measurements taken on Aneityum in Vanuatu. Mean anthropometric measurements (body mass index, body fat percentage, waist circumference) continued to be significantly greater among women than men (P-value < 0.05). Women exhibited higher rates of obesity in all metrics than in previous studies while men remained relatively unchanged. While men still have lower obesity rates compared to those from Efate in 2011, the women of Aneityum have reached similar levels as their counterparts from a decade ago. There is debate whether Ni-Vanuatu populations are more accurately measured by WHO or Asian-Pacific BMI cutoffs. When Asian-Pacific BMI guidelines are applied, male obesity rate rises 4.87% and the female obesity rate rises 17.74%, indicating drastically worse population health than previously thought. Potential explanations for the disparity in obesity rates between males and females include sex-associated fat distribution patterns, social inequality, and cultural habits. This paper provides valuable insights into the state of Vanuatu's health in its transitional period and a greater understanding of the interplay between sex and health.

Assessing disparities in pancreatic cancer outcomes in African Americans.

612 Background: Pancreatic Adenocarcinoma (PA) is a leading cause of cancer-related death across the world, with poorer outcomes noted in minority populations. The observed variation in outcomes has been attributed to delayed diagnosis, barriers to optimal treatment and health care related disparities. We evaluated the impact of race on clinical presentation and outcomes in pancreatic cancer at a large academic teaching center. Methods: We performed a retrospective review of patients with pancreatic adenocarcinoma diagnosed between January 2016 to December 2021. The demographic characteristics (age, tobacco use, alcohol use, BMI); comorbidities (diabetes, acute/chronic pancreatitis); pathology, treatment (chemotherapy regimen, radiation, surgery) and recurrence free survival (RFS) and overall survival based on race were analyzed. Results: The cohort (N=947) consisted of 147 (16%) African Americans (AA) and 775 (82%) Non-Hispanic Whites (NHW). The mean age at diagnosis was 68 years (±10) among AA and 70 years (±11) in NHW. Thirty-seven (26%) of AA and 104 (14%) of NHW were current smokers; 46 (33%) of AA and 323 (45%) of NHW consumed alcohol regularly. Among AA, 32 (22%) were obese (BMI>30), compared to 194 (25%) in NHW. Other comorbidities included diabetes (35% in AA vs. 32% in NHW) and acute/chronic pancreatitis (11% among AA vs. 9% among NHW). Eighteen percent (18%) of AA and 17% of NHW had stage II disease, 16% and 12% had stage III and 48% in both had stage IV disease respectively. The treatment modality consisted of chemotherapy (63% in AA vs. 66% in NHW), surgery (25% in AA vs. 26% in NHW) and radiation (10% in AA vs. 12% in NHW). The median time to treatment initiation was 30 (17, 41) months for AA and 26 (16, 40) months for NHW. On univariate analysis, AA race was associated with younger age at diagnosis (p 0.043), higher current tobacco use (p 0.001), lower alcohol use (p 0.012), lower rates of obesity (p 0.024) and higher rate of acute pancreatitis (p 0.037) in pancreatic cancer. On multivariate analysis, race was not associated with difference in recurrence free survival (12 months in AA vs. 14 months in NHW; p 0.96) when adjusted for age, sex, alcohol use, tobacco use, cancer stage and chemotherapy. High mean age, clinical stage II, III and IV, current alcohol use, underweight and BMI>30 and cerebrovascular accident as a comorbidity was associated with worse overall survival when adjusted for other variables. Conclusions: Our study revealed that pancreatic cancer in AA was diagnosed at a younger age, associated with active smoking and pancreatitis. We observe there was no difference in treatment initiation among AA and NHW. There was no significant difference in recurrence free survival and overall survival compared to NHW when adjusted for other variables. Future studies incorporating germline mutations, novel biomarkers are needed to determine impact of racial health disparities on outcomes in pancreatic cancer.

Early Home Visits and Health Outcomes in Low-Income Mothers and Offspring

Individuals with low income may have heightened rates of obesity and hypertension. To determine whether prenatal and infancy home visitation by nurses reduces maternal and offspring obesity and hypertension. This randomized clinical trial of prenatal and infancy nurse home visitation in a public health care system in Memphis, Tennessee, enrolled 742 women with no previous live births and at least 2 sociodemographic risk factors (unmarried, <12 years of education, unemployed) from June 1, 1990, through August 31, 1991. At registration during pregnancy, 727 mothers (98%) were unmarried, and 631 (85%) lived below the federal poverty level. At offspring ages 12 and 18 years, maternal and offspring obesity and hypertension were assessed by staff masked to treatment. The data analysis was performed from July 1, 2021, to October 31, 2023. Women assigned to the control group received free transportation for prenatal care and child developmental screening and referral at child ages 6, 12, and 24 months. Women assigned to nurse visitation received transportation and screening plus prenatal and infant and toddler nurse home visits. Obesity and hypertension among mothers and their offspring at child ages 12 and 18 years, although not hypothesized in the original trial design, were analyzed using post-double selection lasso method. Of the 742 participants randomized (mean [SD] age, 18.1 [3.2] years), interviews were completed with 594 mothers and 578 offspring at child age 12 years and 618 mothers and 629 offspring at child age 18 years. Obesity was assessed for 576 offspring at age 12 years and 605 at age 18 years and for 563 and 598 mothers at child ages 12 and 18 years, respectively. Blood pressure was assessed for 568 offspring aged 12 years and 596 aged 18 years and 507 and 592 mothers at child ages 12 and 18 years, respectively. There were no overall treatment-control differences in offspring obesity or hypertension at ages 12 and 18 years combined, although nurse-visited female offspring, compared with controls, had a lower prevalence of obesity (adjusted relative risk [ARR], 0.449; 95% CI, 0.234-0.858; P = .003) and severe obesity (ARR, 0.185; 95% CI, 0.046-0.748; P < .001). There were reductions at ages 12 and 18 years combined for stage 1 and stage 2 hypertension for nurse-visited vs control group mothers, with differences limited to mothers of females (stage 1: ARR, 0.613 [95% CI, 0.440-0.855; P = .001]; stage 2: ARR, 0.217 [95% CI, 0.081-0.582; P < .001]). For both obesity and hypertension outcomes, there was no intervention effect among male offspring or the mothers of males. Self-reported maternal health aligned with program effects on hypertension. In this clinical trial follow-up at offspring ages 12 and 18, nurse-visited female offspring had lower rates of obesity and mothers of females had lower rates of hypertension than control-group counterparts. These findings suggest that risks for chronic disease among mothers of females and their female offspring who live in extreme poverty may be prevented with prenatal and infant and toddler home visitations by nurses. ClinicalTrials.gov Identifier: NCT00708695.

Comparison of Nutritional Status Between Migrant and Nonmigrant School-Age Children in Kunming, Yunnan Province, China

This study explores the nutritional status of migrant and nonmigrant school-age children in Kunming, Yunnan Province, China, along with the contributing factors. A cross-sectional survey (n = 1655) was conducted among students aged 9–11 years across four schools. The findings reveal that 73% of the students’ parents are migrants. Compared with nonmigrants, migrant students exhibited a significantly lower obesity rate (5.2% vs. 8.8%). The migrant parents demonstrated lower levels of nutritional knowledge and education compared to nonmigrants, albeit local parents invested more time in work. Risk factors affecting the nutritional status of migrant children included age, sex, and cooking time, while for local children, gender, family size, sweet food consumption, and nutritional knowledge were identified as risk factors.

The Japanese Paradox: Between Physical And Psychological Well-Being In Japanese Approaches To The Obesity Epidemic

Using an anthropological approach that emphasizes understanding the total social and political context of eating behavior, I draw on ethnographic research in Japan in order to understand factors that enable or mitigate obesity. Japan is an important comparative example in obesity research because of its low obesity rates despite being a wealthy nation with affordable access to high-caloric foods. This is found to be an outcome of social and institutional processes that limit food intake and stigmatize weight, producing desirable outcomes in physical health but through pressures that have negative implications for psychological/emotional health. Consequently, while Japan provides an intriguing cross-cultural model for weight control, the possibility or desirability of replicating this elsewhere may be limited.

Risk of Venous Thromboembolic Events Among Obese Hormonal Contraceptive Users

Background: Obesity and hormonal contraception (HC) are independent risk factors for venous thromboembolism (VTE). Thirty eight percent of women in the United States (US) are obese, and the prevalence of childhood obesity in the US is among the highest in the world. Obesity (BMI&amp;gt;30 kg/m2), increases VTE risk via several mechanisms, and the VTE risk in obese individuals is 2.5 times higher than that of their non-obese peers. More than half of women aged 15-49 years use some form of contraception, and 14% report using oral contraceptive pills specifically. The overall VTE risk with combined hormonal contraception (CHC) is approximately two-fold higher than an individual's baseline risk, with further increase depending on the type/dose of progesterone and estrogen, and route of administration. To date case-control and cohort studies have demonstrated an increased VTE risk among obese contraceptive users. But these data do not include adolescents and were derived from populations with relatively low rates of obesity. This study aimed to assess and compare the VTE risk among obese females, age 10-44 years, who were prescribed HC compared to non-obese HC users and obese non-users utilizing a national electronic-medical record database. Using a large national database allowed the inclusion of females from diverse ethnic, economic, and geographic background. Methods: Population level data was collected from TriNETX, LLC, an administrative database that contains comprehensive inpatient and outpatient data from 56 tertiary care hospitals in US. Prevalence data regarding the type and dose of progesterone and estrogen and mode of administration was assessed. Data on females ages 10-44 years from 1/1/2000 to 12/30/2022, who received a new prescription for any HC as identified by the prescription name in pharmaceutical claims and procedure codes was analyzed. Recorded BMI was used to divide the cohort into obese and non-obese individuals as per CDC guidelines. VTE events were defined as presence of ≥1 ICD 9 or 10 codes for VTE diagnosis and presence of a prescription for an anticoagulant drug within the first year after hormonal prescription. Data was summarized descriptively and VTE rates were calculated. Results: Of the 97,026,002 females who met inclusion criteria, 1,370,481 were obese and 2,649,987 were non-obese. The overall rate of VTE for obese vs. non-obese users was 0.9% vs. 0.5% (p&amp;lt;-0.001) and obese HC users vs. obese non-users was 0.9 and 1.06% (p&amp;lt;0.05). VTE rates among obese users versus non-obese users was significantly higher for most progesterone only options (p&amp;lt;0.001), excluding drospirenone only pills and high dose norethindrone (Table 1). A similar pattern of higher VTE rates in obese vs non-obese users was observed for the majority of CHC preparations with few exceptions (p&amp;lt;0.001). (Table 1) In general, VTE rates were higher among obese non-users compared to obese users. However, the rate of VTE was significantly higher among obese users of oral norethindrone 5mg and all medroxyprogesterone acetate users (p&amp;lt;0.001). (Table 2) Discussion: Utilizing the data from a large inpatient/outpatient administrative database, our study shows that obese HC users have a higher VTE rate within one year of initiating HC when compared to non-obese HC users, for progesterone only options (excluding drospirenone, high dose norethindrone) and most CHCs. With few exceptions, obese HC non-users had a higher rate of VTE when compared to obese users. This observation is likely due to confounding by indication bias as prescribers may avoid HC in individuals with underlying risk factors for VTE. Applying propensity score analysis and examining different subcategories of obesity may help overcome this bias in future analysis. Our study highlights the utility of large databases to study healthcare outcomes of VTE risk in females with and without obesity and HC users and non-users. Although limited by the use of administrative claims data and acknowledging that all statistically significant results may not be clinically significant, our study suggests obesity as a VTE risk factor in females for most HCs.

Pediatric Obesity Prevalence inthe U.S. Military Health System, Fiscal Years 2012-2018.

Obesity prevalence in Military Health System (MHS) children has been reported through fiscal year (FY) 2012 as consistently lower than in the general population. Our study reports military pediatric overweight, obesity, and severe obesity prevalence through FY2018. We compared FY2018 prevalence to a sample of the general population using National Health and National Health and Nutrition Examination Survey (NHANES) 2017-2018 data. The MHS Data Repository was queried for all children aged 2-17 years seen at any military treatment facility between FY2012 and FY2018. We calculated overweight and obesity (classes 1, 2, and 3) prevalence for each FY and performed subgroup analysis for sex, age, and sponsor rank. We also compared FY2018 to NHANES 2017-2018 data. This study was approved by the Walter Reed National Military Medical Center Institutional Review Board. The prevalence of overweight and obesity was stable from FY2012 (14.4% and 11.3%, respectively) to FY2018 (14.1% and 10.7%). Rates of classes 2 and 3 obesity combined were also stable at around 2.5% of all children. In FY2018, obesity prevalence was greater in assigned males, increased with age, and was highest in 16-17-year-olds (odds ratio: 2.75) and children with an enlisted military sponsor (odds ratio: 1.78). Compared to NHANES, MHS children had lower rates of obesity (10.7% versus 19.3%) with a smaller proportion of severe obesity (24% versus 32%). The prevalence of pediatric overweight and obesity in the MHS was stable over time. Disparities were observed between age and sponsor rank groups. When compared to the general population, overall obesity prevalence was lower in younger military children. Further research is needed to explore disparities and to identify optimal strategies to mitigate the increase in obesity prevalence with age.

Snoring might be a warning sign for metabolic syndrome in nonobese Korean women

Metabolic syndrome (MetS) is an underlying cause of various diseases and is strongly associated with mortality. In particular, it has been steadily increasing along with changes in diet and lifestyle habits. The close relationship between sleep apnea and MetS is well established. In addition, these two diseases share a common factor of obesity and have a high prevalence among obese individuals. Nevertheless, the association can vary depending on factors, such as race and sex, and research on the relatively low obesity rates among East Asians is lacking. This study aimed to investigate the association between snoring and MetS in nonobese Koreans. A total of 2478 participants (827 men and 1651 women) were enrolled in the Korean National Health and Nutrition Examination Survey from 2019 to 2020. We used the National Cholesterol Education Program Adult Treatment Panel III criteria for MetS and a snoring questionnaire. Logistic regression analysis was used to measure the association between MetS and various confounding factors according to age and sex in participants with body mass index (BMI) < 23 kg/m2. MetS was significantly higher in participants with snoring than in those without snoring (26.9% vs. 19.6%; p = 0.007). In multivariate logistic regression analysis, age (odds ratio [OR] 1.070, 95% confidence interval [CI] 1.059–1.082, p < .001), sex (OR 1.531, 95% CI 1.139–2.058, p = 0.005), and snoring (OR 1.442, 95% CI 1.050–1.979, p = 0.024) were significantly associated with MetS in patients with a BMI < 23 kg/m2. Finally, regression analysis showed that snoring was significantly associated with MetS in women with a BMI of less than 23 kg/m2, especially with younger ages (40–49 years, OR 4.449, 95% CI 1.088 to 18.197, p = 0.038). Snoring was closely associated with MetS in women aged 40–50 years with a BMI of less than 23 kg/m2 compared to other participants. However, the association was not found in women aged 60 and over. Therefore, sufficient consideration should be given to the possibility of MetS when snoring is present in nonobese middle-aged Asian women.

Overlap of pain-related and general measures of disability among adults with chronic pain.

Chronic pain is known to be correlated with disability. We aimed to determine the overlap between a general self-reported measure of disability and a measure of disability due to pain problems among adults with chronic pain. We used data from the National Health Interview Survey (NHIS) and analyzed respondents with chronic pain in the past 3 months. General disability was defined as being limited in the kind or amount of work one can do due to any physical, mental, or emotional problem. Pain-related disability was defined as pain limiting one's activity on "most days" or "every day." Based on a sample of 6874 respondents with chronic pain, 58% had either kind of disability, including 9% who reported only pain-related, but not general disability; and 27% who reported both types of disability. Respondents reporting only pain-related, but not general disability tended to be younger and had lower rates of obesity, smoking, diabetes, and hypertension than respondents reporting both pain-related and general disability. Among people with chronic pain, most people with disability are experiencing limitations related to pain problems. Assessment of disability without addressing pain interference has likely underestimated the disability burden in this population.

Examining the Connection Between Health Outcomes, State Political Ideology, and Food Access in the United States.

To estimate the impact of county-level income, access to food, availability of health resources, socioeconomic factors, and state political ideology on population obesity and mental health in US counties. We compiled a county-level data set from the US Census, County Health Rankings, USDA Food Environment Atlas, the American Community Survey, and the State Ideology Database. We specify 2 multivariable regression models for county-level obesity rate and per capita poor mental health days and control for rurality, food access, income, availability of health care resources, state political ideology, and socioeconomic characteristics. We find that higher food access reduces obesity in counties; an increase in per capita full-service restaurants by 1 unit is associated with reduction in obesity rate by 1.24 points and an increase in per capita grocery stores reduces poor mental health days by 0.14. We also find that counties in liberal-leaning states tend to have lower obesity rates. Access to primary care providers (increase in primary care physicians by 1 is associated with decline in obesity rate by 1.18 points and poor mental health days by 0.11 days), and recreational facilities (increase in recreational facilities per 1000 by 1 is associated with reduction in obesity rate by 3.16 points and poor mental health days by 0.47 days) reduces obesity rates and poor mental health days. Median income is associated with decrease in obesity rate and poor mental health days. Increase in median household income by 1% is associated with reduction in obesity rate 4.75% and reduction in poor mental health days by 1.39 days. We find that access to food and health care at county level and state ideology through policy making affects health outcomes. Our analysis indicates that counties can improve access to food and health care by investing in these services thereby improving county-level health outcomes and save dollars in the process.

ОСОБЕННОСТИ ФАКТОРОВ РИСКА РАЗВИТИЯ КАРДИОВАСКУЛЯРНЫХ ОСЛОЖНЕНИЙ ПРИ ОЖИРЕНИИ У ДЕТЕЙ

Introduction. The most common risk factors for the development of cardiovascular diseases are hypertension and obesity, which are formed in childhood, however, the most significant clinical and metabolic markers of cardiovascular risk have not yet been identified in pediatric practice. Aim. To study the characteristics and interrelations of cardiovascular risk factors in obese children and adolescents for planning correction at the stage of functional changes. Material and methods. The study included 141 obese children – 69 boys and 72 girls (in whom the degree of standard deviation of the body mass index was 2.88 [2.75; 3.41] and 2.93 [2.59; 4.05], respectively) and 78 healthy children (40 boys and 38 girls), comparable by sex and age. Results and discussion. In the examined children, there is an insufficient decrease in blood pressure at night from both systolic blood pressure and diastolic blood pressure, in the absence of clinically and statistically significant deviations in single measurements. The triglyceride-glucose index and the N-terminal inactive peptide of natriuretic hormone demonstrated high concentrations in normoglycemia and the absence of dyslipidemia. Against the background of obesity, trimethylaminoxide concentrations were lower than in healthy children. Conclusion. In order to timely correct blood pressure, it is necessary to use daily monitoring in obese children, even against the background of the absence of signs of arterial hypertension with single measurements. Even against the background of lean normoglycemia in obese children and adolescents, it is advisable to diagnose the formation of insulin resistance and hyperinsulinemia using indicators of insulin levels, calculation of the HOMA-IR index, triglyceride-glucose index. Correction of blood pressure variability is possible with changes in certain parameters of body composition (decrease in fat mass and increase in muscle mass) and hormonal and metabolic parameters (decrease in glycemia, very low-density lipoproteins, insulin and increase in high-density lipoproteins). The level of trimethylaminoxide showed lower rates of obesity in children compared to healthy peers, which differs from the literature data on the adult population and limits its use as a biomarker for the development of cardiovascular complications in obesity in children

Obesity and environments external to the body.

Studies of environment and obesity usually use epidemiologically tractable measures that are proxies for energy balance or macronutrient composition intake, mostly to identify individual behavioural changes for prevention or reduction of obesity, or inform policy. Of environments external to the body as they relate to obesity, the built environment and the food environment are considered among the most important. Incorporating human sociality into obesity and environments research enriches the field by offering possible ways for understanding obesity production via social stress, dietary preference, food consumption and physical activity. External environments are in flux, however, especially with changing urban form and social environmental hybridity since Web 2.0, with urban polycentricity and networked and online activity influencing obesity production in new ways. While the world's rural populations are experiencing the fastest increases in obesity, large urban populations benefit from scale in setting the physical conditions for physical activity and healthy food availability, with larger and polycentric cities having lower rates of obesity than smaller monocentric or dispersed cities. It is argued that built, food and social environments set the context for obesity production or its amelioration, with sociodemographic factors being more important than new phenomena such as digital and smart technologies. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.

Prevalence, risk factors and outcomes of cardiac disease in cystic fibrosis: a multinational retrospective cohort study.

Although people living with cystic fibrosis (PwCF) often have some risk factors for cardiovascular disease, including diabetes and chronic inflammation, little is known about the long-term cardiac risk in this condition. We aimed to determine the characteristics, rates and outcomes for cardiac disease in CF. We looked at rates and outcomes for cardiac disease in 5649 adult PwCF in the UK CF Registry and 6265 adult PwCF in TriNetX (a global federated database of electronic healthcare record data). We used propensity matching to compare risk of major adverse cardiac events (MACE) (myocardial infarction, left-sided heart failure and atrial fibrillation) in PwCF against matched non-CF comparators in the general population and other inflammatory diseases. PwCF had a high prevalence of diabetes but low rates of hypertension and obesity. Some cardiac risk factors (age, diabetes and hypertension) were associated with MACE, but relationships between disease-specific risk factors (lung function and intravenous antibiotic days) were also observed. In propensity score-matched analyses, PwCF had higher risk of MACE than matched general population comparators (hazard ratio (HR) 1.65, 95% CI 1.40-1.95; p<0.001) and an equivalent or higher relative risk compared with other inflammatory conditions considered "high risk" for cardiovascular disease, including systemic lupus erythematosus (HR 0.95, 95% CI 0.82-1.09; p=0.44), rheumatoid arthritis (HR 1.21, 95% CI 1.00-1.48; p<0.001) and HIV (HR 0.93, 95% CI 0.82-1.06; p=0.29). PwCF are at increased risk of adverse cardiac disease events. Future work should focus on defining determinants of cardiovascular risk such that appropriate risk stratification can be employed.