Lower Rates Of Obesity Research Articles

Abstract PS7-69: Molecular profiles and clinical-pathological features of Asian early-stage breast cancer patients

Abstract Background/Objective: Breast cancer incidence in Asian populations has increased in recent years, and variation in prognosis and tumor subtypes indicates that further study is warranted to characterize these differences and identify actionable targets. Patients of Asian ancestry are underrepresented in US registries, and few studies have characterized molecular profiles for these patients. In the current analysis, we assess clinical, pathological, and molecular profiles from self-reported Asian breast cancer patients (AS), in comparison with age-matched Caucasian (CA) and African American patients (AA), to evaluate the influence of Asian ancestry on differential gene expression in breast tumors. Methods: This meta-analysis included cohorts of self-reported AS, CA, and AA with early-stage, invasive breast cancer (EBC) prospectively enrolled in the US from 2011 to 2020 in FLEX (NCT03053193), MINT (NCT01501487), or IMPACt (NCT02670577) trials. AS were significantly younger (mean, 55 years) than CA (mean, 61 years, p<0.001) or AA (mean, 59 years, p=0.005); thus, an age-matched subset was selected for analyses. 70-gene signature (MammaPrint, MP), 80-gene signature (BluePrint, BP), and clinical-pathological features were compared among age-matched AS (n=103), CA (n=103), and AA (n=100). Whole-genome expression data were quantile normalized using R limma package, and differentially expressed genes (DEGs) were compared among AS (n=90), CA (n=102), and AA (n=96). DEGs with adjusted p-value <0.05 and log2 fold change > ± 0.5 were considered significant. Results: AS tumors were classified as 59% MP HR, compared with 44% HR in age-matched CA (p=0.08) and 64% HR in age-matched AA (p=0.17). AS had a significantly lower rate of obesity (16%, body mass index ≥30) compared with CA (41%) and AA (67%) (p<0.001). Tumors of AS were predominantly ductal carcinoma (84%), T1 (59%), grade 1 or 2 (70%), lymph-node negative (69%), ER+ (95%), and HER2-negative (89%). Distribution of ER, PR, and HER2 pathology and BP subtypes for AS were similar to CA but significantly different from AA (Table). Histologic tumor type, tumor grade, tumor stage, nodal stage, menopausal status, and frequency of Type 2 diabetes mellitus were not significantly different between AS and CA or AA. Whole-genome expression comparisons revealed 19 significant DEGs between AS and CA, and 45 significant DEGs between AS and AA. Immune-related genes, primarily those involved with B cell responses and signaling, were more highly expressed in AS compared with CA. Expression of genes related to cell-cycle pathways was greater in AS compared with AA. Conclusions: AS were significantly younger and more often pre/peri-menopausal at diagnosis compared with CA and AA, consistent with the literature. Most clinical-pathological factors were similar between age-matched groups, except for the obesity rate, which was significantly lower in AS than in CA or AA. Although not significant, AS had EBC that was more often MP HR than CA and less often HR than AA; studies with larger patient groups will help confirm these trends. The current analysis revealed different underlying gene expression pathways in AS compared with other ethnic groups, which may result in differential clinical outcomes. As genomic profiling data are not widely available for Asian American EBC patients, further analyses are warranted to elucidate these outcomes and identify appropriate therapeutic strategies. Pathology and Genomic Results(unknowns excluded)Asian (n=103)Caucasian (n=103)African American (n=100)p-valueAS vs. CAp-value AS vs. AAER status (IHC)ER Positive69 (94.5%)89 (98.9%)73 (80.2%)0.1250.010ER Negative4 (5.5%)1 (1.1%)18 (19.8%)PR status (IHC)PR Positive64 (87.7%)81 (90%)63 (69.2%)0.4110.006PR Negative9 (12.3%)9 (10%)28 (30.8%)HER2 (IHC/FISH)HER2 Positive3 (4.2%)3 (3.4%)13 (14.3%)0.1720.017HER2 Negative64 (88.9%)85 (95.5%)77 (84.6%)Equivocal5 (6.9%)1 (1.1%)1 (1.1%)MP/BP resultsLuminal A39 (40.6%)51 (53.7%)28 (30.4%)0.2320.043Luminal B45 (46.9%)38 (40.0%)42 (45.7%)HER2 (MP HR)7 (7.3%)4 (4.2%)5 (5.4%)Basal (MP HR)5 (5.2%)2 (2.1%)17 (18.5%) Citation Format: Margaret Chen, Ava Kwong, Carolyn Hendricks, Nina D'Abreo, Laura Lee, Hatem H. Soliman, Charles Cox, Heather M. Kling, Rajith Bhaskaran, Shiyu Wang, Andrea Menicucci, Sarah Untch, William Audeh, FLEX Investigators Group. Molecular profiles and clinical-pathological features of Asian early-stage breast cancer patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-69.

The epidemiology of NAFLD and lean NAFLD in Japan: a meta-analysis with individual and forecasting analysis, 1995-2040.

NAFLD is increasing in Asia including Japan, despite its lower obesity rate than the West. However, NAFLD can occur in lean people, but data are limited. We aimed to investigate the epidemiology of NAFLD in Japan with a focus on lean NAFLD. We searched PubMed, Cochrane Library, EMBASE, Web of Science, and the Japan Medical Abstracts Society (inception to 5/15/2019) and included 73 eligible full-text original research studies (n = 258,531). We used random-effects model for pooled estimates, Bayesian modeling for trend and forecasting, contacted authors for individual patient data and analyzed 14,887 (7752 NAFLD; 7135 non-NAFLD-8 studies) patients. The overall NAFLD prevalence was 25.5%, higher in males (p < 0.001), varied by regions (p < 0.001), and increased over time (p = 0.015), but not by per-person income or gross prefectural productivity, which increased by 0.64% per year (1983-2012) and is forecasted to reach 39.3% in 2030 and 44.8% in 2040. The incidence of NAFLD, HCC, and overall mortality were 23.5, 7.6 and 5.9 per 1000 person-years, respectively. Individual patient-level data showed a lean NAFLD prevalence of 20.7% among the NAFLD population, with lean NAFLD persons being older and with a higher all-cause mortality rate (8.3 vs. 5.6 per 1000 person-years for non-lean NAFLD, p = 0.02). Older age, male sex, diabetes, and FIB-4 were independent predictors of mortality, but not lean NAFLD. NAFLD prevalence has increased in Japan and may affect half of the population by 2040. Lean NAFLD individuals makeup 20% of the NAFLD population, were older, and had higher mortality.

In-hospital outcomes after percutaneous coronary interventions in cardiac allograft recipients.

Introduction:The average age and survival of heart transplant recipients have improved significantly over the last 10 years. In these long-term survivors, coronary allograft vasculopathy is one of the most common causes of death. There is a paucity of large-data research highlighting the short-term outcomes of percutaneous coronary interventions in cardiac allograft recipients.Methods:We compared the in-hospital outcomes of heart transplant recipient and non-transplant recipients following percutaneous coronary intervention using data from the National inpatient sample (NIS). All adult patients (age ⩾ 18 years) who had percutaneous coronary intervention in the index admissions from January of 2005 to December of 2014 were included in the analysis. They were then divided into two groups based on their heart transplant status. The primary outcome was in-hospital mortality. Secondary outcomes were stroke, cardiac arrest, duration of hospitalization, and total hospital charges. Logistic regression models were used to compare in-hospital outcomes between the two groups.Results:Of 1,316,528 patients who had percutaneous coronary intervention, 618 (0.05%) were heart transplant recipients and 1,315,910 (99.95%) were not. The heart transplant recipient group was significantly younger with lower rates of obesity and peripheral vascular disease but higher rate of chronic kidney disease, iron deficiency anemia, and chronic liver disease. There was significantly higher in-hospital mortality in transplant recipients below 65 years of age (adjusted odds ration = 2.3, p value < 0.0001). Subjects in the heart transplant recipient group also had longer hospital stays (p value = 0.002).Conclusion:Heart transplant recipients younger than 65 years had higher in-hospital mortality. Subjects in the heart transplant recipient group were also younger and had longer duration of hospitalization than the non-transplant cohorts.

The Role of Life Style Modifications in Comprehensive Non-Alcoholic Fatty Liver Disease Treatment.

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Conjunctural hunger and structural obesity in the global scenario: reflections on what Covid-19 masks reveal

ABSTRACT This essay is a reflection on the interconnection of the Covid-19 pandemic, social inequality, food insecurity and obesity in the global scenario. The pandemic health crisis is bound to an economic and social crisis marked by an increase in unemployment and a decrease in income with a consequent growth of food and nutritional insecurity. The impacts are felt worldwide, although the situation in each country, with regard to the conditions of social inequality and access to food, influences the magnitude of the pandemic consequences. At the same time, we are aware that food and nutritional insecurity is associated with low food quality and higher rates of obesity, which impairs the immune response and predisposes to worse prognosis. Thus, more economically vulnerable populations must face poorer disease outcome, besides the worsening of the economic situation and food and nutritional insecurity and the increase in obesity rates.

Consumer Comprehension of the Nutrition Facts Label: A Comparison of the Original and Updated Labels.

Compare consumers' overall label comprehension of the original Nutrition Facts (NF) label with the updated label. Online survey conducted in 2019. Participants randomly assigned to original label, updated-single column, or updated-dual column labeling condition and asked to complete a series of label comprehension questions. Online survey; participants recruited through Prolific. N = 992 U.S. adults. Sample similar to U.S. population in terms of sex (49.2% female), race (73.3% White/Caucasian), and household size (mean = 2.7 members). However, sample was younger (median age: 29.0), more educated (98.8% high school graduate or higher), and exhibited a lower rate of obesity (22.6% obese) than the U.S. population. Dependent variables: objective (% correct) NF label comprehension. Independent variables: label condition, nutrition knowledge, and socio-demographic variables. Regression analysis assessed relationships between label condition and label comprehension. Significance level of 5% used for analyses. Average score for objective comprehension was 81.4%. The updates did not significantly improve label comprehension. Participants in the updated NF label conditions had trouble answering questions related to total and added sugars. Results suggest consumers may struggle to correctly utilize information on the updated NF label, specifically total and added sugars. Consumers may benefit from educational opportunities on using the new label.

Obesity may contribute to Japanese COVID-19 death rate

Japan enjoys the longest expectation of life at birth among major developed countries, and one possible reason for this is that obesity is rare in Japan. Further, COVID-19 death rate is extremely low in South Korea and Japan compared to the other developed countries, and low obesity rate may be related to this phenomenon.

An Assessment of the Food Retail Environment in Counties with High Obesity Rates in Mississippi

ABSTRACT Low dietary quality and high obesity rates have been associated with poor food environments. Existing literature on food environments generally uses store audits, which presents several limitations. Our study addresses this shortcoming by using store-level scanner data to analyze prices and store healthfulness across counties with high and low obesity rates in Mississippi. We find that overall food prices are lower in counties with higher obesity rates, which seems to be driven by the lower prices of unhealthy foods. In contrast, healthy foods are more expensive in counties with higher rates of obesity compared with the rest of the state.

COVID-19 mortality effects of underlying health conditions in India: a modelling study

ObjectiveTo model how known COVID-19 comorbidities affect mortality rates and the age distribution of mortality in a large lower-middle-income country (India), and to identify which health conditions drive differences with...

Trends in obesity by socioeconomic status among non-pregnant women aged 15-49 y: a cross-sectional, multi-dimensional equity analysis of demographic and health surveys in 11 sub-Saharan Africa countries, 1994-2015.

BackgroundGlobal obesity estimates show a steadily increasing pattern across socioeconomic and geographical divides, especially among women. Our analysis tracked and described obesity trends across multiple equity dimensions among women of reproductive age (15–49 y) in 11 sub-Saharan African (SSA) countries during 1994–2015.MethodsThis study consisted of a cross-sectional series analysis using nationally representative demographic and health surveys (DHS) data. The countries included were Cameroon, Comoros, Congo, Cote d'Ivoire, Ghana, Kenya, Lesotho, Nigeria, Senegal, Zambia and Zimbabwe. The data reported are from a reanalysis conducted using the WHO Health Equity Assessment Toolkit that assesses inter- and intra-country health inequalities across socioeconomic and geographical dimensions. We generated equiplots to display intra- and inter-country equity gaps.ResultsThere was an increasing trend in obesity among women of reproductive age across all 11 SSA countries. Obesity increased unequally across wealth categories, place of residence and educational measures of inequality. The wealthiest, most educated and urban dwellers in most countries had a higher prevalence of obesity. However, in Comoros, obesity did not increase consistently with increasing wealth or education compared with other countries. The most educated and wealthiest women in Comoros had lower obesity rates compared with their less wealthy and less well-educated counterparts.ConclusionA window of opportunity is presented to governments to act structurally and at policy level to reduce obesity generally and prevent a greater burden on disadvantaged subpopulation groups in sub-Saharan Africa.

Prevalence of obesity in children enrolled in private and public primary schools

Obesity is a growing scourge in Africa. More and more children are exposed to it. This study was designed to assess obesity in children enrolled in private and public primary schools in three communes in the health district of Abidjan, in the south of Côte d'Ivoire. This study involved 1251 children enrolled in six schools due to two schools per municipality (Cocody, Yopougon and Treichville) including 587 boys and 664 girls aged 5-15 years. Children were recruited from private and public primary schools. Anthropometric parameters (Weight, Height, waist circumference, Body mass index) and blood pressure were measured. Data on eating habits were collected using a questionnaire. Overall, 1251 children were enrolled, or 592 and 659 children in private and public primary schools, respectively. The majority of the children (54.2% [678/1251]) were of normal weight. However, 35.5%, 7.8% and 2.4% of the children were, respectively, underweight, overweight and obese. Overweight including obesity was 10.2%. Overweight and abdominal obesity were common among girls compared to boys (χ2=0.113, P=0.001). The low obesity rate (2.4%) observed in our study is probably due to the fact that children are very active. The prevalence of hypertension in overweight people, including obese, was 20.3%. Systolic and diastolic blood pressure was influenced by both BMI and gender with higher systolic (χ2=0.142, P=0.001) and diastolic (χ2=0.135, P=0.001) blood pressure observed in girls. Our study points out that in addition to a sedentary lifestyle; obesity is also linked to the socio-economic status and daily diet of children. We recommend introducing and operationalizing sports activity in the education system in order to reduce the frequency of obesity and its corollary of metabolic diseases among children.

High plasma salivary \u03b1-amylase, but not high AMY1 copy number, associated with low obesity rate in Qatari adults: cross-sectional study

The relationship between salivary α-amylase activity (psAAa) or AMY1 copy number and the risk of obesity remains controversial. We aimed to assess this relationship in a cohort from Qatar, where obesity affects 43% of adults. The relationship was investigated cross-sectionally in 923 Qatari adults from the Qatar biobank cohort. AMY1 CN was estimated form whole genome sequencing data. The associations with obesity prevalence were assessed by linear and logistic regressions. We found no difference in AMY1 CN between obese and normal-weight individuals. However, the psAAa was significantly lower in obese individuals. Significant inverse correlations were found between adiposity markers and psAAa in both sexes, but were marginally stronger in men. A significant effect of high psAAa, but not AMY1 CN, on reduced obesity rates was identified in men (OR per psAAa unit 0.957 [95% CI 0.937–0.977], p < 0.001, with psAAa ranging between 5 to 66 U/L). A significantly higher prevalence of obesity was observed in the lowest quartile of psAAa in men (75% (Q1) vs. 36% (Q4), p < 0.001) and women (74% (Q1) vs 56% (Q4), p = 0.009). Our findings suggest that high psAAa, but not AMY1 CN, has a potential positive benefit against obesity in the Qatari population.

Omega-3 fatty acids improve flow-induced vasodilation by enhancing TRPV4 in arteries from diet-induced obese mice.

Previous studies have shown the intake of omega-3 polyunsaturated fatty acids is associated with low rates of obesity and ischaemic pathologies. Omega-3 also have anti-inflammatory and plaque-stabilization effects and regulate vasodilation and constriction. However, there are few studies of the role of omega-3 in flow-induced vasodilation involving Ca2+-permeable ion channel TRPV4 in high-fat diet-induced obese (DIO) mouse. Here, we determined whether omega-3 protect against vascular dysfunction induced by a high-fat diet by enhancing TRPV4 activity and subsequently improving flow-mediated vasodilation. Flow-mediated vasodilation in second-order mesenteric arteries from mice was measured using a pressure myograph. The intracellular Ca2+ concentration in response to flow and GSK1016790A (a TRPV4 agonist) was measured by Fluo-4 fluorescence. Whole-cell current was measured by patch clamp. Cell membrane tether force was measured by atomic force microscopy. Impairment of flow-mediated vasodilation in arteries and Ca2+ influx in endothelial cells from DIO mice was restored by omega-3 treatment. The improved flow-induced vasodilation was inhibited by the TRPV4 antagonist HC067047 and in TRPV4-/- mice. Omega-3 treatment enhanced endothelial TRPV4 activity and altered cell membrane mechanic property, as indicated by enhanced GSK1016790A-induced Ca2+ influx and whole-cell current and altered membrane mean tether force in endothelial cells from DIO mice. Omega-3 improve vascular function by improving flow-induced vasodilation via enhancing TRPV4 activity in the endothelium of obese mice which may be related to improved cell membrane physical property. Activation of TRPV4 in endothelium plays an important role in the protective mechanisms of omega-3 against vascular dysfunction in obesity by improving flow-mediated vasodilation.

Prevalence, incidence and predictors of cardiovascular risk factors: longitudinal data from rural and urban South India and comparison with global data

IntroductionIndia has high mortality rates from cardiovascular disease (CVD). Understanding the trends and identifying modifiable determinants of CVD risk factors will guide preventive strategies and policy making.Research design and methodsCVD...

Cardiovascular risk factors among 3712 Greek seafarers.

Global concern on seafarers' health and its potential cost is widely evident across the shipping industry. Seafarers are at increased cardiovascular risk since it is common to have risk factors associated with that risk such as hyperlipidaemia, obesity and smoking. The aim of this study is to assess the prevalence of the main risk factors for cardiovascular disease (CVD), i.e. hyperlipidaemia, smoking and obesity, in Greek seafarers. During pre-embarkation medical examination, seafarers undergo an interview with a physician, physical examination and laboratory tests. The parameters studied included hyperlipidaemia, identified as low density lipoprotein > 150 mg/dL, tobacco use or severe obesity, as defined by body mass index > 35 kg/m2. A total of 3712 seafarers have been examined. Seafarers had overall rates of 3% hyperlipidaemia, 4% tobacco use and 0.2% severe obesity, with similar distributions in all age groups. Our study shows that Greek seafarers have lower risk for CVD, as low rates of obesity, tobacco use, and hyperlipidaemia are observed. The related literature is discussed. Unhealthy eating patterns are the rule and contribute to CVD. Shipping management could improve diet on board; however, smoking falls rather under individual control. We conclude that, despite the low rates of hyperlipidaemia, smoking and obesity among Greek seafarers compared to other nations, campaigns for promoting awareness of the phenomenon and on the potential health impact of these conditions should be promoted.

Caesarean section rates in women in the Republic of Ireland who chose to attend their obstetrician privately: a retrospective observational study

BackgroundCaesarean section (CS) rates are increasing and there are wide variations in rates internationally and nationally. There is evidence that women who attend their obstetrician privately have a higher incidence of CS than those who attend publicly. The purpose of this observational study was to further investigate why CS rates may be higher in women who chose to attend their obstetrician privately.MethodsThis study analysed data collected as part of the clinical records by midwives at the woman’s first antenatal appointment in a large European maternity hospital. All women who delivered between the years 2009 and 2017 were included. Data were analysed both cross-sectionally and longitudinally.ResultsOverall, 73,266 women had a singleton pregnancy and 1830 had a multiple pregnancy. Of the packages of maternity care, 75.2% chose public, 10.8% chose semiprivate and 14.0% chose private. During the study, 11,991 women attended the hospital for their first and second pregnancies. Overall, women who attended privately were older and had higher proportions of infertility treatment and history of miscarriage (all p < 0.001) compared to those publicly-funded. Private patients were more likely to have a history of infertility, a history of miscarriage, a multiple pregnancy and to be ≥35 yrs. They had lower rates of obesity, smoking and illicit drug use in pregnancy (all p < 0.001). In women who chose private care, the overall rate of CS was higher compared to women choosing publicly-funded (42.7% vs 25.3%, p < 0.001) The increase was due to an increase in elective rather than emergency CS. The increase in elective CS fell after adjustment for clinical risks. In the longitudinal analysis, 89.7% chose the same package second time around. Women who changed from public to private care for the second pregnancy were more likely to have had a previous emergency CS or admission to the Neonatal Unit.ConclusionsThis study suggests that the increased CS rate in women privately insured may be attributed, in part, to the fact that women who can afford health insurance choose continuity of care from a senior obstetrician because they are risk adverse and wish to have the option of an elective CS.

Syndemic effects in complex humanitarian emergencies: A framework for understanding political violence and improving multi-morbidity health outcomes

A hallmark of complex humanitarian emergencies is the collective exposure, often over extended periods of time, to political violence in the forms of war, terrorism, political intimidation, repression, unlawful detention, and forced displacement. Populations in complex humanitarian emergencies have higher risks of multiple co-morbidities: mental disorders, infectious diseases, malnutrition, and chronic non-communicable diseases. However, there is wide variation in the health impacts both across and within humanitarian emergencies. Syndemic theory is an approach to conceptualizing disease and social determinants to understand differential patterns of multi-morbidity, elucidate underlying mechanisms, and better design interventions. Syndemic theory, if applied to complex humanitarian emergencies, has the potential to uncover origins of localized patterns of multi-morbidity resulting from political violence and historical inequities. In this paper, we present two case studies based on mixed-methods research to illustrate how syndemic models can be applied in complex humanitarian emergencies. First, in a Nepal case study, we explore different patterns of posttraumatic stress disorder (PTSD) and depression co-morbidity among female former child soldiers returning home after war. Despite comparable exposure to war-related traumas, girl soldiers in high-caste Hindu communities had 63% co-morbidity of PTSD and depression, whereas girl soldiers in communities with mixed castes and religions, had 8% PTSD prevalence, but no cases of PTSD and depression co-morbidity. In the second case study, we explore the high rates of type 2 diabetes during a spike in political violence and population displacement. Despite low rates of obesity and other common risk factors, Somalis in Ethiopia experienced rising cases of and poor outcomes from type-2 diabetes. Political violence shapes healthcare resources, diets, and potentially, this epidemiological anomaly. Based on these case studies we propose a humanitarian syndemic research agenda for observational and intervention studies, with the central focus being that public health efforts need to target violence prevention at family, community, national, and global levels.

High carbohydrate and noodle/meat-rich dietary patterns interact with the minor haplotype in the 22q13 loci to increase its association with non-alcoholic fatty liver disease risk in Koreans

Non-alcoholic fatty liver(NAFLD) is prevalent in Asians despite the low obesity rate. We hypothesized that the haplotype of genetic variants in the 22q13 loci has a strong association with non-alcoholic fatty liver disease (NAFLD) that can be identified by genome-wide association study and that lifestyles may interact with the haplotype. We tested the hypothesis in middle-aged and elderly adults in a large city hospital-based cohort from the KoGES study. Men and women diagnosed with fatty liver, but who respectively consumed over 40 and 30 g ethanol per day were excluded. The haplotype of the selected SNPs from the 22q13 loci that influences NAFLD risk was generated. Among the 27374 participants, 1486 (5.4%) were diagnosed with NAFLD. LARGE_rs240072, RBFOX2_rs11089778, TRIOBP_rs12628603, PNPLA3_rs738409, and PARVB_rs2073080 in the 22q13 loci were included in the haplotype. Participants with the minor haplotype had 1.8, 2.3, and 1.8 times higher in the risk for NAFLD and serum AST and ALT activities, respectively, than those with the major haplotype. BMI, waist circumferences, serum glucose concentrations, and blood pressure interacted with the haplotype for NAFLD risk. We also found that a high carbohydrate intake and a dietary pattern characterized by high noodle and meat consumption significantly interacted with the minor haplotype to increase the risk of NAFLD. We hypothesized that the high incidence of NAFLD among Koreans, despite a relatively low incidence of obesity, might be due to genetic factors and perhaps their interactions with dietary patterns. The hypothesis was accepted since this study confirmed that participants with the minor allele of the haplotype in the 22q13 loci had a higher NAFLD risk that was exacerbated by high intakes of carbohydrates and a dietary pattern characterized by high noodle and meat consumption.

Body mass index and waist-to-hip ratio misclassification of overweight and obesity in Chinese military personnel

BackgroundThe rising prevalence of obesity in military personnel has raised great concerns. Previous studies suggest that body mass index (BMI)- and waist-to-hip ratio (WHR)-based obesity classifications in US military personnel and firefighters have high false negative and subsequently cause obesity misclassification.ObjectiveTo determine whether BMI and WHR could reflect the fat mass of Chinese military personnel.MethodsThree hundred fifty-three male Chinese military personnel and 380 age-matched male adults were recruited. Obesity classification was defined by BMI, WHR, and body fat percentage (BFP).ResultsChinese military personnel had extremely low obesity rate determined by either BFP (0.3%) or BMI (0.6%). By combining overweight and obese individuals, BMI- and WHR-determined prevalence of overweight/obesity was 22.4% and 17.0% compared to BFP-based standard (4.0%) (P < 0.05). In reference to BFP, BMI and WHR have high false-positive rate compared to the control group. Further analysis showed that Chinese military personnel consisted of high percentage of BFPlowBMIhigh and/or BFPlowWHRhigh subpopulations. Eighty-one percent of BMIhigh and 78.3% of WHRhigh of them were BFP low.ConclusionsChinese military personnel has extremely low obesity rate. BMI and WHR have high false-positive rates in reference to BFP, which cannot accurately reflect the mass of adipose tissue and leads to obesity misclassification.

Land use mix in the neighbourhood and childhood obesity.

SummaryLand use mix (LUM) in the neighbourhood is an important aspect for promoting healthier lifestyles and consequently reducing the risk for childhood obesity. However, findings of the association between LUM and childhood obesity remain controversial. A literature search was conducted on Cochrane Library, PubMed and Web of Science for articles published before 1 January 2019. In total, 25 cross‐sectional and two longitudinal studies were identified. Among them, Geographic Information Systems were used to measure LUM in 15 studies, and perceived LUM was measured in 12 studies. Generally, most studies revealed an association between a higher LUM and higher PA levels and lower obesity rates, although some studies also reported null or negative associations. The various exposure and outcome assessment have limited the synthesis to obtain pooled estimates. The evidence remains scare on the association between LUM and children's weight status, and more longitudinal studies are needed to examine the independent pathways and causality between LUM and weight‐related behaviours/outcomes.