Obese Middle-aged Adults Research Articles

Accuracy of the WHO's body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil.

Introduction.Obesity is defined by the World Health Organization (WHO) as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. However, the appropriate cut-off point of body mass index (BMI) based on body fat percentage (BF%) for classifying an individual as obese in middle-aged adults living in Rio de Janeiro remains unclear.Materials and methods.This was a prospective cross-sectional study comprising of 856 adults (413 men and 443 women) living in Rio de Janeiro, Brazil ranging from 30-59 years of age. The data were collected over a two year period (2010-2011), and all participants were underwent anthropometric evaluation. The gold standard was the percentage of body fat estimated by bioelectrical impedance analysis. The optimal sensitivity and specificity were attained by adjusting BMI cut-off values to predict obesity based on the WHO criteria: BF% >25% in men and >35% in women, according to the receiver operating characteristic curve (ROC) analysis adjusted for age and for the whole group.Results.The BMI cut-offs for predicting BF% were 29.9 kg/m2 in men and 24.9 kg/m2 in women.ConclusionsThe BMI that corresponded to a BF% previously defining obesity was similar to that of other Western populations for men but not for women. Furthermore, gender and age specific cut-off values are recommended in this population.Significance for public healthWorld Health Organization (WHO) defines obesity as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. The WHO suggested cut-off point for obesity is a body mass index (BMI) of 30 kg/m2, which is associated with morbidity and mortality. An important issue in the debate over measuring obesity concerns the use of BMI to define obesity across different populations. However, it is not clear, what is an appropriate cut-off point of BMI based on body fat percentage (BF%) to classify an individual as obese within gender-age groups and to distinguish categories of BF% in middle-aged adults living in the city of Rio de Janeiro.

복합 운동이 비만 중년성인의 건강변인에 미치는 효과에 대한 메타분석

The aim of this study is to analyze the effect of exercise programs through the meta-analysis of the influence of combined exercise by obese middle-aged adults on health-related parameters. For the analysis of the data, 38 preceding studies were selected to analyze the effect of the combined exercise program and meta-analysis was conducted by using the CMA3.0 program. The findings of the study are as follows: First, a total of 38 effect sizes were calculated and the overall effect size of the combined exercise was .810, indicating a large effect size. Second, according to the sub-analysis based on the health variables of composite exercise, all health variables had a moderate effect size. Specifically, participating in combined exercise had a strong effect on BMI, body fat percentage among the sub-factors of body composition as well as cardiopulmonary endurance among the sub-factors of fitness. In addition, Adiponectin Insulin, HOMA-IR, TNF-a, Leptin, LDL-C and Glucose had a significant effect on blood variables. Third, for obese middle-aged adults, working out in the order of resistance exercise after aerobic exercise at least 4 times per week for a minimum 60 minutes a day for a period of 10 weeks or more was effective.

Accumulated exposure to rural areas of residence over the life course is associated with overweight and obesity in adulthood: a 25-year prospective cohort study

PurposeThis prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood. MethodsParticipants aged 7–15 years in 1985 (n = 8498) were followed up in 2004–2006 (n = 3999, aged 26–36 years) and 2009–2011 (n = 3049, aged 31–41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009–2011). We tested which of three life-course models (“accumulation,” “sensitive period,” “mobility”) best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework. ResultsAccumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m2 per time in a rural area, P = .005) and were more likely obese (relative risk = 1.13 per time in a rural area, P = .002). Living in rural areas at ages 26–30 years was also associated with a higher BMI and obesity in mid-adulthood. ConclusionsGreater cumulative exposure to rurality and exposure during the “sensitive period” of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.

Whey Protein Supplementation and Higher Total Protein Intake Do Not Influence Bone Quantity in Overweight and Obese Adults Following a 36-Week Exercise and Diet Intervention

Controversy exists concerning the effects of higher total protein intake (TPro) on bone health, which may be associated with reduced bone mineral density (BMD). However, whey protein (WP) may induce bone formation because of its basic component, milk basic protein. This study assessed the effects of WP supplementation, TPro, and change in TPro (postsupplementation - presupplementation) on BMD and bone mineral content (BMC; total body, lumbar spine, total femur, and femoral neck) in overweight and class I obese middle-aged adults following an exercise intervention. This analysis used data from a double-blind, randomized, placebo-controlled 36-wk WP supplementation trial, wherein participants consumed a 1.7-MJ (400-kcal) supplement (0, 20, 40, or 60 g WP/d) along with their otherwise unrestricted diet while participating in a resistance and aerobic exercise intervention (3 d/wk). TPro was the summation of WP and habitual dietary intakes (4-d food record). Statistical analyses for WP were based on group and bone data [n = 186, 108 women; mean ± SD age: 49 ± 8 y; body mass index (BMI; in kg/m2): 30.1 ± 2.8], whereas TPro was based on dietary and bone data (n = 113, 70 women; age 50 ± 8 y; BMI 30.1 ± 2.9). WP supplementation, regardless of dose, did not influence BMD or BMC following the intervention. By using a multiple linear regression model, TPro (expressed as g/d or g · kg-1 · d-1) and change in TPro (expressed as g/d) were not associated with responses over time in total or regional BMD or BMC. By using a cluster analysis approach [<1.0 (n = 41), 1.0-1.2 (n = 28), and ≥1.2 g · kg-1 · d-1 (n = 44)], TPro was also not associated with responses in total or regional BMD or BMC over time. WP supplementation and total dietary protein intake did not negatively or beneficially influence bone quantity in overweight and obese adults during a 9-mo exercise intervention. This trial was registered at clinicaltrials.gov as NCT00812409.

In silico dissection of miRNA targetome polymorphisms and their role in regulating miRNA-mediated gene expression in esophageal cancer.

Esophageal cancer is the eighth most common cancer worldwide. Also middle-aged obese adults with higher body mass index during childhood have a greater risk to develop esophageal cancer. The contribution of microRNAs to esophageal cancer has been extensively studied and it became clear that these noncoding RNAs may play crucial roles in pathogenesis, diagnosis and prognosis of the disease. Increasing evidences have suggested that polymorphisms perturbing microRNA targetome (i.e., the compendium of all microRNA target sites) are associated with cancers including esophageal cancer. However, the extent to which such variants contribute to esophageal cancer is still unclear. In this study, we applied an in silico approach to systematically identify polymorphisms perturbing microRNA targetome in esophageal cancer and performed various analyses to predict the functional consequences of the occurrence of these variants. The computational results were integrated to provide a prioritized list of the most potentially disrupting esophageal cancer-implicated microRNA targetome polymorphisms along with the in silico insight into the mechanisms with which such variations may modulate microRNA-mediated regulation. The results of this study will be valuable for future functional experiments aimed at dissecting the roles of microRNA targetome polymorphisms in the onset and progression of esophageal cancer.

Higher Total Protein Intake and Change in Total Protein Intake Affect Body Composition but Not Metabolic Syndrome Indexes in Middle-Aged Overweight and Obese Adults Who Perform Resistance and Aerobic Exercise for 36 Weeks1–3

Background: Studies assessing the effects of protein supplementation on changes in body composition (BC) and health rarely consider the impact of total protein intake (TPro) or the change in TPro (CTPro) from participants' usual diets.Objective: This secondary data analysis assessed the impact of TPro and CTPro on changes in BC and metabolic syndrome (MetS) indexes in overweight and obese middle-aged adults who participated in an exercise training program.Methods: Men and women [n = 117; age: 50 ± 0.7 y, body mass index (BMI; in kg/m2): 30.1 ± 0.3; means ± SEs] performed resistance exercise 2 d/wk and aerobic exercise 1 d/wk and consumed an unrestricted diet along with 200-kcal supplements (0, 10, 20, or 30 g whey protein) twice daily for 36 wk. Protein intake was assessed via 4-d food records. Multiple linear regression model and stratified analysis were applied for data analyses.Results: Among all subjects, TPro and CTPro were inversely associated (P < 0.05) with changes in body mass, fat mass (FM), and BMI. Changes in BC were different (P < 0.05) among groups that consumed <1.0 (n = 43) vs. ≥1.0 to <1.2 (n = 29) vs. ≥1.2 g · kg−1 · d−1 (n = 45). The TPro group with ≥1.0 to <1.2 g · kg−1· d−1 reduced FM and %FM and increased percentage of LM (%LM) compared with the lowest TPro group, whereas the TPro group with ≥1.2 g · kg−1· d−1 presented intermediate responses on changes in FM, %FM, and %LM. The gain in LM was not different among groups. In addition, MetS indexes were not influenced by TPro and CTPro.Conclusions: In conjunction with exercise training, higher TPro promoted positive changes in BC but not in MetS indexes in overweight and obese middle-aged adults. Changes in TPro from before to during the intervention also influenced BC responses and should be considered in future research when different TPro is achieved via diet or supplements. This trial was registered at clinicaltrials.gov as NCT00812409.

Depressive symptoms, anxiety and well-being among metabolic health obese subtypes

BackgroundThe metabolically healthy obese (MHO) phenotype is characterized by favorable lipid and inflammatory profiles, preserved insulin sensitivity and normal blood pressure. Limited data regards whether metabolically healthy obesity also confers beneficial effects on mental health and well-being exists. MethodsWe investigated depressive symptoms, anxiety and well-being among metabolically healthy and unhealthy obese and non-obese adults from a cross-sectional sample of 2047 middle-aged Irish men and women. Subjects were classified as obese (BMI ≥30kg/m2) and non-obese (BMI <30kg/m2). Metabolic health status was defined using three metabolic health definitions based on a range of cardiometabolic abnormalities including metabolic syndrome criteria, insulin resistance and inflammation. Depressive symptoms, anxiety and well-being were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization (WHO)-5 Well Being Index. ResultsRelative to the metabolically healthy non-obese individuals the risk of anxiety and depressive symptoms was greater among the metabolically unhealthy obese subjects (odds ratios (ORs) 1.63–1.66 and ORs 1.82–1.83 for anxiety and depressive symptoms, respectively depending on metabolic health definition). Increased risk of these conditions was not observed among the MHO subjects. ConclusionsOur data suggest that a favorable metabolic profile is positively associated with mental health among obese middle-aged adults, although findings were dependent on metabolic health definition. Improved understanding of the relationship between obesity associated metabolic health subtypes, anxiety and depressive symptoms may inform future targeted screening and interventions for those at greatest risk of adverse mental and cardiometabolic health outcomes.

016. Prevalence of metabolic syndrome between patients with obstructive sleep apnea

Background Obstructive sleep apnea (OSA) and metabolic syndrome (MS) are highly prevalent disorders among obese middle-aged adults. MS has been associated with OSA. Diagnosis of MS is set after fulfillment of either the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATP III) criteria or the International Diabetes Federation (IDF) criteria.

Abdominal obesity is associated with arterial stiffness in middle-aged adults

Background and aimsThe relation between adiposity and arterial stiffness remains controversial. We determined whether abdominal and visceral adipose tissue may be a better predictor of arterial stiffness than general obesity in middle-aged adults. Methods and resultsA total of 146 participants (76 men, 70 women; 50 years) were studied. The automatic vascular screening device (Omron VP-1000plus) was used to measure blood pressure simultaneously in the arms and ankles and to determine arterial stiffness by pulse wave velocity (PWV). Using multiple linear regressions, the relations between indicators of obesity and arterial stiffness were examined after adjustment for confounders. Both carotid-femoral PWV and brachial-ankle PWV were significantly associated with BMI (both P < 0.05) but not with body fat percentage. Measures of abdominal obesity, including waist circumference and visceral fat mass (via DXA), were strongly associated with PWV and remained positively associated with arterial stiffness after adjustment for age and gender. Cardiovascular fitness as assessed by maximal oxygen consumption was related to body fat percentage but not with visceral fat. More favorable cardiovascular health profile was associated with both lower visceral fat mass and PWV (both P < 0.001). ConclusionAbdominal obesity and visceral fat are associated with large artery stiffness. These findings support the importance of adiposity measures as a risk factor for arterial stiffening in middle-aged adults.

Childhood body mass index in relation to future risk of oesophageal adenocarcinoma.

Background:Middle-aged obese adults are at substantially elevated risk of oesophageal adenocarcinoma. It is unclear whether this risk originates earlier in life.Methods:We assessed associations between childhood body mass index (BMI) and height—measured annually between ages 7 and 13—with adult oesophageal adenocarcinoma in a cohort from the Copenhagen School Health Records Register. Analyses included 255 053 children born during 1930–1971. Danish Cancer Registry linkage provided outcomes. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression.Results:During 5.4 million person-years of follow-up, 254 (216 males) incident oesophageal adenocarcinomas occurred. At each examined age, cancer risk increased linearly per unit BMI z-score, although associations were only statistically significant for ages 9–13. The HR for the age of 13 years was 1.31 (95% CI: 1.13, 1.51) per unit BMI z-score. Associations were similar in men and women and across birth cohorts. Childhood height was not related to cancer risk in men but was in women, although these analyses included just 38 female cases. HRs per unit height z-score at the age of 13 years were 1.04 (0.90, 1.19) in males and 1.77 (1.27, 2.47) in females, with similar results observed at the other examined ages.Conclusion:Individuals with higher childhood BMI were at elevated risk of oesophageal adenocarcinoma, even though these cancers occurred many decades later in life. Although the mechanisms require further investigation, our findings provide additional evidence for the long-term health risks of childhood obesity.

Diastolic blood pressure is predictive of an elevated ventilatory efficiency slope in at-risk middle-aged obese adults that are asymptomatic for cardiovascular disease

Background: Cardiopulmonary exercise tests (CPET)assess oxygen uptake (VO 2 ) and ventilatory efficiency (V E /VCO 2 slope) as both are predictive measures of cardiovascular disease (CVD) severity in symptomatic adults. Specifically, the V E /VCO 2 slope is a powerful prognostic tool for assessing CVD severity and prognosis as it is effectively independent of a patient’s capacity to reach volitional fatigue. In asymptomatic adults, several clinical risk factors for CVD have been established for use in health assessments, and as a method for early CVD detection and prevention. Therefore, we evaluated the relationship between the V E /VCO 2 slope and several clinical CVD risk factors in at-risk but asymptomatic middle-aged obese adults. Methods: 29 obese adults (Mean ± SE; Age 46.5 ±2.6 years; BMI 35.9 ±1.1 kg/m 2 ) were stratified into low (LR<2 risk factor) or moderate risk (MR≥2 risk factors) from self-reported health history questionnaires and quantitative assessments and performed a treadmill CPET. Results: No differences in V E /VCO 2 slope between risk groups (LR30.1 ±1.8, MR29.2 ±0.9 V E /VCO 2 slope). The V E /VCO 2 slope positively associated with age and diastolic blood pressure (DBP) and not with the CVD risk factors BMI, HDL-C, LDL-C, fasting blood glucose, systolic blood pressure, or total risk factors; further DBP was the only predictor(r=0.429, r 2 =0.184, p= 0.037). Conclusion: DBP predicted a steeper ventilatory efficiency (V E /VCO 2 slope) in at-risk but asymptomatic for CVD middle-aged obese adults. Our findings indicate that the ventilatory efficiency slopes CVD risk and prognosis assessment extends to clinically at-risk middleaged asymptomatic obese adults, and may function as an additional measure for long-term health monitoring. Key words: body weight, exercise test, heart disease, obesity, & risk factors.

Short-Term Effect of Cinnamon on Blood Pressure in Middle-Aged Obese Adults

Short-Term Effect of Cinnamon on Blood Pressure in Middle-Aged Obese Adults

Type 2 diabetes in children.

Obesity is a major healthcare problem with more than six out of 10 Australian adults (1), and around one in four of all children and adolescents (2), being overweight or obese – a situation that is predicted to continue to worsen over the next 15 years (1). Childhood obesity is associated with numerous comorbidities (3), including a propensity to insulin resistance, which can lead to type 2 diabetes mellitus (T2DM) in susceptible individuals. While T2DM is still most commonly diagnosed in overweight or obese middle-aged adults, it is now not unheard of in adolescents (and even younger children) with this condition (4), leading to claims that we now face an ‘epidemic’ of T2DM in youth (5). Data from the SEARCH for Diabetes in Youth Study Group highlight this, with reports of an incidence of T2DM in 15–19-year-olds (between 2002 and 2003) of 11.8 per 100 000 person years – a figure similar to the incidence of type 1 diabetes mellitus (T1DM) within this age group (6,7). Further inspection of these data, however, reveals that the majority of young people diagnosed with T2DM are from ethnic groups who are at much higher risk of the condition (e.g. African–American, Hispanic, Asian/Pacific Islanders and American Indians) and that, within the whole paediatric cohort surveyed, the overall incidence of T2DM remained low when compared with T1DM. This had led some workers to question the claims of an ‘epidemic’ of paediatric T2DM (8), although there is general agreement that T2DM in youth appears to be emerging as a serious clinical issue (9). Paediatric T2DM is associated with a number of novel and complex management issues not been previously encountered within routine paediatric practice, and it is important that we begin to address these if we are to develop effective management programmes. Diagnostic difficulties

Predictors of increased body weight and waist circumference for middle-aged adults.

To identify predictors of increased adiposity for different measures of adiposity. Prospective cohort study, the Melbourne Collaborative Cohort Study (MCCS), with data at baseline (1990-1994) and wave 2 (2003-2007). Participants recruited from the community. Australian-born participants (n 5879) aged 40 to 69 years who were not current smokers and who were free from common chronic diseases at recruitment. At baseline and at wave 2, weight and waist circumference were measured; while demographic and lifestyle variables were obtained at baseline via structured interviews. Participants who reported any recreational physical activity at baseline had lower weight and smaller waist circumference at wave 2 than those who did not, particularly for younger participants and for vigorous physical activity. Walking for leisure was not associated, and greater physical activity at work was associated, with greater adiposity measures at wave 2. A diet low in carbohydrates and fibre, but high in fat and protein, predicted greater weight and waist circumference at wave 2. Participants were less likely to have elevated weight or waist circumference at wave 2 if they consumed low to moderate amounts of alcohol. Our findings indicate that promoting vigorous physical activity, encouraging a diet high in carbohydrate and fibre but low in fat and protein, and limiting alcohol intake could be promising approaches for preventing obesity in middle-aged adults. Similar interventions should successfully address the management of both weight and waist circumference, as they were predicted by similar factors.

Effect of cinnamon on blood glucose, satiety and caloric intake in middle‐aged obese adults

The objective of this study was to examine the effect of cinnamon on postprandial blood glucose, satiety and subsequent caloric intake in middle‐aged obese adults. Using a crossover design, subjects consumed 50 g available carbohydrate as a breakfast drink with or without 6 g ground cassia cinnamon. Blood glucose and satiety were evaluated at 0, 15, 30, 45, 60, 90 and 120 minutes. Ad libitum caloric intake was estimated from a meal served at 240 minutes. Twenty‐six adults (9 males and 17 females), aged 40–63 years, completed the study. Paired t‐test, with Bonferroni correction, assessed differences in blood glucose, satiety and caloric intake between the control and cinnamon conditions. There were no significant differences in blood glucose and satiety values at any time point between the two conditions (p&gt;;0.05). Subsequent caloric intake was similar in the two conditions (p&gt;;0.05). The lack of agreement with earlier research may be related to differences in study populations and/or study foods.

Watermelon extract supplementation reduces ankle blood pressure and carotid augmentation index in obese adults with prehypertension or hypertension

Ankle-brachial index (ABI) and ankle blood pressure (BP) are associated with increased carotid wave reflection (augmentation index, AIx). Oral L-citrulline and L-arginine from synthetic or watermelon sources have reduced brachial BP, aortic BP, and aortic AIx. A directly measured carotid AIx (cAIx) rather than aortic AIx has been proposed as a better measurement of central AIx. We evaluated the effects of watermelon extract on ankle BP and cAIx in individuals with normal ABI and prehypertension or stage 1 hypertension. Ankle and brachial systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), cAIx, ABI, and heart rate (HR) were evaluated in the supine position in 14 adults (11 women/3 men, age 58 ± 1 years) with prehypertension or stage 1 hypertension (153 ± 4 mm Hg). Subjects were randomly assigned to 6 weeks of watermelon extract supplementation (L-citrulline/L-arginine, 6 g daily) or placebo followed by a 2-week washout period and then crossover. Ankle and brachial SBP (-11.5 ± 3.8 and -15.1 ± 2.8 mm Hg), DBP (-7.8 ± 2.3 and -7.6 ± 1.8 mm Hg), and MAP (-9.8 ± 2.6 and -7.3 ± 1.8 mm Hg), and cAIx (-8.8 ± 2.6 %) decreased significantly (P < 0.05) after watermelon supplementation compared to placebo. Watermelon supplementation had no significant effect (P > 0.05) on ABI and HR. This study shows that watermelon extract supplementation reduces ankle BP, brachial BP, and carotid wave reflection in obese middle-aged adults with prehypertension or stage 1 hypertension and normal ABI, which may reflect improved arterial function.

유산소 운동과 저항 운동의 병행 실시가 비활동적인 중년 비만인의 심폐 체력에 미치는 영향

The purpose of this study was to investigate (1) whether combined aerobic and resistance training improves cardiorespiratory fitness more than aerobic training alone and (2) changes in cardiorespiratory fitness during relatively short period(4 months) of inactivity in obese middle-aged adults. 34 obese middle-aged adults(19 male, 15 female) underwent maximal exercise tests before and after 4 months of inactivity(control period, 1 exercise/week). After control period, subjects were divided into 3 treatments groups: aerobic training(A, n=10), resistance training(R, n=13), and combined aerobic and resistance training(AR, 11). Exercise training lasted 8 months and another maximal exercise test was conducted at the end of training. Although there was no changes in VO2max during control period, treadmill exercise time to exhaustion(TTE) was decreased(57 seconds, p.01) and body weight was increased(0.8kg, p0.5). R group showed significant improvements in VO2max, TTE, peak O2pulse. However, there was no additive effects of resistance training on VO2max in AR group. Increases of TTE in AR group (26.5%) was largest and significantly different from R group(8.2%, p.01), but there was no difference between A(18.8%) and AR. Ventilatory anaerobic threshold(VAT) improved significantly in both R and AR groups after training(p.01). TTE and VAT are more relevant to functional ability and endurance capacity of individuals than VO2max and results suggest that resistance training could be utilized as an important part of exercise program for the improvements of cardiorespiratory fitness in obese middle-aged adults.

Obesity in Middle-Aged Adults Linked to Childhood Abuse

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessObesity in Middle-Aged Adults Linked to Childhood AbuseJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:15 Aug 2008https://doi.org/10.1176/pn.43.16.0016aAs the obesity epidemic spreads throughout the world—China seems to be the latest casualty, according to the July/August Health Affairs—psychiatric researchers are stepping up their efforts to discover the mental health ramifications of obesity.For example, they have found associations between anxiety, depression, and binge eating and obesity, although whether these mental disorders contribute to obesity or result from it is not clear (Psychiatric News, September 16, 2005; August 18, 2006). They have linked late-teen depression with early-adulthood obesity in women (Psychiatric News, November 21, 2003). And now Claudia Thomas, Ph.D., of University College London and colleagues have coupled physical abuse in childhood with midlife obesity. Results were published in the May Pediatrics.A general population sample representative of United Kingdom adults in midlife—some 9,400 subjects born in 1958—participated in this study. At ages 7, 11, and 16, each subject was visited by a study investigator and evaluated for negative experiences such as physical or emotional neglect, domestic tension, parental alcoholism, or mother having little interest in a child's education.At age 45 each subject provided his or her recollections about negative experiences that he or she had encountered as a child—say, verbal, physical, or sexual abuse; parental depression; an authoritarian upbringing; or parental separation or divorce. Also at age 45, each subject's body mass index was determined.The researchers then used the prospectively and retrospectively obtained negative-experience findings, as well as subjects' body mass index at age 45, to determine whether negative childhood experiences could be linked with obesity at age 45.They found that such a link did in fact exist. Even when possibly confounding factors were considered, a highly significant link was found between physical abuse and midlife obesity, and statistically significant links were found between verbal abuse, a strict upbringing, and a mother having little interest in her child's education and midlife obesity.In contrast, no significant association was found between other negative childhood experiences—such as not getting along with parents, parental separation or divorce, or parental alcoholism—and midlife obesity. Intriguingly, a significant inverse association was found between maternal depression during childhood and midlife obesity.Thus, “Some childhood adversities increase the risk of obesity in adulthood,” Thomas and her colleagues concluded in their study report, whereas others do not, and still others, such as parental depression, might even be protective in this regard. However, the mechanisms underlying such associations remain to be clarified, they pointed out.The study was funded by the United Kingdom National Health Service, the United Kingdom Medical Research Council, and England's Department of Health.An abstract of “Obesity and Type 2 Diabetes Risk in Mid-Adult Life: The Role of Childhood Adversity” is posted at<http://pediatrics.aappublications.org/cgi/content/abstract/121/5/e1240>.▪ ISSUES NewArchived

The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study

BackgroundObesity causes or exacerbates a host of medical conditions, including cardiovascular, pulmonary, and endocrine diseases. Recently obesity in elderly women was associated with greater risk of dementia, white matter ischemic changes, and greater brain atrophy. The purpose of this study was to determine whether body type affects global brain volume, a marker of atrophy, in middle-aged men and women.MethodsT1-weighted 3D volumetric magnetic resonance imaging was used to assess global brain volume for 114 individuals 40 to 66 years of age (average = 54.2 years; standard deviation = 6.6 years; 43 men and 71 women). Total cerebrospinal fluid and brain volumes were obtained with an automated tissue segmentation algorithm. A regression model was used to determine the effect of age, body mass index (BMI), and other cardiovascular risk factors on brain volume and cognition.ResultsAge and BMI were each associated with decreased brain volume. BMI did not predict cognition in this sample; however elevated diastolic blood pressure was associated with poorer episodic learning performance.ConclusionThese findings suggest that middle-aged obese adults may already be experiencing differentially greater brain atrophy, and may potentially be at greater risk for future cognitive decline.

Obesity and Related Factors in Middle-aged Adults in Chung-Hsing Village, Taiwan

Background. For this study, we used data collected in Chung-Hsing Village, Taiwan in May 1998 to evaluate the relationship between obesity and the related factors in middle-aged adults. Methods. Employees working for the Taiwan Provincial Government in Chung-Hsing Village, Taiwan between the ages of 40 and 64years were the candidates for this study. Only 707 volunteers completed the necessary blood tests. To determine which factors were significantly related to obesity, t-test, chi-squared analysis, and multivariate logistic regression were used. Results. Forty percent of the subjects were men and 60.0% were women. The mean age was 50.5±6.8 years. The mean values of body mass index were 24.7±2.8 kg/m2 in men and 23.7±3.1 kg/m2 in women (p ＜ 0.01). The prevalence of obesity was 11.0% in men and 8.7% in women (p ＞0.05). After controlling the covariates, the multivariate logistic regression analysis showed that the significant factors of obesity were high systolic pressure and hyperuricemia. Conclusions. The prevalence of obesity was high in middle-aged adults in Chung-Hsing Village, Taiwan. It may be important to check blood pressure and serum uric acid levels simultaneously in middle-aged obese adults.