Normal-weight Participants Research Articles

Obesity Paradox and the Effect of NT-proBNP on All-Cause and Cause-Specific Mortality.

In heart failure patients, obesity is associated with better outcomes as compared to normal weight, a phenomenon called the obesity paradox. To examine if obesity modifies the relationship between NT-proBNP and all-cause and cause-specific mortality in adults without coronary artery disease or heart failure history. We used the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and linked it with mortality through December 31, 2019. Participants > 18 years were categorized into normal weight (BMI ≤ 25 kg/m2), overweight (BMI > 25-29.9 kg/m2) and obese (BMI > 29.9 kg/m2). NT-proBNP levels were categorized as low (< 126 pg/mL) or high (≥ 126 pg/mL). Using Cox proportional hazard models, we examined effect modification by obesity using interaction, without and with adjusting for potential confounders. Of the 12 621 participants, 2794 (22%) died during 202 859 person-years follow-up. In adjusted models, normal-weight participants with high NT-proBNP had 2 times higher all-cause mortality risk than those with low NT-proBNP (HR = 2.05; 95%CI = 1.74, 2.41; p < 0.001); however, this mortality risk was 27% lower in obese participants (HR interaction = 0.73; 95%CI = 0.59, 0.92; p = 0.008). Similarly, in normal-weight participants, the difference in other-cause mortality risk between high and low NT-proBNP participants was significant in adjusted models (HR = 2.27; 95%CI = 1.81, 2.85; p < 0.001) and obese participants had 48% lower other-cause mortality risk between those with high and low NT-proBNP (interaction HR = 0.52; 95%CI = 0.36, 0.77; p = 0.001). Conversely, obesity did not modify the relationship between NT-proBNP and cardiovascular or cancer mortality. In patients free of heart failure or coronary artery disease, obesity may be protective against mortality associated with high NT-proBNP.

Dietary Patterns of Healthy Underweight Individuals Compared to Normal-BMI Individuals Using Photographic Food Diaries.

Previously, we found that healthy underweight (HU) subjects, with BMI < 18.5, eat about 12% less food (by calories) each day. It is presently unclear whether this lower intake is associated with them making food choices that provide high satiation and satiety. Using 7-day photographic records of food intake, we analyzed 52 HU and 50 normal-weight participants. We included 52 HU and 50 normal-weight participants in the final analysis. HU individuals ate 25% fewer calories than normal-weight individuals. Their intake included a higher % of rice (p = 0.0013) and vegetables (p = 0.0006) and a lower % of livestock meat (p = 0.0007), poultry meat (p < 0.0001), and starchy roots (p = 0.0015), compared with the normal-weight population. The percent energy from carbohydrates was significantly higher (p = 0.0234), and the % energy from fat was significantly lower (p < 0.0001) in the HU group, with no difference in the % energy from protein. HU individuals sourced more of their protein from plants. Dietary patterns were grouped into three clusters, with 24 individuals grouped into cluster 1 (87.5% normal-weight population), 28 individuals into cluster 2 (64.3% normal-weight group), and 50 individuals into cluster 3 (78% HU group). The HU group ate less overall and had proportionally more rice and vegetables and less poultry and livestock meat, starchy roots, and drinks. With respect to macronutrients, they also ate a greater % carbohydrates and less % fat, and they sourced more of their protein intake from plant sources. HU individuals did not follow a low-carbohydrate lifestyle.

Dissecting implicit food-related behaviors in Binge Eating Disorder and obesity: insights from a mobile approach-avoidance framework.

Bulimic episodes experienced by patients with Binge Eating Disorder (BED) might be sustained by an enhanced behavioral propensity to approach food stimuli. To test this hypothesis, automatic approach avoidance tendencies toward high-calorie foods (HCF), low-calorie foods (LCF), and neutral objects were assessed in a group of 23 patients with BED, and their performance was compared to the one of 17 patients with obesity without BED and a group of 32 normal weight participants. All participants performed a mobile approach-avoidance task in which they were required to approach and avoid different stimuli by respectively pulling their phone toward themselves or pushing it away. Reaction times were analyzed. Results showed a significant three-way interaction between group, type of movement and stimulus. Post-hoc analyses revealed that all the groups displayed an approach bias toward HCF. Patients with BED and healthy controls also displayed an approach bias toward LCF, a bias that was absent in obese individuals without BED. Moreover, patients with BED were faster in approaching food stimuli, both HCF and LCF, compared to healthy controls. These behavioral tendencies are quite consistent with the real-life attitudes of both BED patients and patients with obesity and might contribute to the maintenance of unhealthy eating habits such as binging in patients with BED and high-calorie diets in patients with obesity.

Association between bone age maturity and childhood adiposity.

Evidence shows that overweight and obesity are associated with advanced bone age (BA). To analyse the effect of adiposity on BA among Mexican children. This cross-sectional study included 902 children (5-18 years old). Anthropometric measurements, dual-energy X-ray absorptiometry (DXA) and automated hand X-ray-based BA measurements were obtained. BA curves of children stratified by sex and age were created based on nutritional status. We also calculated odds ratios for advanced BA associated with the body mass index (BMI), waist/height ratio and adiposity estimated using DXA (total and truncal fat mass). Participants with overweight/obesity by BMI (SDS ≥1) advanced earlier in BA than did normal weight participants (6.0 vs. 12.0 years in boys and 6.0 vs. 10.3 in girls, p < 0.01); similarly, participants with a greater body fat percentage (SDS ≥1) exhibited earlier advanced BA (7.5 vs. 10.0 years in boys and 6.0 vs. 9.6 in girls, p < 0.01). Differences were also observed according to the waist/height ratio and truncal fat. Children with a BMI or DXA SDS ≥1 had greater odds of presenting an advanced BA of more than 1 year (OR 1.79-3.55, p < 0.05). Increased adiposity in children, mainly in boys, is associated with advanced BA at earlier ages.

Association betweentransitions in metabolic health and colorectal cancer across categories of body size phenotype: a prospective cohort study.

We aimed to investigate the associations of changes in metabolic health across categories of body size phenotype with the risk of colorectal cancer in a community-based prospective cohort. In the current study, a total of 70,987 participants were included. Changes in metabolic health across categories of body size phenotype were assessed between the health examination for the first time in the years 2006 through 2009 and a 2010/2011 health examination. A multivariate Cox proportional hazards model was used to assess the associations of changes in metabolic health across body size phenotype categories with risk of colorectal cancer. During the median follow-up time of 11.04 years, 428 (0.60%) participants developed colorectal cancer. Compared with metabolically healthy normal-weight (MHNW) participants who remained MH, the risk of colorectal cancer was increased by 144% (95% CI: 1.21-4.95) for participants with metabolically healthy obesity (MHO) who converted to a metabolically unhealthy (MU) phenotype. Participants who were MU at baseline were still at increased risk of colorectal cancer, regardless of obesity status. The MHO phenotype was a dynamic status over time, and converting to MU during follow-up and being initially MU were associated with having an increased risk of colorectal cancer, regardless of degree of obesity and body size phenotype.

Trends and Disparities in Diet Quality and Nutrient Intake among US Adults by Bodyweight Status.

The prevalence of obesity has been increasing in the US. Among the multifactorial contributors to obesity, dietary factors stand out as primary drivers. Using data from NHANES, we investigated the trends and disparities in diet quality and nutrient intake among US adults with different bodyweight statuses. Participants were divided into normal weight, overweight, and obese groups based on BMI. Diet quality was examined using HEI-2020. Nutrient intake was estimated based on the USDA Food and Nutrient Database for Dietary Studies. From 1999 to 2020, Despite an overall improvement in diet quality among overweight and obese US adults, disparities persisted for most HEI-2020 components, and worsened for whole grains, seafood and plant proteins, and fatty acids between normal weight and obese participants. Overweight and obese participants tended to consume less energy from total carbohydrates and more from total fat. The estimated total energy intake increased among obese participants over the past two decades, while no significant changes were observed among normal weight and overweight participants. In the 2017-2020 period, obese participants had lower HEI-2020 scores than both normal weight and overweight participants. However, no significant differences in total energy intake were observed among normal weight, overweight, and obese populations.

Genetic polymorphisms (FTO rs9939609 and TMEM18 rs6548238), adipokines (leptin and adiponectin) and adiposity in children and adolescents with asthma

ObjectiveTo describe independent factors related to the interaction of FTO rs9939609, TMEM18 rs6548238, leptin, and adiponectin in children/adolescents with asthma, under the influence of obesity. MethodsThe authors performed a cross-sectional study with 57 children/adolescents, ages 8–19 years, at a tertiary hospital, from 2017 to 2018. Participants were classified by nutritional status, performed spirometry with a bronchodilator test and completed an asthma questionnaire, higher scores indicated more asthma symptoms. Two asthma groups were formed: Group 1(G1)-normal-weight; Group 2(G2)-overweight/obese. Serum was collected for adipokines (n = 32) and genetic polymorphisms (n = 53) dosages. ResultsAge and body mass index (BMI) correlated directly in normal-weight (p = 0.009) and obese participants (p = 0.004). Girls reported more asthma complaints (p = 0.044). Participants with negative bronchodilator responses presented lower BMI (14.55–17.16) than responders (19.4–26.84) (p = 0.049). Leptin dosages are related directly to BMI (5,34–40 ng/ml in obese × 0,54–42 ng/ml in nonobese) (p = 0.003). Levels were high in girls (4.78–17.55 µg/ml) (p = 0.029) and low in nonobese boys (0.54–6.92 µg/ml) (p = 0.006). In obese, low leptin levels (< 10 ng/ml) were found in small airway dysfunction carriers (p = 0.025); elevated adiponectin (> 5 µg/ml) correlated with FEV1/FVC > 80 % (p = 0.035) and positive bronchodilator tests (8.84–13 µg/ml) (p = 0.039); and FTO A allele correlated with low adiponectin 0–8.84 µg/ml (p = 0.021) and low FEV1/FVC (46 %-88 %) (p = 0.023). ConclusionBMI correlated directly with age and leptin levels. Obese participants presented high serum levels of leptin and FTO A allele correlated with low FEV1/FVC. Larger cohorts are necessary for better elucidation of the role of adipokines and polymorphisms in the pathophysiology of asthma and obesity.

Association between blood lipid levels in early pregnancy and urinary organophosphate metabolites in the Japan Environment and Children’s Study

BackgroundHigh low-density lipoprotein cholesterol levels (LDL-C) during pregnancy have been associated with adverse pregnancy and offspring outcomes. While previous studies have suggested a potential link between organophosphate pesticide (OPP) exposure and higher LDL-C in the general population and agricultural workers, the relationship in pregnant women and the effect of body mass index on this relationship remain unclear. We examined the association between the urinary concentrations of OPP metabolites (dialkylphosphates) and blood lipid levels in pregnant women. MethodsWe used data from the Japan Environment and Children’s Study, which included 5,169 pregnant women with urinary dialkylphosphate data. We examined the association between urinary concentrations of six dialkylphosphates (DEP, DETP, DEDTP, DMP, DMTP, DMDTP) and blood lipid levels (LDL-C, total cholesterol, high-density lipoprotein cholesterol, and triglycerides) during the first trimester using multiple linear regression under a Bayesian paradigm. We examined the association between high LDL-C, defined as ≥90th percentile of LDL-C, and urinary dialkylphosphate concentrations, using multiple logistic regression under a Bayesian paradigm. These analyses were repeated in underweight, normal-weight, and overweight participants. ResultsDEP, DMP, and DMTP were detected in >50 % of the participants. Multiple linear regression analyses did not show associations between LDL-C and these dialkylphosphates. Stratified analyses showed a positive association between DEP and LDL-C in overweight women (beta coefficient = 2.13, 95 % credible interval = 0.86–3.38, probability of direction (PD) = 100 %); however, the association was not significant (percentage in region of practical equivalence (% in ROPE) = 84.0). Higher DEP was significantly associated with high LDL-C (odds ratio = 1.32, 95 % credible interval = 1.13–1.55, PD = 100 %, % in ROPE = 0.2). ConclusionsAmong overweight pregnant women in the first trimester, higher urinary DEP concentrations were associated with high LDL-C. The effects of OPP on blood lipid profiles merit further investigation.

Older adult women with chronic anorexia nervosa: heterogeneous adaptation to undernutrition over time.

Anorexia nervosa (AN) in older adult women is primarily described through reviews or case reports focusing on psychiatric traits, with no comprehensive studies evaluating their complete nutritional and hormonal profiles. This study aimed to describe a group of women with anorexia nervosa aged above 35 years old (AN35), and compare them with young women with anorexia nervosa (ANY) and normal-weight control participants. Anthropometric, metabolic, nutritional, and psychiatric parameters were collected and compared among three groups of women: 50 AN35, 37 ANY, and 38 controls. AN35 exhibited a mean disease duration of 271 ± 19 months, with 94% chronic forms and 58% restrictive types. Despite having similar BMI as ANY, AN35 displayed more altered parameters, including higher liver enzymes (p = 0.007), free T3 (p = 0.0046) and leptin (p < 0.0001); and lower albumin (p = 0.0029), and white cells (p < 0.0001). AN35 showed significant heterogeneity in hormonal adaptation, such as free T3. Half of the patients aged above 51 years revealed high gonadotropin levels despite being undernourished. Additionally, AN35 groups presented with 50% of bones fractures, decreased T-scores under -2.5 (p < 0.0001 for femoral), and altered micro architectural HRPQT parameters compared to ANY. Anorexia nervosa in older adult women is predominantly chronic. Nutritional parameters changes with age suggests a significant heterogeneity and possible adaptation of energy balance and bodyweight set point for others. Complications may be severe, altering the quality of life, and sometimes potentially lethal. These findings highlight the potential adaptation of energy balance with age, and should assist clinicians in clinical practice.

Ramadan Intermittent Fasting and Plasma Volume Variations in Individuals with Different Body Weights.

Background: There is increasing awareness of the physiological effects of Ramadan intermittent fasting (RIF) in obese subjects. However, there are no data on the effects of RIF on plasma volume changes (ΔPV) in individuals with different body weights. Background and Objectives: This study investigated the effects of RIF on ΔPV in normal-weight (NW) and overweight (OW) adult men, and adult men with obesity (OB) and severe obesity (SO). Materials and Methods: Thirty-two male subjects (32) were divided into four groups (n = 8 per group) according to their body mass index (BMI): normal weight (NW) (BMI < 25 kg/m2; age = 27.4 ± 3.8), overweight (OW) (BMI between 25 and 29.9 kg/m2; age = 26.8 ± 3.7), obese subjects (OB) (BMI between 30 and 34.9 kg/m2; age = 25.6 ± 2.9), and severely obesity (SO) (BMI between 35 and 40 kg/m2; age = 24.0 ± 4.1). Blood samples were collected for 24 h on 4 different occasions, at T0 before the start of the Ramadan month, at T1 15 days after the start of Ramadan, at T2 one day after the end of Ramadan, and at T3 on the 21st day after the end of Ramadan to determine ΔPV. All groups completed their fasting rituals for the 30 days of Ramadan. Results: A significant group × time effect occurred for body mass (p = 0.001; ES = 0.53), BMI (p = 0.001; ES = 0.53), and body fat percentage (p = 0.001; ES = 0.52). Post hoc tests indicated reductions in body mass in OB and SO at T1 (p = 0.03; ES = 0.21 and p = 0.002; ES = 0.12) and T2 (p = 0.03; ES = 0.31 and p = 0.02; ES = 0.23), reductions in BMI in OB and SO at T1 (p = 0.04; ES = 0.35 and p = 0.03; ES = 0.42) and T2 (p = 0.03; ES = 0.52 and p = 0.005; ES = 0.48), and reductions in body fat percentage only in OB AT T1 (p = 0.002; ES = 0.31) and T2 (p = 0.001; ES = 0.17). A significant group × time effect occurred for hematocrit (p = 0.02; ES = 0.34), hemoglobin (p = 0.01; ES = 0.35), and ΔPV (p = 0.02; ES = 0.18). Post hoc tests indicated increases in hematocrit in OB at T2 (p = 0.03; ES = 0.36) and hemoglobin in OB and SO at T1 (p = 0.03; ES = 0.35 and p = 0.002; ES = 0.32) and T2 (p = 0.003; ES = 0.21 and p = 0.002; ES = 0.33). There were also increases in ΔPV in OB at T1 and T2 (p = 0.002; ES = 0.25 and p = 0.003; ES = 0.22) and in SO only at T2 (p = 0.02; ES = 0.37). Contrast analysis indicated that NW was significantly lower than the grand mean of OW, Ob, and SO for all anthropometric and PVV variables (all p < 0.05). Conclusions: The effects of RIF on ΔPV and anthropometric characters was greater in obese individuals compared to normal-weight and overweight participants, suggesting that the improvements in body composition and ΔPV produced by RIF could positively influence obesity.

Associations of hypertension, diabetes and heart disease risk with body mass index in older Chinese adults: a population-based cohort study

ObjectiveObesity is a well-established risk factor for disease. Controversy exists regarding the relative risk of morbidity and mortality in individuals who are overweight or underweight compared with individuals with a...

Possible pitfalls in the prediction of weight gain in middle-aged normal-weight individuals: Results from the NDB-K7Ps-study-2

BackgroundThe prevalence of obesity has not decreased worldwide and obesity-related morbidities have been increasing steadily. However, few studies have investigated factors contributing to weight gain in normal-weight individuals. Thus, in this community-based cohort study, we aimed to investigate factors contributing to weight gain in normal-weight participants. MethodsClinical variables and 10 % increase in weight over 10 years (10 %IBW10Y) were retrospectively investigated in apparently healthy 615,077 normal-weight (body mass index (BMI) 21.0–24.9 kg/m2) participants aged 40–64 years who had regularly undergone health checkup. Machine learning and logistic regression analysis (nested case-control study) were used to predict 10 %IBW10Y. ResultsIn total, 6.8 % of men and 8.9 % of women had 10 %IBW10Y (P < 0.0001). The prevalence of obesity (BMI ≥25.0 kg/m2) after 10 years and weight gain were higher in participants with 10 %IBW10Y (72.3 %, 8.9 kg) (case-group) versus those without 10 %IBW10Y (11.5 %, −0.4 kg) (control-group), respectively. Machine learning showed positive contributing factors to 10 %IBW10Y were, in descending order, age early 40 s, current smoking, female sex, low serum triglyceride (≤59 mg/dL), and low glycated hemoglobin (HbA1c) (≤4.9 %). Age early 60 s, non-smoking, male sex, high triglyceride (≥200 mg/dL), and HbA1c 6.0 %−6.9 % were negative contributing factors. Logistic regression analysis showed similar results except for high HbA1c (≥7.5 %) as a positive contributing factor. ConclusionsIn middle-aged individuals with normal weight who undergo regular health check-ups, certain favorable features (female sex, low triglyceride, and low HbA1c), as well as smoking habits that are subject to change in the future, which could lead to weight gain, may be overlooked.250 ＜250 words

Constitutional thinness might be characterized by physiologically adapted and not impaired muscle function and architecture: new results from the NUTRILEAN study.

While muscle mass and skeletal muscle fibers phenotype have been shown atypical in constitutional thinness (CT), force production capacities and its architectural determinants have never been explored. The present study compared muscle functionality and architecture between participants with CT and their normal-weight (NW) counterparts. Anthropometry, body composition (Dual-X-ray Absorptiometry), physical activity/sedentary behavior (ActiGraph wGT3X-BT), ultrasound recording of the Vastus Lateralis (2D-ultrasound system), and functional capacities at maximal isometric and isokinetic voluntary contractions (MVCISO and MVCCON) during knee extension (isokinetic dynamometer chair Biodex) have been measured in 18 women with CT (body mass index < 17.5kg/m2) and 17 NW women. A lower fat-free mass (ES: -1.94, 95%CI: -2.76 to -1.11, p < 0.001), a higher sedentary time, and a trend for a lower time spent at low-intensity physical activity, were observed in CT vs NW participants. While absolute MVCISO, MVCCON, rate of torque development (RTD), and torque work were all markedly lower in CT, these differences disappeared when normalized to body or muscle mass. Muscle thickness and fascicle length were found lower in CT (ES: -1.29, 95%CI: -2.03 to -0.52, p < 0.001; and ES: -0.87, 95%CI: -1.58 to -0.15, p = 0.02, respectively), while pennation angle was found similar. Despite lower absolute strength capacities observed in CT, present findings support the hypothesis of physiological adaptations to the low body and muscle mass than to some intrinsic contractile impairments. These results call for further studies exploring hypertrophy-targeted strategies in the management of CT.

Association of osteoporosis with sarcopenia and its components among community-dwelling older Chinese adults with different obesity levels: A cross-sectional study.

We aimed to investigate whether sarcopenia and its components are associated with osteoporosis in community-dwelling older Chinese adults with different obesity levels. This cross-sectional study included 1938 participants (42.1% male) with a mean age of 72.1 ± 5.9 years. The categorization of individuals into various weight categories was based on the Working Group on Obesity in China's criteria, utilizing the body mass index (BMI) as follows: underweight, BMI < 18.5 kg/m2; normal weight, 18.5 ≤ BMI < 24 kg/m2; overweight, 24 ≤ BMI < 28 kg/m2; and obesity, BMI ≥ 28 kg/m2. In this research, the osteoporosis definition put forth by the World Health Organization (bone mineral density T-score less than or equal to -2.5 as assessed by Dual-energy X-ray absorptiometry (DXA)). Sarcopenia was defined according to the diagnostic criteria of the Asian Working Group for Sarcopenia. The prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI (Underweight: 55.81% vs Normal weight: 45.33% vs Overweight: 33.69% vs Obesity: 22.39). Sarcopenia was associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates (OR = 1.70, 95% CI = 1.22-2.35, P = .002). In normal-weight participants, a higher appendicular skeletal muscle mass index (ASMI) was associated with a reduced risk of osteoporosis (OR = 0.56, 95% CI = 0.42-0.74, P < .001). In this study, we found that the prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI. Sarcopenia, body fat percentage, and ASMI were associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates, and higher percent body fat (PBF) was associated with an increased risk of osteoporosis in overweight people, and no such association was found in other weight groups. Different amounts of adipose tissue and muscle mass may alter bone biology. Further longitudinal follow-up studies are required to more accurately assess the risk of osteoporosis and sarcopenia in different weight populations. This cross-sectional study found that the prevalence of osteoporosis was highest in the underweight group and gradually decreased with increasing BMI. Sarcopenia was associated with elevated odds of osteoporosis in normal-weight subjects independent of potential covariates.

Improving the Nutritional Quality of Protein and Microbiota Effects in Additive- and Allergen-Free Cooked Meat Products.

The primary objective of the meat industry is to enhance the quality and positive attributes of meat products, driven by an increasing consumer demand for healthier, less processed options. One common approach to achieving this goal is the replacement of additives and allergens with natural ingredients. Nevertheless, the nutritional impact of these changes has not been extensively studied. To address these gaps, two new meat products were developed: cooked turkey breast and cooked ham. The products in question exclude additives and allergens and instead incorporate a blend of natural extracts containing vitamin C, chlorogenic acids, hydroxytyrosol, catechins, epicatechins, vinegar, and inulin fibre. The objective of this study was to evaluate the impact of these reformulations on protein quality and gut microbiota. Protein quality was evaluated using the Digestible Indispensable Amino Acid Score (DIAAS) following in vitro digestion. The microbial composition and short-chain fatty acid (SCFA) production were analysed through in vitro colonic fermentations in both normal-weight and obese participants in order to gauge their effect on gut microbiota. The results demonstrated that the reformulation of cooked turkey breast increased its digestibility by 6.4%, while that of cooked ham exhibited a significant 17.9% improvement. Furthermore, protein quality was found to have improved significantly, by 19.5% for cooked turkey breast and 32.9% for cooked ham. Notwithstanding these alterations in protein digestibility, the microbial composition at the phylum and genus levels remained largely unaltered. Nevertheless, total SCFA production was observed to increase in both groups, with a more pronounced effect observed in the normal-weight group. In conclusion, the substitution of artificial additives with natural ingredients in reformulated cooked meat products has resulted in enhanced digestibility, improved protein quality, and increased production of short-chain fatty acids.

Neurocomputational Mechanisms Underlying Differential Reinforcement Learning From Wins and Losses in Obesity With and Without Binge Eating

BackgroundBinge-eating disorder (BED) is thought of as a disorder of cognitive control, but evidence regarding its neurocognitive mechanisms is inconclusive. Key limitations of previous research include a lack of consistent separation between effects of BED and obesity and a disregard for self-report evidence suggesting that neurocognitive alterations may emerge primarily in loss- or harm-avoidance contexts. MethodsTo address these gaps, in this longitudinal study we investigated behavioral flexibility and its underlying neurocomputational processes in reward-seeking and loss-avoidance contexts. Obese participants with BED, obese participants without BED, and healthy normal-weight participants (n = 96) performed a probabilistic reversal learning task during functional imaging, with different blocks focused on obtaining wins or avoiding losses. They were reinvited for a 6-month follow-up assessment. ResultsAnalyses informed by computational models of reinforcement learning showed that unlike obese participants with BED, obese participants without BED performed worse in the win than in the loss condition. Computationally, this was explained by differential learning sensitivities in the win versus loss conditions in the groups. In the brain, this was echoed in differential neural learning signals in the ventromedial prefrontal cortex per condition. The differences were subtle but scaled with BED symptoms, such that more severe BED symptoms were associated with increasing bias toward improved learning from wins versus losses. Across conditions, obese participants with BED switched more between choice options than healthy normal-weight participants. This was reflected in diminished representation of choice certainty in the ventromedial prefrontal cortex. ConclusionsOur study highlights the importance of distinguishing between obesity with and without BED to identify unique neurocomputational alterations underlying different styles of maladaptive eating behavior.

Should gestational weight gain charts exclude individuals with excess postpartum weight retention?

High gestational weight gain is associated with excess postpartum weight retention, yet excess postpartum weight retention is not an exclusion criterion for current gestational weight gain charts. We aimed to assess the impact of excluding individuals with high interpregnancy weight change (a proxy for excess postpartum weight retention) on gestational weight gain distributions. We included individuals with an index birth from 2008 to 2014 and a subsequent birth before 2019, in the population-based Stockholm-Gotland Perinatal Cohort. We estimated gestational weight gain (kg) at 25 and 37 weeks, using weight at first prenatal visit (<14 weeks) as the reference. We calculated high interpregnancy weight change (≥10 kg and ≥5 kg) using the difference between weight at the start of an index and subsequent pregnancy. We compared gestational weight gain distributions and percentiles (stratified by early-pregnancy body mass index) before and after excluding participants with high interpregnancy weight change. Among 55,723 participants, 17% had ≥10 kg and 34% had ≥5 kg interpregnancy weight change. The third, tenth, 50th, 90th and 97th percentiles of gestational weight gain were similar (largely within 1 kg) before versus after excluding participants with high interpregnancy weight change, at both 25 and 37 weeks. For example, among normal weight participants at 37 weeks, the 50th and 97th percentiles were 14 kg and 23 kg including versus 13 kg and 23 kg excluding participants with ≥5 kg interpregnancy weight change. Excluding individuals with excess postpartum weight retention from normative gestational weight gain charts may not meaningfully impact the charts' percentiles.

The Significant Impact of High-Fat, Low-Carbohydrate Ketogenic Diet on Serum Lipid Profile and Atherosclerotic Cardiovascular Disease Risk in Overweight and Obese Adults.

Background and objectives Overweight and obesity are becoming more commonplace globally. The ketogenic diet (KD), also known as the high-fat, low-carbohydrate diet, has become increasingly popular in recent years as a means to lose weight quickly. This present study aims to examine the clinical effects of ketogenic diets in individuals who are obese or overweight by evaluating or assessing variations in metabolic parameters associated with lipid control, the risk of atherosclerotic cardiovascular disease, and other kidney risk indicators. Methods and subjects This observational case-control research involved 250 individuals in total and was conducted from May 2023 to January 2024. Of these, 158 were on a ketogenic diet, and 92 adults not following any type of diet were chosen to serve as controls. The biochemistry parameters of the kidney function test and lipid profile were measured for the two comparing groups. Data were analyzed for statistical significance using the Student t-test, Mann-Whitney U test, and one-way analysis of variance (ANOVA), followed by a post hoc test (least significant difference (LSD)). Chi-square tests were employed in the analysis to compare proportions. Results Out of 250 participants, there was a 20-80 age range, with their median age being 40 years old. The two comparing groups' lipid profiles were very different from one another; the cardiovascular risk (triglyceride (TG)/high-density lipoprotein (HDL)), total cholesterol, low-density lipoprotein (LDL), and triglyceride levels were all greater in the KD group when compared to the non-KD group. The mean LDL cholesterol (LDL-C) of the normal-weight participants was 56 mg/dL (p=0.079). Thereafter, it experienced a significant rise to 97.58 mg/dL and 108.2 mg/dL in thoseindividuals who were overweight and obese, respectively (p<0.020). Conclusions As obesity rates in the populace keep rising, dietary fads such as the ketogenic diet are gaining traction. Although they could help with weight loss, this study had a notable observation of severe hypercholesterolemia and increased risk of atherosclerotic cardiovascular disease among the ketogenic diet participants. Additional research is necessary to ascertain if a ketogenic diet can be sustained over the long term and how it affects endpoints that are more clinically significant, such as morbidity and mortality due to obesity.

Prevalence of Overweight/Obesity Associated With Anemia Among Female Medical Students at Umm Al-Qura University in Makkah, Saudi Arabia: A Cross-Sectional Study.

Introduction The obesity epidemic has been linked to a wide range of health and nutritional problems, including anemia, which is often caused by impaired iron metabolism. The World Health Organization considers anemia and obesity to be global health issues among adolescent girls and women experiencing menstruation. This study aims to examine the association between iron deficiency anemia and obesity/overweight among female medical students. Methodology This cross-sectional descriptive study conducted as an online self-administered questionnaire. Furthermore, blood samples were collected from 206 students to evaluate the complete blood count, iron and lipid profile. Results The convenience sampling technique was used and a total of 206 students were enrolled in the study. The average body mass index (BMI) was 22.51 ± 3.25, with 83.5% (n = 172) falling within the normal weight range, 12.6% (n = 26) as overweight, and 3.9% (n = 8) as obese. Anemia was present in 16.0% (n = 33) of the participants overall. Higher prevalence of anemia was observed among overweight participants with 10 out of 26 (38.5%) subjects compared to obese with two out of eight (25.0%) and normal weight 21 out of 172 (12.2%); this difference was highly significant (P = 0.005). Individuals with anemia exhibited a significant association with those experiencing a diet full of unhealthy fats and carbohydrates (P = 0.05) and a diet containing all essential nutrients (P = 0.01). There is no statistically significant correlation between anemia prevalence and participants' response to the presence of signs of anemia, physical activity or other dietary habits. Obese participants had a significantly higher mean value of triglycerides (129.5 ± 20.5) compared to normal weight and overweight participants (74.5 ± 12.02 and 51.2 ± 15.04), respectively (P = 0.001). Conclusion A dependable assembly exists between obesity and overweight in cases of iron deficient anemia. The prevalence of iron deficiency anemia was substantially higher among overweight/obese females, highlighting that overweight/obesity signifies both quantitative and qualitative malnutrition. A high BMI was associated with elevated triglycerides, typically considered indicators of obesity. This association may suggest compromised iron homeostasis.

Nutritional status and age at menarche in Amazonian students

ObjectivesAge at menarche (MA) is a proxy for biological maturation and a parameter of socioeconomic changes. Worldwide, anticipation of menarche is associated with nutritional transition and excess weight. The objective of this study was to evaluate the MA in Amazonian students and its association with nutritional status, ethnicity, and socioeconomic level. MethodsCross-sectional study with 1,017 students aged 6 to 17 living in the city of Manaus, Brazil. MA was analyzed by status quo and recall; its association with body mass index (BMI), race, socioeconomic status, and adult height was examined. Results559 (51.9%) participants had already experienced menarche. In 91.7%, menarche occurred between 10 and 14 years of age; the mean age at the onset of menarche was 11.9 years. Overweight (11.6 years) and obese (11.4 years) participants reached menarche earlier than those with normal weight (12 years) and lean (12.7 years) participants. The associations between MA and nutritional status showed that overweight and obesity are risk factors for the early occurrence of menarche. MA was not associated with socioeconomic status/parental education or race. However, excess weight was associated with earlier MA in all races and social classes. The adult height was slightly lower in girls with menarche before 12 years old (157.9 vs 159.4 cm). ConclusionRegardless of socioeconomic level or ethnicity, excess weight was associated with earlier menarche in Amazonian students.