Obesity Status Research Articles

Evaluation of Obesity-Related Physiological Changes on Pantoprazole Clearance in Children Using a Population Pharmacokinetic Approach.

Pediatric obesity is a growing health concern, affecting millions of children worldwide. While pharmacokinetic (PK) changes in numerous commonly prescribed medications have been linked to obesity, the physiological mechanisms driving these alterations and their implications for drug dosing remain poorly understood. The objective of this study was to evaluate previously reported observations of reduced pantoprazole clearance (CL) in children with obesity, investigate obesity-related characteristics in liver physiology as explanatory causes for these observations, and evaluate the clinical relevance of obesity on drug dosing. A prospective, comparative PK study, enrolling participants 6-21 years of age, with and without obesity, was conducted to evaluate the association between obesity-related characteristics and pantoprazole CL. A nonlinear mixed-effects modeling approach was used to identify sources of interindividual variability in pantoprazole PK. Monte Carlo simulations were performed to assess pantoprazole exposure in children and evaluate the association between obesity and pantoprazole exposure. The study population consisted of 39 pediatric participants: 31% without obesity and 69% with obesity. A two-compartment PK model with covariate effects of total body weight (TBW), CYP2C19 metabolizer phenotype, and obesity status adequately described the PK data. After accounting for differences due to TBW and CYP2C19 metabolizer phenotype, obesity was associated with an estimated 18% reduction in pantoprazole CL (comparable to the reduction estimated for a CYP2C19 loss of function allele). Further research is warranted to evaluate the physiological mechanisms associated with reduced drug CL in children with increased body size and the implications for drug dosing.

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.

The relationship between lifestyle habits and obesity among students in the Eastern province of Saudi Arabia: using the Arab Teens Lifestyle (ATLS) questionnaire

BackgroundThe Arab Teens Lifestyle (ATLS) questionnaire was an initiative to assess the lifestyle habits influencing obesity rates in the Middle East and North Africa (MENA) region, including physical activity (PA) patterns, sedentary and eating behaviours. Since its implementation, the ATLS questionnaire has been used in several studies among different age groups and populations. This instrument has not previously been administered among the university students of the Eastern Province of Saudi Arabia, where the obesity rates are the highest in the country. This research was the first that aimed to identify lifestyle habits influencing the rates of obesity among 18-25-year-old university students in the Eastern Province of the Kingdom of Saudi Arabia (KSA) using the ATLS questionnaire.MethodsQuantitative cross-sectional research among n = 426 students of the Eastern Province of Saudi Arabia using the ATLS questionnaire.ResultsOut of n = 426 participants, n = 200 (47%) were categorised (using body mass index) as normal weight; n = 113 (26.5%) were overweight, and n = 73 (17.1%) were obese. The findings showed that most of the nutritional, PA, and sedentary behavioural factors (e.g., screen time) in the questionnaire were not associated with obesity status amongst the participants. In the obese group, more of the males that consumed fruits, French fries, cakes, sweets and doughnuts more than three times per week were likely to be obese, which was not the case for females.ConclusionThe reported lifestyles of the students could potentially lead to long-term negative health effects, which is of concern given the rising rates of overweight, obesity, and obesity-related non-communicable diseases (NCDs) among the Kingdom’s adult and ageing population. Further studies are recommended to explore the knowledge, attitudes, and perceptions of Saudi students in the Eastern Province in relation to PA, sedentary behaviours, and dietary habits, along with their views on how these can be improved.

Sex and Obesity-Specific Associations of Ultrasound-Assessed Radial Velocity of Sound with Body Composition

Background: This study aimed to investigate the association between body composition (BC) specific parameters such as fat mass (FM) and lean body mass (LBM) and bone quality in obese and non-obese young Slovak adults (18–30 years) using bioelectrical impedance analysis and quantitative ultrasound while considering the factors of sex and obesity status; Methods: BC was evaluated using bioelectrical impedance analysis (InBody 770) and bone quality by the speed of sound (SOS) in radius using QUS (Sunlight MiniOmni) in 774 young Slovak young adults aged 18–30 years, categorized by sex and obesity status (body fat %, PBF, ≥28% for men and ≥20% for women); Results: In non-obese individuals, radial SOS correlated positively with FM parameters. Significant positive correlations with LBM, including skeletal muscle mass (SMM), were observed in non-obese men but not in women. Conversely, SOS correlated negatively with FM parameters in obese individuals, significantly only in women. The correlation of SOS with LBM in obese individuals was insignificant in both sexes. Age, visceral FM, FM in the arm, and vitamin D intake were identified as the main predictors of radial SOS in young adults, except in obese men. Conclusions: Findings indicate FM benefits bone tissue in non-obese individuals, while excessive adiposity deteriorates bone quality in obese individuals, necessitating tailored evaluations and interventions based on sex, obesity status, and specific predictors.

Hidden barriers: obesity bias in hypertension treatment.

Individuals with obesity often face obesity bias, which may influence the delivery of appropriate medical care. Our aim is to evaluate the adequacy of therapeutic decisions regarding the pharmacological treatment for hypertension in patients with diabetes, both with and without obesity. This is a multicentric cross-sectional study of patients with type 2 diabetes and arterial hypertension who received outpatient care in Southern Brazil. Participants were stratified into two groups according to their body mass index (BMI): lower weight (BMI < 25.0 kg/m2) and with obesity (BMI ≥ 30.0 kg/m2). The primary outcome evaluated was the difference in pharmacological treatment decisions for hypertension between groups, considering individualized hypertension targets from American Diabetes Association (ADA), European Society of Hypertension (ESH), and European Society of Cardiology (ESC) guidelines. Data were analyzed as a binary endpoint (failure to receive treatment intensification vs. receiving treatment intensification when necessary) and groups were compared using multivariable logistic regression. This study included 204 participants, of which 53 were at a lower weight and 151 had obesity. Patients with obesity more frequently failed to receive appropriate treatment intensification when compared to individuals with lower weight. The differences between the study groups were observed when considering the blood pressure target of three societies: ESH (adjusted OR 2.28 [95% CI 1.12-4.63], p = 0.022), ESC (adjusted OR 2.13 [95% CI 1.05-4.31], p = 0.035), and ADA (adjusted OR 2.33 [95% CI 1.13-4.77], p = 0.021). These findings suggest that patients with obesity may face potential disparities in hypertension management, and obesity status may be related to therapeutic inertia in the management of arterial hypertension in this group.

Effect of skipping on body mass index, waist to hip ratio and muscle strength in overweight adolescent girls

Overweight problems in adolescents tend to increase, with obese nutritional status prevalence for Indonesian teenagers in group aged–13-15 and 16-18 years respectively 11,2% and 9,5%. This study aimed to analyze the effect of skip training on the body mass index for age z-score (BAZ), waist-to-hip ratio (WHR), and muscle strength in overweight adolescent girls. The method of this research was a quasi-experimental design using a subject study of 28 female students, which were divided into two groups: those age between 15-18 years old. The research was conducted at Senior High School 1 West Sumatra and Batipuh from October to December 2023. The skipping group received 4-8 minutes of exercise 3 times per week for 8 weeks of intervention. The statistical analysis employed a paired t-test and simple regression linear test. The results of this study revealed that skipping intervention had a significant effect on the reduction of BAZ (p&lt;0,05; R2=0,286) and WHR (p&lt;0,05; R2=0,174) in the skipping group compared to the control group. There was no significant difference in the muscle strength between the skipping and control groups (p&gt;0,05; R2=0,049). In conclusion, skipping for a duration of 4-8 minutes conducted three times a week for 8 weeks, which reduced the value of BAZ and WHR in adolescent girls.

A National Survey of Marijuana Use Among U.S. Adults According to Obesity Status, 2016-2022.

Background and Objective: Research has linked marijuana use with lower body mass index (BMI). The current study explores the correlation between marijuana use on BMI in the general U.S. population. It reports the prevalence of marijuana in adults in relation to BMI, overall and across the levels of important variables. Materials and Methods: This study used a probability sample of U.S. adults 18 years of age and older from the 2016 through 2022 Behavioral Risk Factor Surveillance System, a telephone-administered survey. The survey collects data from a representative sample regarding health-related risk behaviors, chronic health conditions, and use of preventive services. The primary outcome variables are current (at least once in the last 30 days) and daily (at least 20 of the last 30 days) marijuana use. Results: The study sample consists of 735,921 participants in the surveys that completed the optional module on marijuana use. Prevalence of marijuana use in adults doubled during the study period (7.48% to 14.91%). The increase directly corresponds with a shift toward legalization of medical and recreational marijuana. On average, the prevalence of use is 9% higher when medical marijuana is legal and 81% higher when recreational marijuana is legal (vs. not legal). For obese individuals, prevalence of current marijuana use is 35% lower than for nonobese individuals on average. Lower prevalence of marijuana use in obese individuals is consistently observed across the levels of certain demographic variables, employment status, tobacco smoking history, marijuana legalization status, and certain medical conditions (asthma, arthritis, and depression). In 2022, the adjusted odds of current or daily marijuana use are significantly lower and similar among obese (vs. non-obese) (0.68, 0.69, respectively), such that reduced obesity does not require daily use. Similarly, the adjusted odds of current marijuana use decrease in similar fashion to daily marijuana use with higher BMI weight classification. Conclusion: Marijuana use is correlated with lower BMI. As legalization and prevalence of the drug in the U.S. increases, the prevalence of obesity may decline. However, clinicians should view this outcome along with the known health risks associated with marijuana use.

Effects of aerobic exercise and resistance training on obstructive sleep apnea: a systematic review and meta-analysis.

We investigated the therapeutic effects of exercise in patients with obstructive sleep apnea (OSA), aiming to identify the subgroups that benefit the most and determine the optimal exercise protocol. Major databases were searched for randomized controlled trials involving patients with OSA performing aerobic exercise and/or resistance training. The investigated outcomes included apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), body mass index (BMI), and peak oxygen consumption during exercise (VO2peak). The pre- and postintervention unstandardized mean difference (USMD) of these parameters was compared between the exercise and control groups. Twelve studies involving 526 patients were included. Exercise training significantly reduced AHI (USMD = -7.08 events/hour, 95% confidence interval [CI]: -9.98 to -4.17, p < 0.00001), ESS (USMD = -2.37, CI: -3.21 to -1.54, p < 0.00001), and BMI (USMD = -0.72 kg/m2, CI: -1.22 to -0.22, p = 0.005) and enhanced VO2peak (USMD = 3.46 mL/kg/min, CI: 1.20 to 5.71, p = 0.003). Subgroup analyses revealed that in continuous positive airway pressure (CPAP)-adherent patients, exercise significantly improved VO2peak but did not reduce AHI and ESS. A trend was observed that combining resistance training with aerobic exercise resulted in greater AHI reduction and VO2peak enhancement. Notably, exercise improved AHI, ESS, BMI, and VO2peak regardless of the baseline AHI or BMI. Exercise, including resistance and aerobic training, should be part of treatment for patients with OSA of all severities, regardless of obesity status, and even for those who are already under CPAP. The study protocol was registered with the PROSPERO database (#CRD42023423527).

Dietary inflammatory index and type 2 diabetes in US women: a cross-sectional analysis of the National Health and Nutrition Examination Survey, 2007-2018.

Type 2 diabetes (T2D) is a major public health concern in the United States and worldwide. The dietary inflammatory index (DII) is a useful tool for assessing dietary inflammation. Although much research links the DII to diabetes, little is known about the relationship in adult women with a reproductive history in the United States. We aimed to investigate how the relationship between the DII and T2D varies among different subgroups of American women. Secondary data from the National Health and Nutrition Examination Survey from 2007 to 2018 were analyzed. Cross-sectional analysis of 8,394 American women aged 20 years or older who had at least one live birth. The main outcome was the diagnosis of T2D. Multivariate survey-weighted regression was used to determine the odds ratio (OR) and 95% confidence interval (95%CI) for the association between DII and T2D. A weighted restricted cubic spline (RCS) model was constructed to establish OR curves at three knots to examine the dose-response association between DII and T2D. Additionally, a weighted subgroup analysis was performed in a fully adjusted model to verify that the association was robust. The study main found a significant association between the DII and T2D (OR = 1.19, 95%CI: 1.12, 1.26, p < 0.001). Participants in the highest third of DII scores had a 56% increased risk of T2D (OR = 1.56, 95%CI: 1.16, 2.10; p for trend = 0.003) compared with those in the lowest third of DII scores, after adjusting for all covariates. The multivariable RCS demonstrated a linear association between DII and T2D (p = 0.892). The subsidiary found that subgroup analyses revealed a significant variation in the association between DII and T2D according to obesity, oral health, and poverty-income ratio (PIR) status. Among non-obese women, the OR was 1.22 (95%CI: 1.08, 1.37); among women with good oral health, the OR was 1.17 (95%CI: 1.07, 1.28); among women with low PIR, the OR was 1.17 (95%CI: 1.05, 1.30); and among women with high PIR, the OR was 1.26 (95% CI: 1.07, 1.48). Our findings suggest that there is a significant association between DII and T2D and that oral health, obesity, and PIR status may influence the relationship between DII and T2D risk. Further studies are warranted to validate our results and evaluate whether the results are similar in other populations.

Comparison of cardiovascular disease risk association with metabolic unhealthy obesity identified by body fat percentage and body mass index: Results from the 1999-2020 National Health and Nutrition Examination Survey.

Cardiovascular disease (CVD) risk among individuals across different categories of metabolic obesity phenotypes is controversial. The study used body fat percentage (BFP) or body mass index (BMI) to categorize obese status and to investigate the association between metabolic obesity phenotypes and CVD risk in a nationally representative population. This cross-sectional study included 49463 adult participants in National Health and Nutrition Examination Survey from 1999 to 2020. Metabolic healthy status was defined by the absence of metabolic syndrome according to the revised National Cholesterol Education Program Adult Treatment Group definition. Obesity was identified by BFP, assessed by dual-energy X-ray absorptiometry scan, and BMI. The primary outcome was CVD prevalence. The multivariable logistic regression model and restricted cubic spline analyses were used to examine the associations between metabolic obesity phenotypes and the risk of CVD. Among 49463 adult participants, 32.12% were metabolically unhealthy, 34.10% were overweight, 37.94% were obese; and 8.41% had CVD. Compared with metabolic healthy normal weight, metabolic healthy obesity, and metabolic unhealthy normal weight/overweight/obesity were all associated with increased CVD risk with adjusted odds ratios (95% confidence intervals) of 1.45 (1.14-1.85), 2.80(1.53-5.11), 2.55(1.88-3.47), and 2.96(2.18-4.02), respectively. Nonlinear dose-response relationships between BFP and CVD were observed both in metabolically healthy and unhealthy participants (both P for non-linearity<0.0001). When obesity was defined with BMI, there were a similar prevalence of obesity, and similar associations between metabolic obesity phenotypes and CKD risks. Metabolic healthy and unhealthy obesity were both associated with higher risks of CVD, whether using BFP or BMI to define obese status. It suggests that metabolic obesity phenotype is a risk factor for CVD.

Impact of Smoking and Obesity on the Selected Peptide Hormones and Metabolic Parameters in the Blood of Women with Polycystic Ovary Syndrome-Preliminary Study.

We investigated the effects of tobacco smoke exposure and abnormal body weight on selected peptide hormones and their association with metabolic and hormonal disorders in women with polycystic ovary syndrome (PCOS). The study group included 88 women with PCOS and 28 women without the disease. In women with PCOS, chemerin, lipocalin, and apelin concentrations were influenced by overweight and obesity status, with the highest concentrations observed in those with a body mass index (BMI) ≥ 30.0. Exposure to tobacco smoke significantly increased only lipocalin-2 concentration. The disease itself did not affect the concentrations of chemerin, lipocalin, and apelin. Additionally, we found a positive correlation between chemerin concentration and fasting glucose, fasting insulin, and triglycerides levels, while a negative correlation was observed with high-density lipoprotein (HDL-C) concentration. In the smoking subgroup, chemerin concentration was positively correlated with free testosterone concentration and the free androgen index and negatively associated with sex hormone-binding globulin concentration. Our findings indicate that abnormal body weight has a stronger impact than tobacco smoke exposure on metabolic and hormonal disorders in women with PCOS, highlighting the important role of weight control in such individuals. However, smoking appears to be an additional factor that intensifies hormonal disorders associated with adipose tissue.

Insulin resistance and periodontitis: Mediation by blood pressure.

This study investigated the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, and moderate/severe periodontitis and the role of blood pressure as a mediator in this association. A second aim was to assess the role of cardiometabolic conditions such as obesity, hypertension, and dyslipidemia as potential effect modifiers. Data from 5733 US adults aged 30-64 years and with complete periodontal examination were analyzed (NHANES 2011-2014). Participants were classified as having moderate/severe periodontitis or mild/no periodontitis according to the CDC/AAP criteria as the outcome. The exposure was the TyG index, while both systolic (SBP), and diastolic (DBP) blood pressure were tested as mediators using parametric g-formula. Analyses were adjusted for relevant confounders, namely, age, sex, ethnicity, poverty-income ratio, and smoking, using inverse probability treatment weighting. Obesity status (based on a body mass index ≥30 kg/m2), self-report of hypertension and dyslipidemia (calculated based on the thresholds provided by National Cholesterol Education Program-Adult Treatment Panel-III) were tested as effect modifiers. The findings showed the TyG index to be associated with increased odds of moderate/severe periodontitis [odds ratio (OR), 95% confidence interval (CI) = 1.17 (1.11-1.23)], with 50% of the total effect mediated by SBP. Stratified analysis showed a stronger association in individuals with obesity, hypertension, and dyslipidemia compared to those without these conditions. However, in those taking anti-hypertensive medications, the association was partially mitigated. Sensitivity analysis using imputed data showed consistent results. The TyG index was associated with increased odds of moderate/severe periodontitis, especially in individuals with obesity, hypertension, and dyslipidemia. SBP levels partially mediated this association.

Risk of incident type 2 diabetes in male NAFLD and NAFLD-free smokers: a 7-year post-cessation study

BackgroundWe aimed to investigate the post-cessation T2DM risk in male NAFLD and NAFLD-free smokers in a 7-year cohort study.MethodsThe study population was male adults who underwent annual health checkups in a 7-year cohort study. Recent quitters were categorized into four groups based on their weight gain during follow-up: < 0 kg, 0–1.9 kg, 2.0–3.9 kg, and ≥ 4.0 kg. Cox proportional hazard models, adjusted for various variables, were used to estimate hazard ratios (HRs) for the association between post-cessation weight gain and incident T2DM in NAFLD and NAFLD-free individuals.ResultsAt baseline, we included 1,409 NAFLD and 5150 NAFLD-free individuals. During a total of 39,259 person-years of follow-up, 222 (15.8%) NAFLD patients and 621 (12.1%) NAFLD-free participants quit smoking, with the corresponding means (standard deviations) of post-cessation weight gain being 2.24 (3.26) kg and 1.15 (3.51) kg, respectively. Among NAFLD individuals, compared to current smokers, the fully adjusted HRs (95% CI) for incident T2DM were 0.41 (0.06–3.01), 2.39 (1.21–4.70), 4.48 (2.63–7.63), and 6.42 (3.68–11.23) for quitters with weight gains < 0 kg, 0.0–1.9 kg, 2.0–3.9 kg, and ≥ 4.0 kg, respectively. For NAFLD-free individuals, we only observed a significant association between post-cessation weight gain ≥ 4.0 kg and the risk of incident T2DM (P < 0.001). Further analysis revealed that the impact of post-cessation weight gain on T2DM risk was not affected by alcohol consumption or obesity status at baseline.ConclusionsMild post-cessation weight gain significantly increased the risk of T2DM in male NAFLD patients but not in male NAFLD-free individuals. Therefore, it is recommended that individuals with NAFLD manage their weight after quitting smoking.

Prevalence and influencing factors of subjects at high risk for cardiovascular disease in different regions of Gansu province, China: a cross-sectional study of 100,725 residents from 2017 to 2022.

To investigate the prevalence rate of subjects at high risk for cardiovascular disease (CVD) and to analyze the influencing factors in different regions of Gansu Province. We used data from the China Patient-centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project (MPP), which screened 100,725 residents aged 35-75 years from 10 project sites in Gansu Province, China, from 2017 to 2022. In addition, a questionnaire survey, anthropometric measurements, and collection of biological samples were carried out. Of the 100,082 residents included, 21,059 were identified as subjects at high-risk for CVD. The overall prevalence rate of subjects at high risk for CVD was 19.7%, and the prevalence rate in the HeXi region was greater than that in the LongZhong and LongDong regions. The prevalence rates were 14.0%, 58.2%, 34.9%, and 5.7% for cardiovascular history, hypertension, dyslipidemia, and WHO-assessed risk ≥20%, respectively. The prevalence rate of cardiovascular history type was the highest in the HeXi region, hypertension and dyslipidemia types were the highest in the LongZhong region, and WHO-assessed risk ≥20% type was the highest in the LongDong region. Male, higher education level, smoking status, snoring status, overweight and obesity status, central obesity status, and disease history were more likely to be risk factors for subjects at high risk for CVD. There were some differences among different regions in age, annual household income, farming status, rural/urban status, and drinking status. The prevalence rate of subjects at high risk for CVD in Gansu Province is relatively high. Individualized intervention measures as well as comprehensive prevention and control strategies should be adopted, focusing on the distribution characteristics of risk factors among high-risk subjects in different regions.

Serum NT-proBNP levels in diabetes and its association with obesity, inflammation and glycemic status

Background: Type 2 diabetes mellitus (T2DM) patients are more prone to develop cardiovascular complications, and there is a dire need of a routine screening tool for risk assessment of heart failure (HF) in them. Aims and Objectives: The current study was conducted to estimate the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in subjects with and without T2DM and evaluate the association between NT-proBNP and body mass index (BMI), waist circumference as markers of obesity, hemoglobin A1c (HbA1c), plasma fasting blood sugar (FBS), plasma postprandial blood sugar (PPBS),duration of diabetes as markers of glycemic control and serum C-reactive protein (CRP),an inflammatory marker in diabetic subjects. Materials and Methods: A hospital-based cross-sectional non-interventional study was done with 82 non-diabetic healthy volunteers and 82 T2DM patients. Anthropometric measurements (waist circumference [WC] and body mass index [BMI]) were recorded, and blood was analyzed for serum NT-proBNP, C-reactive protein (CRP), plasma fasting blood sugar (FBS), postprandial blood sugar (PPBS), and hemoglobin A1c (HBA1c). Data collected were analyzed by statistical software with P&lt;0.05 as the significance level. Results: Serum NT-proBNP level was significantly higher in diabetic group (P&lt;0.001) compared to non-diabetic group statistically. Correlation analysis in diabetic subjects showed a significant positive correlation of NT-proBNP with CRP (ρ+0.576, P&lt;0.001), duration of diabetes (ρ+0.780, P&lt;0.001), plasma FBS (ρ+0.524, P=0.003), plasma PPBS (ρ+0.673, P=0.013), and HbA1c (ρ+0.571, P=0.001) but there was no statistically significant correlation of NT-proBNP with BMI or WC values although the correlation was negative for both. Conclusion: The present study provides a novel perspective that measuring serum NT-proBNP may help in the earlier identification of impending HF in diabetic individuals assisting in prompt intervention which may be further confirmed by larger studies.

Association between diabetes, obesity, and quality of life in preoperative patients with degenerative cervical myelopathy: A cross-sectional study.

Degenerative cervical myelopathy (DCM) is a debilitating condition characterized by compression of the cervical spinal cord, leading to neurological deficits. This study aimed to investigate the association between comorbidities like diabetes mellitus (DM) and obesity and quality of life (QOL) in preoperative patients with DCM, and to examine the distribution of pain and numbness. A cross-sectional study with 86 preoperative patients with DCM was conducted. Patient-reported outcome measures (PROMs) including Core Outcome Measure Index for the neck (COMI-Neck), Neck Disability Index (NDI), EQ-5D-3L, SF-12v2 assessed QOL, and baseline characteristics were collected. Patients were categorized by diabetic and obesity status, resulting in 17 with and 69 without DM, and 27 obese, 59 nonobese patients. In the statistical analysis, we compared PROMs and baseline characteristics, and conducted MANCOVA to investigate the association of DM and obesity with PROMs. The study found no significant differences in preoperative QOL between patients with and without DM or obesity. Additionally, the results of MANCOVA indicated that neither DM nor obesity alone, nor their combination, had an association with the total scores of PROMs. In each group, the Symptom-specific well-being score on the COMI-Neck was notably high, implying distressing current symptoms (median: 10). On the NDI, the median score for pain intensity, lifting, work, and recreation subitems was 3. Pain was predominantly reported in the neck and lower back, while numbness was more prevalent in the peripheral regions of the upper and lower limbs. Preoperative QOL was not significantly affected by the presence of DM and/or obesity. DCM-related symptoms may mask the associations with these comorbidities. Regardless of the preoperative condition, it is important to address the PROMs items that posed challenges before surgery.

Total knee arthroplasty using a cemented single-radius, condylar-stabilized design performed without posterior cruciate ligament sacrifice.

Total knee arthroplasty (TKA) with a highly congruent condylar-stabilized (CS) articulation may be advantageous due to increased stability versus cruciate-retaining (CR) designs, while mitigating the limitations of a posterior-stabilized construct. The aim was to assess ten-year implant survival and functional outcomes of a cemented single-radius TKA with a CS insert, performed without posterior cruciate ligament sacrifice. This retrospective cohort study included consecutive patients undergoing TKA at a specialist centre in the UK between November 2010 and December 2012. Data were collected using a bespoke electronic database and cross-referenced with national arthroplasty audit data, with variables including: preoperative characteristics, intraoperative factors, complications, and mortality status. Patient-reported outcome measures (PROMs) were collected by a specialist research team at ten years post-surgery. There were 536 TKAs, of which 308/536 (57.5%) were in female patients. The mean age was 69.0 years (95% CI 45.0 to 88.0), the mean BMI was 32.2 kg/m2 (95% CI 18.9 to 50.2), and 387/536 (72.2%) survived to ten years. There were four revisions (0.7%): two deep infections (requiring debridement and implant retention), one aseptic loosening, and one haemosiderosis. Kaplan-Meier analysis demonstrated no difference in implant survival according to sex, age, or obesity status. Ten-year PROMs were available for 196/387 (50.6%) surviving patients and were excellent: mean Oxford Knee Score 34.4 (95% CI 32.7 to 36.1); mean Forgotten Joint Score (FJS) 51.2 (95% CI 16.1 to 86.3); mean EuroQol five-dimension five-level questionnaire score 69.9 (95% CI 46.8 to 93.0); 141/196 (71.9%) achieved the 22-point FJS patient-acceptable symptom state (PASS); and 156/196 (79.6%) were "very satisfied or satisfied". This is the only large study reporting ten-year implant survival and functional outcomes of TKA using a cemented single-radius design and with a CS tibial bearing construct. The findings of excellent implant survival, safety, and functional outcomes indicate that this combination is a safe and effective option in routine TKA. Further investigation of this single-radius design TKA with CS tibial bearings with well-matched patient study groups will allow further insight into the performance of these implants.

Italian and Middle Eastern adherence to Mediterranean diet in relation to Body Mass Index and non-communicable diseases: nutritional adequacy of simulated weekly food plans

BackgroundThe Mediterranean diet (MD), known to prevent obesity, overweight and the related non communicable diseases (NCD), is based on typical dishes, foods and on a common cultural milieu. Although MD is the basis of dietary guidelines, the prevalence of obesity, overweight and NCD, is increasing both in Western regions, and even more in Middle Eastern regions (MER). This study aimed to analyze (i) the impact of different levels of adherence to the MD, in Italy and MER, on body mass index (BMI) (ii) the bromatological composition of a simulated 7-days food plan (7-DFP) based on Italian or MER typical meals, following MD criteria and the Italian or MER food base dietary guideline; (iii) the optimization of nutrients impacting on NCD.MethodsThe 7-DFPs were implemented using a dietary software. The association between adherence to MD and BMI was evaluated by pooled estimated ORs (with 95% confidence intervals and p-values). Pooled measures were obtained by the methods appropriate for meta-analysis. The different food-based guidelines have been compared.ResultsThe pooled ORs of obese status comparing medium vs. high adherence to MD were: 1.19 (95% C.I.: 0.99; 1.42, p-value = 0.062) and 1.12 (95% C.I.: 0.90; 1.38, p-value = 0.311) for MER and Italy respectively. For the comparison of low vs. high adherence, the pooled ORs were 1.05 (95% C.I.: 0.88; 1.24, p-value = 0.598) for MER, and 1.20 (95% C.I.: 1.02; 1.41, p-value = 0.031) for Italy when outliers are removed. High adherence to the MD resulted as potential protective factor against obesity. In MER 7-DFP: total fats is higher (34.5 E%) vs. Italian 7-DFP (29.4 E%); EPA (20 mg) and DHA (40 mg) are lower than recommended (200 mg each); sugars (12.6 E%) are higher than recommended (< 10 E%). Calcium, Zinc, and vitamin D do not reach target values in both 7-DFPs.ConclusionThis study highlights that, even when 7-DFPs follow MD and refer to nutrient needs, it is necessary to verify nutrient excesses or deficits impacting on NCD. High MD adherence is protective toward NCDs. MD principles, and energy balance should be communicated according to socioeconomic and educational levels.

Sociodemographic and Lifestyle Factors and Epigenetic Aging in US Young Adults

Epigenetic clocks represent molecular evidence of disease risk and aging processes and have been used to identify how social and lifestyle characteristics are associated with accelerated biological aging. However, most research is based on samples of older adults who already have measurable chronic disease. To investigate whether and how sociodemographic and lifestyle characteristics are associated with biological aging in a younger adult sample across a wide array of epigenetic clock measures. This cohort study was conducted using data from the National Longitudinal Study of Adolescent to Adult Health, a US representative cohort of adolescents in grades 7 to 12 in 1994 followed up for 25 years to 2018 over 5 interview waves. Participants who provided blood samples at wave V (2016-2018) were analyzed, with samples tested for DNA methylation (DNAm) in 2021 to 2024. Data were analyzed from February 2023 to May 2024. Sociodemographic (sex, race and ethnicity, immigrant status, socioeconomic status, and geographic location) and lifestyle (obesity status by body mass index [BMI] in categories of reference range or underweight [<25], overweight [25 to <30], obesity [30 to <40], and severe obesity [≥40]; exercise level; tobacco use; and alcohol use) characteristics were assessed. Biological aging assessed from banked blood DNAm using 16 epigenetic clocks. Data were analyzed from 4237 participants (mean [SD] age, 38.4 [2.0] years; percentage [SE], 51.3% [0.01] female and 48.7% [0.01] male; percentage [SE], 2.7% [<0.01] Asian or Pacific Islander, 16.7% [0.02] Black, 8.7% [0.01] Hispanic, and 71.0% [0.03] White). Sociodemographic and lifestyle factors were more often associated with biological aging in clocks trained to estimate morbidity and mortality (eg, PhenoAge, GrimAge, and DunedinPACE) than clocks trained to estimate chronological age (eg, Horvath). For example, the β for an annual income less than $25 000 vs $100 000 or more was 1.99 years (95% CI, 0.45 to 3.52 years) for PhenoAgeAA, 1.70 years (95% CI, 0.68 to 2.72 years) for GrimAgeAA, 0.33 SD (95% CI, 0.17 to 0.48 SD) for DunedinPACE, and -0.17 years (95% CI, -1.08 to 0.74 years) for Horvath1AA. Lower education, lower income, higher obesity levels, no exercise, and tobacco use were associated with faster biological aging across several clocks; associations with GrimAge were particularly robust (no college vs college or higher: β = 2.63 years; 95% CI, 1.67-3.58 years; lower vs higher annual income: <$25 000 vs ≥$100 000: β = 1.70 years; 95% CI, 0.68-2.72 years; severe obesity vs no obesity: β = 1.57 years; 95% CI, 0.51-2.63 years; no weekly exercise vs ≥5 bouts/week: β = 1.33 years; 95% CI, 0.67-1.99 years; current vs no smoking: β = 7.16 years; 95% CI, 6.25-8.07 years). This study found that important social and lifestyle factors were associated with biological aging in a nationally representative cohort of younger adults. These findings suggest that molecular processes underlying disease risk may be identified in adults entering midlife before disease is manifest and inform interventions aimed at reducing social inequalities in heathy aging and longevity.

Kajian Pantangan Konsumsi Sayuran Hijau, Pola Makan dan Status Gizi Masyarakat Adat di Desa Detuara Kabupaten Ende

Food taboos in Indonesia are still a problem because there are still many foods that should be consumed but are still taboo. As a result, pregnant women, nursing mothers, infants and children dare not consume certain foods, reducing their food intake, which can reduce their nutritional status. The indigenous people in Detuara Village have a taboo of not consuming green vegetables during a traditional ritual called Pire Kema One in the process of building a house. This study aims to examine the practice of abstinence from green vegetable consumption, diet, and nutritional status of indigenous people in Detuara Village. This type of research is qualitative research using phenomenological methods with in-depth interviews and SQ-FFQ to assess food consumption habits with data obtained in the form of adequate levels of energy, protein, fat and carbohydrates. The informants consisted of four main informants and four key informants. The informants were selected using purposeful sampling. The results showed that all informants complied with the abstinence from consuming green vegetables until the house construction process was completed. Four informants (100%) had a poor diet during the abstinence from green vegetable consumption, while only one informant (25%) had a good diet during the normal diet. There were two informants (50%) who had normal nutritional status. There was one informant (25%) with overweigth nutritional status and one informant (25%) with obese nutritional status. Conclusion Food taboos still apply in Detuara Village until now and there will be bad risks if you violate these taboos.