Obese Population Research Articles

Evaluating a novel method for vitamin A analysis in an observational study of the UAE's obese population

Vitamin A plays a critical role in various biological functions, including vision, cellular differentiation, and immune regulation. However, accurately assessing its status, particularly in obese individuals, presents challenges due to potential alterations in metabolism and distribution. This study utilized Liquid Chromatography–Tandem Mass Spectrometry (LC–MS/MS) methodology to precisely measure serum vitamin A concentrations in population of UAE. The methodology's reliability and precision, as demonstrated through validation procedures, underscore its potential utility in clinical settings. Employing the Multiple Reaction Monitoring mode of positive ion electrospray ionization, the LC–MS/MS system achieves a limit of detection (LOD) of 0.48 ng/mL in serum, while adhering to FDA-US regulations for accuracy and compliance. A key aspect of this study was the application of LC–MS/MS to assess vitamin A status in an obese population within UAE. By employing a diverse cohort of 452 Emirati participants, including 277 individuals from a randomized controlled trial who were assessed at baseline and at 6th month, and 175 healthy individuals aged 18–82 assessed at baseline, this study explores the relationship between obesity and vitamin A levels, shedding light on potential implications for health and well-being. It was an observational study based on a new vitamin A method and participants were asked to eat vitamin A rich foods. The robust performance of the LC–MS/MS methodology positions it as a valuable tool for clinical research. By accurately quantifying vitamin A levels in human serum, this methodology opens avenues for advancing our understanding of vitamin A physiology and its implications for health, particularly in obese populations. In summary, this LC–MS/MS methodology presents a potent tool for clinical studies, providing reliable, specific, and robust detection of vitamin A in human serum, thus, opening a new frontier for advancing our understanding of vitamin A related physiology and health in the obese population.

Functional Outcome in Obese Patients Undergoing Image-Based Cruciate Retaining Robotic-Assisted Total Knee Arthroplasty Using the Subvastus Approach: A Short-Term Study.

Introduction Knee osteoarthritis (OA) is a prevalent degenerative joint disease that significantly affects quality of life, especially among obese and morbidly obese individuals. Total knee arthroplasty (TKA) is an effective treatment for end-stage OA, but it presents unique challenges in obese patients. The mini-subvastus approach (SA) and robotic-assisted TKA (RA-TKA) are emerging techniques that may address these challenges. This study evaluates the clinical and radiological outcomes of cruciate-retaining (CR) RA-TKA using the mini-subvastus approach in obese and morbidly obese patients. Methods This study included 114 obese patients (215 knees) with primary OA who underwent CR RA-TKA (Maxx Meril CR knee, USA) using the Cuvis Joint® robotic system. Patients had a BMI of ≥30 kg/m² (n=101) and morbid obesity with a BMI ≥40 kg/m² (n=13). Preoperative planning involved CT scans and the J-planner for optimal implant size and positioning. Surgery was performed without tourniquets, and patients were mobilized postoperatively. Clinical outcomes were assessed using visual analog scale (VAS) scores and the American Knee Society Score (AKSS) at three and six months. Results The study included 85 females and 29 males with an average age of 61.8 years. Satisfactory knee exposure was achieved in all cases using SA, with no major complications such as wound infections, deep vein thrombosis, or component misalignment. Intraoperative challenges were managed effectively, including two cases of medial collateral ligament avulsion and one partial patellar tendon avulsion. Postoperative VAS scores showed significant pain reduction from pre-op (6.54) to post-op day 3 (1.3). AKSS improved from a pre-op average of 33.9 to 70.7 at three months and 80.9 at six months. Most patients (80%) achieved exceptional range of motion (ROM) ≥120° at six months. Discussion The mini-subvastus approach in RA-TKA offers several advantages, including reduced postoperative pain, faster recovery, and improved quadriceps strength, even in obese patients. The use of robotic assistance ensures accurate component positioning and alignment, mitigating the challenges typically associated with obese patients undergoing TKA. Conclusion The study demonstrates the feasibility and effectiveness of CR RA-TKA using the mini-subvastus approach in obese and morbidly obese patients. This technique provides adequate exposure, reduces pain, and promotes early mobilization and recovery with satisfactory clinical and radiological outcomes. The findings support the potential for wider adoption of this approach in managing knee OA in obese populations, though further studies with longer follow-up are warranted.

Comparison of Serum Vitamin D Levels in Obese Subjects with and without Type 2 Diabetes Mellitus.

Although observational studies have reported a correlation between vitamin D deficiency and type 2 diabetes mellitus (T2DM), epidemiological evidence on the risk of obese subjects suffering T2DM due to a vitamin D deficiency is limited. Therefore, we investigated the correlation between T2DM and serum vitamin D, lipids, blood pressure, insulin indexes in an obese population. A total of 1440 participants including 450 healthy controls and 990 obese subjects, 470 without T2DM and 520 with T2DM. Serum vitamin D levels were measured, and the association between low levels and T2DM in obese subjects was examined using multinomial and linear regression analyses. Of the participants, 35% had deficient or insufficient vitamin D levels (ie, <20 ng/mL). Compared with healthy controls, obese subjects, particularly those with T2DM had lower vitamin D levels. Multinomial logistic regression analysis showed that obese subjects with T2DM had a gradually increasing risk for desirable (RO = 1.41, 95% CI 1.06-1.93, P = 0.027), insufficient (RO = 1.83, 95% CI 1.27-2.84, P < 0.001), or deficient ((RO = 2.14, 95% CI 1.15-3.75, P = 0.014) vitamin D levels. In obese subjects with T2DM, vitamin D levels correlated inversely with the risk indicators for diabetes, such as the levels of HbA1c (β = -0.16, P = 0.002), fasting insulin (Fins; β = -0.31, P = 0.008), and HOMA-IR (β = -0.19, P < 0.001). In obese subjects without T2DM, vitamin D was associated negatively with the risk of having T2DM at five-year follow-up (relative risk = 0.93, 95% CI 0.79-0.97, P = 0.037). This study demonstrates that low vitamin D levels correlate with the presence of T2DM in the obese population. This finding indicates that hypovitaminosis D may be a potential biological vulnerability factor for the development of T2DM in obese subjects.

Sleeve gastrectomy prior to primary total hip and total knee arthroplasty is associated with increased risk of early complications

AimsThe purpose of this study was to determine the association between prior sleeve gastrectomy in patients undergoing primary total hip and knee arthroplasty, and 90-day complications, incidence of revision arthroplasty, and patient-reported outcome scores at final follow-up.MethodsThis is a retrospective, single-centre analysis. Patients undergoing primary hip or knee arthroplasty with a prior sleeve gastrectomy were eligible for inclusion (n = 80 patients). A morbidly obese control group was established from the same institutional registry using a 1:2 match, for cases:controls with arthroplasty based on propensity score using age, sex, pre-sleeve gastrectomy BMI, Current Procedural Terminology code to identify anatomical location, and presurgical haemoglobin A1C. Outcomes included 90-day complications, incidence of revision arthroplasty, and patient-reported outcome scores at final follow-up. Multivariable logistic regressions evaluated associations of underlying preoperative demographic and treatment characteristics with outcomes.ResultsComplications within 90 days of surgery were increased in the sleeve gastrectomy group relative to the obese control group after controlling for underlying preoperative demographic characteristics (odds ratio (OR) 4.00 (95% CI 1.14 to 13.9); p = 0.030). Postoperative revisions were similar in the sleeve gastrectomy group relative to the obese control group after controlling for underlying preoperative demographic characteristics (OR 17.8 (95% CI 0.64 to 494.3); p = 0.090). Patient-Reported Outcomes Measurement Information System (PROMIS) depression decreased by a greater amount from pre- to postoperative in the obese controls relative to the sleeve gastrectomy group (OR 4.04 (95% CI 0.06 to 8.02); p = 0.047). PROMIS pain interference and physical function change from pre- to postoperative was not associated with sleeve gastrectomy status.ConclusionWe found a higher rate of complications at 90 days in patients who underwent sleeve gastrectomy prior to primary hip or knee arthroplasty relative to a matched, obese control population. Prosthetic revision rates were similar between the two groups, while improvements in PROMIS depression scores were larger in the obese cohort. This study suggests that sleeve gastrectomy to achieve preoperative weight loss prior to arthroplasty surgery may not mitigate early complication risks in obese patient populations.Cite this article: Bone Joint J 2024;106-B(9):935–941.

Efficacy of Different Doses and Forms of the GLP-1 Receptor Agonist Semaglutide in Weight Reduction Among Non-diabetic Obese or Overweight Populations.

Disorders linked to increased body weight are on the rise and obesity is a global epidemic associated with a rising risk for developing comorbidities, such as hypertension or type 2 diabetes. There is a significant need to develop a multimodal approach targeting obesity within clinical medicine. Pharmacological options to produce weight loss have been a popular research area and the novel glucagon-like Peptide-1 receptor agonists (GLP-1 RA) are highly effective glycemic control agents that have shown a substantial weight loss effect. This systematic review explores the efficacy of semaglutide, a GLP-1 RA agent, in a non-diabetic population, looking at endpoints of changes in weight and waist circumference and the percentage of patients achieving a clinically effective weight loss of at least 5%. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search was undertaken to find applicable papers using three databases, including PubMed, PubMed Central, and Cochrane Library. The included articles were narrowed down from an initial pool of 423 papers using filters, automation tools, inclusion/exclusion criteria, and quality appraisal tools. In this systematic review, we have analyzed 10 high-quality studies published in the last five years, including nine randomized control trials (RCTs) and a retrospective cohort study. The aim was to combine the results of these studies, encompassing 6623 participants, to showcase the effectiveness of GLP-1 RAs in the non-diabetic obese or overweight population. The consolidated data from the literature in this systematic review endorses the use of semaglutide as a highly efficient weight-reducing agent, contributing positive insight to both clinicians and researchers in the field of obesity treatment.

P134 CHARACTERIZATION OF RISK FACTORS IN RELATION TO THE INCREASE IN CARDIOVASCULAR RISK

Objective: Identify risk factors and their relationship with 10-year cardiovascular risk evaluated using the modified Framingham scale, in order to promote education and healthy lifestyle habits, generating an impact on the incidence of this disease. Methods: A descriptive study was carried out to characterize risk factors related to a high cardiovascular risk at 10 years, based on a cross-sectional study consisting of information collection with modified Framingham surveys, for risk assessment at 10 years. Results: A total of 3,025 people were surveyed, where the following factors were associated with a high cardiovascular risk: diabetes with 221 people and 6.7% at high risk, obesity with 242 people with 11.2% at high risk, alcohol consumption with 938 people with 15.3% high risk and smoking with 333 people with a high risk of 5.8%. Conclusions: Cardiovascular diseases are the most common non-communicable diseases with considerable morbidity and mortality worldwide, especially in low- and middle-income countries. As a fundamental part of the study, the importance of risk factors and their relationship with high cardiovascular risk in a capital city of Colombia is considered, within these diabetes, obesity, alcohol consumption and tobacco consumption, the alcohol consumption as the risk factor with the biggest impact linked to high cardiovascular risk with 15.3%. On the other hand, a negative impact is evident in the relationship between obesity associated with high cardiovascular risk with 11.2% of the total the obese population, the results of this study demonstrate the association with high cardiovascular risk, revealing alcohol consumption and obesity and how it is related to the increase in cardiovascular risk according to the Framingham scale, revealing the importance of education as a fundamental pillar for the prevention of risk and development of the disease, generating new educational campaigns and studies about the relationship of the factors and their modification with healthy lifestyle habits

P061 AMBULATORY BLOOD PRESSURE MONITORING (ABPM) CHARACTERIZATION IN PATIENTS CONSULTING A CARE CENTER IN THE CITY OF POPAYÁN, COLOMBIA BETWEEN JANUARY 2019 AND JUNE 2021

Background: Ambulatory blood pressure monitoring (ABPM) provides important information on the circadian behavior of this variable. This measure provides different phenotypes that can be analyzed in more depth than office blood pressure measurement. Several associations have been identified between altered circadian phenotypes, such as non dipper, and adverse cardiovascular outcomes, such as cardiovascular mortality, coronary heart disease, cerebrovascular disease, chronic kidney disease, and hospitalization for heart failure. To date, the behavior of blood pressure according to the MAPA is unknown in the population of the department of Cauca, Colombia. Therefore, our objective was to characterize the arterial hypertension profiles in a sample of this population. Materials and methods: A cross-sectional descriptive study was conducted in patients over 18 years of age, undergoing ambulatory BP monitoring from 2019 to 2021; data were recorded in an instrument containing sociodemographic, clinical, and therapeutic characteristics. The data were analyzed with the SPSS 25 program. Results: A total of 440 blood pressure monitoring (ABPM) records were obtained, of which, 80.4% of the records were found to be compatible with a diagnosis of arterial hypertension. The distribution of the profiles included: normal dipper (55.2%), attenuated dipper (non-dipper) (23.6%), inverted dipper (13.6%) and extreme dipping (1.4%). Most of the overweight and obese patients presented arterial hypertension in the ABPM records, with 41.1% being overweight patients and 25.2% obese. Regarding the arterial hypertension profiles, there were no statistically significant differences in relation to overweight and obesity. Conclusions: Among the BP profiles measured by ABPM in the population studied, the most prevalent was the normal dipper profile, followed by non-dipper, inverted dipper, and extreme dipper. There was a tendency for the overweight and obese population to present abnormal circadian BP profiles more frequently; however, in our study these results were not statistically significant.

Obesity Paradox in Transcatheter Aortic Valve Replacement.

Obesity paradox in cardiovascular risk prediction has gained increasing attention in recent years. We aimed to investigate the impact of BMI on mortality following transcatheter aortic valve replacement (TAVR). We performed a multi-center retrospective analysis of patients with severe aortic stenosis undergoing TAVR. Patients were categorized into: Underweight (BMI < 18.5), normal weight (18.5 ≤ BMI < 25), overweight (25 ≤ BMI < 30) and obese (BMI ≥ 30). Multivariate cox-proportional hazard model was used to compare all-cause mortality. Total of 6688 patients included (175 underweight, 2252 normal weight, 2368 overweight and 1893 with obesity). Mean age of patients was 81 ± 8 years with 55% males. Patients with obesity had higher prevalence of comorbidities but a lower overall STS score. Mortality at 30-days post-TAVR was lower in the obese population compared to underweight, normal weight, and overweight patients (1.6% vs. 6.9%, 3.6%, and 2.8%, respectively, p < 0.001). Similarly, 3-year mortality was lowest in patients with obesity (17.1% vs. 28.9%, 24.5% and 18.6%, respectively, p < 0.001). On multivariate analysis, long term all-cause mortality at 3-years remained significantly lower in patients with obesity compared to underweight (HR 1.74, 95% CI: 1.30-2.40, p < 0.001) and normal weight (HR: 1.41, 95% CI:1.21-1.63, p < 0.001) but not in overweight patients (HR: 1.10, 95% CI:0.94-1.28, p = 0.240). In conclusion, patients with obesity have improved short and long term mortality following TAVR with an observed progressive increase in mortality with lower BMI ranges.

Microsurgical breast reconstruction in the United States: a narrative review of the current state.

Breast reconstruction with microsurgical techniques allows for autologous reconstruction after mastectomy without the complications associated with alloplastic reconstruction. Autologous reconstruction has undergone significant improvement and now offers patients a variety of options depending on patient specific factors and aesthetic outcomes. This review aims to focus on the history of autologous reconstruction, operative considerations, general surgical techniques for flaps, and indications for choosing the ideal free tissue transfer for all medical specialties and not only plastic surgeons. A comprehensive review of the literature was performed using PubMed and Embase databases. Manuscripts that provided objective data with respect to history of microsurgical options, surgical techniques, patient considerations, and contraindications were utilized for this review with the objective to simplify data for all non-plastic surgeon readers. In this study, we find that patient selection is critical in successful outcomes for microsurgical breast reconstruction. We find that abdominal free flaps are now considered gold standard for autologous reconstruction. However, reliable alternatives exist for patients who are not considered ideal candidates for this reconstruction. These include thigh-based flaps such as gracilis myocutaneous flaps, profunda artery perforator flaps, lateral thigh perforator flaps and trunk-based flaps such as lumbar artery perforator flap. Postoperative considerations involve clinical monitoring and enhanced recovery after surgery. The rate of reconstructive success and flap viability is greater that 95%, even in high-risk populations, and therefore risk stratification should be performed based on an individual basis. While there are no absolute contraindications to autologous reconstruction, relative contraindications do exist including obesity and elderly populations due to the increased surgical and medical complications. While implant-based reconstruction remains the predominant method of breast reconstruction in the United States, there have been many exciting advancements in autologous reconstruction that offers high aesthetic outcomes and patient satisfaction.

The Role of Diet and Physical Activity in Obesity and Overweight in Children with Down Syndrome in Developed Countries.

Down's syndrome (DS), or Trisomy 21, represents the most common chromosomal abnormality in live births, characterized by an extra chromosome 21. Children affected by Down's syndrome are more susceptible to the development of obesity and of becoming overweight compared with other children. Furthermore, they seem to present a more unfavorable lipid profile than the non-DS obese pediatric population. Diet and physical activity are closely related to the development of overweight and obesity, and they can be assessed using questionnaires such as the Mediterranean Diet Quality Index in children and adolescents (KIDMED) and the Godin-Shephard Leisure-Time Physical Activity Questionnaire. This review aims to undertake a comprehensive analysis of the intricate interplay between diet and physical activity in children affected by Down's syndrome. Specifically, it seeks to deepen understanding regarding the question of how diet and exercise can influence and prevent the development of overweight and obesity in that special pediatric population.

Effect of a carbohydrate-restricted diet on weight loss in overweight and obese pediatric population: a meta-analysis of randomized controlled trials

BackgroundThere are conflicting findings regarding the effect of low-carbohydrate diets on obesity-related factors. This study aimed to investigate the effect of a carbohydrate-restricted (CR) diet on changes in anthropometric indicators of adiposity and fat distribution in pediatrics populations.MethodsA systematic search was conducted in PubMed/MEDLINE, Web of Science, Scopus, and Embase electronic databases using predefined keywords to identify all randomized controlled trials examining the effects of CR on obesity-related factors. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were calculated using a random-effects model.ResultsFindings from 11 studies demonstrated significant reductions in weight (WMD: -2.31 kg; 95% CI: -4.44, -0.18), BMI (WMD:-1.08 kg/m2; 95% CI: -1.91, -0.26), and fat mass (WMD: -1.43%; 95% CI: -2.43 to -0.43) as well as a significant increase in adiponectin levels (WMD: 0.74 ng/ml; 95% CI: 0.02, 1.47) in the CR diet group compared to the control group. However, no significant effect was observed on BMI z-score (WMD:-0.10; 95% CI: -0.21, 0.01), waist circumference (WMD:-3.03 cm; 95% CI: -6.57, 0.51) or leptin levels (WMD: -0.82 ng/ml; 95% CI: -2.26, 0.61). Stratified analysis rrevealed a greater effect of CR on weight and BMI reduction in interventions ≤ 12 weeks and in very low-carbohydrate diets.ConclusionsIn conclusion, it appears that CR diet, along with other lifestyle factors, can lead to significant improvements in weight loss on pediatrics with obesity/overweight.

Pattern of eye disease among obese population in Erbil city, Iraq

Background and objective: Obesity is a multifactorial disease. It is a multifactorial pathology that can be related to an altered nutritional behaviour or secondary to genetic, hypothalamic, iatrogenic or endocrine diseases. Obesity and visual acuity are negatively correlated, obesity may be linked to dysfunction of the mechanical and vascular components of the eye. The aim of the study is to find out the impact of obesity on eye health and the pattern of eye disease. Methods: Across-sectional study was conducted in the Ophthalmology Department/ Erbil Teaching Hospital during the period from 1st of August 2021 to 31st of March 2022. A simple random sampling method was adopted, and a total of 300 participants with an age of more than 18 years old were enrolled. Results: The percentage of cataract, glaucoma, age-related maculopathy, papilloedema, keratoconus, and retinal vein occlusion was higher in the case group than in the control group. Obesity is a significant risk factor for cataracts, age-related maculopathy, and papilloedema, while it was insignificant regarding keratoconus and retinal vein occlusion. The mean of internal ocular pressure and central corneal thickness was higher in the case group compared to the control group. Conclusion: The prevalence of ocular disease was higher among the obese population than in those with normal weight. Obesity is a significant risk factor for ocular disease. Age and gender represented additional risk factors in some of the ocular diseases in obese people.

Association between Vitamin E, Vitamin B6, and Vitamin B12 with coronary heart disease

Conflicting evidence still exists regarding Vitamin B12’s involvement in coronary heart disease (CHD). There is no precedent for previous studies to include both Vitamin B12, Vitamin B6, as well as Vitamin E in the consideration of CHD associating factors. Our data derived from the National Health and Nutrition Examination Survey (NHANES), which covers the period 2003–2020. 33,640 samples were included in this cross-sectional study. We used an unadjusted covariates and three adjusted covariates. The intake percentage of Vitamins E, B6, and B12 was categorized into continuous and categorical variables using multivariate logistic regression analysis and subgroup logistic regression. To estimate these trends, we applied the percentage categories of Vitamin E, B6, and B12 intake as continuous variables. We recorded Vitamin E, B6, B12, age, race, BMI, gender, household annual income, education level, hypertension status, diabetes status, smoking status, and drinking status for included samples. Multivariate regression analysis revealed that Vitamin E and B6 were negatively associated with CHD and exerted protective effects, while Vitamin B12 had little correlation with CHD. Based on the quartiles of Vitamin E and Vitamin B6 percentage, the strongest protective effect was observed in the third quartile (Q3). Analyses of subgroups showed the effects of Vitamin B6 and Vitamin E on CHD were more noticeable in women, the participant’s BMI was in the 25–30 range, and participants who smoked. We identified the possible protective effect of Vitamin E and Vitamin B6 against CHD, especially in female, obese, and smoking populations, whereas income and education were also viewed as influencing factors that could be taken into account.

Pregnancy outcomes after superovulation-intrauterine insemination (SO-IUI) using gonadotropins versus letrozole in the obese population.

To compare fertilityoutcomes of obese patients (body mass index [BMI] ≥ 30kg/m2) undergoing superovulation and intrauterine insemination (SO-IUI) using gonadotropins versus letrozole. A single centre retrospective cohort study of obese patients undergoing SO-IUI using gonadotropins or letrozole between January/2019 and June/2022. Primary outcome was clinical pregnancy rate (intrauterine pregnancy with positive fetal heart rate). Secondary outcomes included rates of multifollicular development, multiple pregnancy, spontaneous abortion and cycle cancellation. Subgroup analysis was done stratifying by obesity class. A multivariate logistic regression model was used for primary/secondary outcomes, adjusting for clinically determined covariates. Out of 802 total identified SO-IUI cycles, 715 cycles were completed (518-gonadotropins and 197-letrozole cycles). The clinical pregnancy rates were not significantly different in obese patients undergoing SO-IUI with gonadotropins versus letrozole when adjusted for age, gravidity, parity, cause of infertility, IUI cycle number, endometrial thickness, sperm source and post-wash motile sperm count (adjusted odds ratio [aOR] 1.37, 95% confidence interval [CI] 0.72-2.59). Similarly, no significant associations were found in spontaneous abortion (aOR1.46, 95%CI 0.42-5.08), multiple pregnancy (aOR1.33, 95%CI 0.20-8.88) or cancellation rates (OR0.89, 95%CI 0.55-1.45) between the two groups. The rates of multifollicular development were also comparablebetweenthe two groups (aOR0.51, 95% CI 0.19-1.38). For cycles involving gonadotropins, higher BMI classes required higher total gonadotropin dose (p < 0.001). After adjusting for patient and cycle factors, gonadotropins and letrozole led to comparable odds of achieving pregnancy in obese patients undergoing SO-IUI. Future research in the obese population will help to better understand how to optimize fertility treatments for this growing population.

Enhancement of physicochemical, in vitro hypoglycemic, hypolipidemic, antioxidant and prebiotic properties of oat bran dietary fiber: Dynamic high pressure microfluidization

To improve the physicochemical and functional properties of oat bran dietary fiber (ODF) and the comprehensive utilization of oat bran, dynamic high-pressure microfluidization (DHPM) was utilized to treat ODF at different pressures. The particle size, physicochemical, functional and probiotic properties of the ODF samples were analyzed to investigate the modification effect of DHPM. After DHPM modification, the microstructure of ODF was broken, the particle size decreased and the specific surface area increased, with the best effect under 420 MPa pressure treatment. The structural breakage and the increase in the specific surface area of ODF may led to the enhancement of its physicochemical and functional properties, and it had greater advantages in terms of the water retention capacity (2.13 ± 0.01 g/g), oil retention capacity (8.46 ± 0.07 g/g), bile salt binding capacity (52.67 ± 1.21 mg/g) and cholesterol binding capacity (1.03 ± 0.02 mg/g). cholesterol binding capacity (1.03 ± 0.02 mg/g). Meanwhile, ODF also remodelled the gut microbiota of the obese population and increased the relative abundance of beneficial bacteria. In conclusion, DHPM treatment effectively enhanced the physicochemical and functional properties of ODF and broadened its applications in the food industry.

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.

No Increased Risk of All-cause Revision up to 10 Years in Patients Who Underwent Bariatric Surgery Before Single-level Lumbar Fusion.

Retrospective cohort study. This study aimed to assess whether prior bariatric surgery (BS) is associated with higher 10-year surgical complication and revision rates in lumbar spine fusion compared with the general population and morbidly obese patients. Obesity accelerates degenerative spine processes, often necessitating lumbar fusion for functional improvement. BS is explored for weight loss in lumbar spine cases, but its impact on fusion outcomes remains unclear. Existing literature on BS before lumbar fusion yields conflicting results, with a limited investigation into long-term spine complications. Utilizing the PearlDiver database, we examined patients undergoing elective primary single-level lumbar fusion, categorizing them by prior BS. Propensity score matching created cohorts from (1) the general population without BS history and (2) morbidly obese patients without BS history. Using Kaplan-Meier and Cox proportional hazard modeling, we compared 10-year cumulative incidence rates and hazard ratios (HRs) for all-cause revision and specific revision indications. Patients who underwent BS exhibited a higher cumulative incidence and risk of decompressive laminectomy and irrigation & debridement (I&D) within 10 years postlumbar fusion compared with matched controls from the general population [decompressive laminectomy: HR = 1.32; I&D: HR = 1.35]. Compared with matched controls from a morbidly obese population, patients who underwent BS were associated with lower rates of adjacent segment disease (HR = 0.31) and I&D (HR = 0.64). However, the risk of all-cause revision within 10 years did not increase for patients who underwent BS compared with matched or unmatched controls from the general population or morbidly obese patients (P > 0.05). Prior BS did not elevate the 10-year all-cause revision risk in lumbar fusion compared with the general population or morbidly obese patients. However, patients who underwent BS were associated with a lower 10-year risk of I&D when compared with morbidly obese patients without BS. Our study indicates comparable long-term surgical complication rates between patients who underwent BS and these control groups, with an associated reduction in risk of infectious complications when compared with morbidly obese patients. Although BS may address medical comorbidities, its impact on long-term lumbar fusion revision outcomes is limited.

Exploring flavonoid intake and all-cause mortality in diverse health conditions: Insights from NHANES 2007–2010 and 2017–2018

ObjectivesFlavonoids exhibit antioxidative, anti-inflammatory, and anticancer properties, yet the relationship between flavonoid intake and all-cause mortality in the obese population remains unclear. MethodsThis study included NHANES participants from 2007 to 2010 and 2017 to 2018. Cox regression analysis evaluated the impact of total flavonoid intake on all-cause mortality among participants with varying comorbidity profiles. Subgroup analysis was conducted by separately analyzing the six sub-classes of total flavonoids (anthocyanidins, flavan-3-ols, flavanones, flavones, flavonols, and isoflavones). Sensitivity analysis was used to investigate the impact of total flavonoid intake on all-cause mortality among patients with different comorbidities. ResultsDuring a median follow-up period of 9.92 years (interquartile range (IQR), 5.54–14.29 years), a total of 639 participants died. COX regression analysis revealed a positive impact of flavonoid intake on all-cause mortality among participants with chronic kidney disease, with greater benefits observed in obese participants [hazard ratio (HR): 0.22, 95% CI: 0.11–0.44). In metabolically healthy obese participants (HR: 0.15, 95% CI: 0.07–0.35), obese individuals with diabetes (HR: 0.51, 95% CI: 0.29–0.88), and obese individuals with comorbid cardiovascular disease (HR: 0.37, 95% CI: 0.17–0.83), flavonoid intake was associated with a reduced risk of all-cause mortality. Restricted cubic spline (RCS) analysis indicated a non-linear relationship in obese participants, with optimal intake levels ranging from 319.4978 to 448.6907 mg/day, varying based on different comorbidity profiles. Subgroup analysis revealed varying effects of total flavonoid components in different health conditions, with hazard ratios ranging from 0.06 for higher levels of flavonol to 0.59 for higher levels of anthocyanidins in the Cox model. Sensitivity analyses further indicated that individuals with obesity and comorbid diabetes or CKD see the greatest benefit from flavonoid intake. ConclusionsThe consumption of flavonoids may be associated with a decreased risk of all-cause mortality. Consumption of flavonoids is particularly beneficial for individuals with obesity and comorbidities.

Oxygen Consumption During Moderate-Intensity Interval Exercise in Overweight Young Adults

Background: Overweight and obesity have become a problem for younger generations, so weight management must be introduced. Moderate-intensity interval training (MIIT) has been recommended for aging and obese populations because it is friendly and accessible. However, little information is known about the physiological response during moderate-interval intensity exercise, especially for overweight and obese persons. Objectives: To evaluate cardiorespiratory alteration upon a single bout of MIIT exercise among sedentary, overweight young Thai adults. Methods: Fifteen overweight young adults (8 males and 7 females, body mass index between 25.0 - 29.9 kg/m2, aged between 18 - 25 years) underwent cycling ergometry for 45 minutes (warm-up 5 minutes; 3 × 5 minutes at 20 - 40% of heart rate reserve and 5 minutes at 50 - 60%; cool down 10 minutes). A gas analyzer and limb lead electrocardiogram were used to record oxygen consumption (V̇O2), heart rate (HR), and dioxide production (V̇CO2) throughout the experiment. Results: During the 45-minute MIIT exercise protocol, the participants consumed 25.1 ± 8.1 L, equal to approximately 530 ± 171 kJ. As expected, heart rate, O2 uptake, and CO2 production increased during moderated-intensity exercise and declined during low-intensity exercise. A low to moderate duration ratio of 1: 1 was sufficient to return both O2 consumption and CO2 production to their stage level, but not for heart rate. Although there was a very linear relationship between V̇O2 and heart rate for the overall period (0.761 ± 0.090), the correlation was weaker when selectively computed during low (0.549 ± 0.161) or moderate exercises (0.658 ± 0.105). Interestingly, RER larger than one during moderate-intensity exercise indicated the possibility of high acid accumulation. Conclusions: The MIIT protocol in the present study provided a responsive effect on overweight persons toward anaerobic metabolism but was a little aggressive.

Platelet/High-Density Lipoprotein Ratio (PHR) Predicts Type 2 Diabetes in Obese Patients: A Retrospective Study.

Background: Obesity and type 2 diabetes (T2D) pose global health problems that continue to rise. A chronic low-grade inflammation and activation of the immune system are well established in both conditions. The presence of these factors can predict disease development and progression. Emerging evidence suggests that platelet-high density lipoprotein ratio (PHR) is a potential inflammatory marker. The purpose of this study was to investigate the relationship between PHR and T2D among obese patients. Methods: 203 patients with BMI ≥ 30 kg/m2 participated in the study. Patients were categorized into two groups: non-diabetic obese and diabetic obese. Comorbidities, baseline characteristics, laboratory data, as well as PHR levels of the study groups were analyzed. Medians, risk assessment, and the diagnostic performance of PHR values were examined in both groups. Results: In obese patients, the median PHR were significantly increased in obese patients with T2D compared to non-diabetic obese (p < 0.0001). Furthermore, T2D obese with high PHR had a significantly higher FBG and HbA1c (p < 0.05). Although PHR was weakly yet significantly correlated with glycemic markers, ROC curve analysis of the PHR indicated an AUC of 0.700 (p < 0.0001) in predicting T2D in obese patients, and the cutoff value was 6.96, with a sensitivity and specificity of 53.4% and 76.1%, respectively. Moreover, increased PHR (OR = 4.77, p < 0.0001) carried a significantly higher risk for developing T2D in obese individuals. Conclusions: The PHR is a convenient and cost-effective marker that can reliably predict the presence of T2D in high-risk obese population.