Obesity-related Health Problems Research Articles

The potential efficacy of Artemisia anuua L. extract nanoparticles in mitigating obesity-related-metabolic complications in hypercaloric diet-fed rats

ABSTRACT Obesity-related health problems are worsening in various societies worldwide. Artemisia anuua L. (AA) has distinctive health benefits, including anti-inflammatory, antioxidant, and insulin-sensitizing properties. Nanoformulation of herbal extracts is a new approach to enhance the bioavailability of natural products. This study aimed to evaluate the efficacy of AA extract, either the conventional extract (AAE) or its nano-form (AAEN), in modulating obesity-related metabolic complications in hypercaloric (high-fat/high-sucrose) diet-induced obese rats. Forty-eight rats were divided into two groups fed either a basal or hypercaloric diet for twelve weeks. Starting from the eighth week, each main group was subdivided into three subgroups and treated orally with either saline, AAE, or AAEN until the end of the experiment. Both AAE and AAEN exerted antiadipogenic effects. They reduced body weight and epididymal fat, mitigated dyslipidemia, improved glucose utilization and insulin resistance, reduced hyperleptinemia, increased serum adiponectin, and decreased oxidative stress and inflammatory markers. These results were mediated by regulating SIRT-1, PGC-1α, SREBP-1, PPAR-γ, FAS, LPL, IRS 1, and GLUT4 gene expression, suggesting an effect of AA on de novo lipogenesis and glucose utilization. The AAEN produced more expressive ameliorating effects than the conventional extract. AAE administration ameliorated the obesity-associated metabolic complications induced by feeding a hypercaloric diet, implying that this extract may be used as a complementary treatment option for obesity and its metabolic consequences. The antiadipogenic effectiveness of AAE was enhanced by its nanoformulation, suggesting that the nanoparticle system can be applied to boost other herbal medicine effectiveness.

Identifying edible plants with high anti-obesity potential: In vitro inhibitory effect against pancreatic lipase followed by bioactive compound metabolomic screening

The ever-growing number of individuals facing obesity related health problems represents an alarming situation. Within the available obesity control strategies, there is evidence that some natural compounds can inhibit pancreatic lipase (PNLIP, EC 3.1.1.3), a digestive enzyme with pivotal role in the hydrolysis of dietary triacylglycerols, resulting in reduced fat metabolism. In this study, to identify sources of bioactive compounds with anti-obesity potential, 278 extracts originating by 126 food species were prepared in water and dichloromethane (DCM) and their in vitro inhibitory potential against PNLIP was measured. Importantly, 12 extracts exceeded the set cut-off level of significant inhibitory effect (inhibition> 70%) and for them dose-response curves were prepared and metabolomic target screening was performed. By using ultra-high-performance liquid chromatography hybrid quadrupole time-of-flight mass spectrometry (UHPLC-q-TOF-MS), it was possible to tentatively identify 28 and 22 secondary metabolites in the aqueous and DCM extracts, respectively. Several species-specific compounds were detected, e.g., hesperidin and eriocitrin in lemon and lime fruit aqueous extracts or curcuminoids in DCM turmeric extracts. Additionally, the highest percentage of the total analytical signal detected in dill, walnut, caper and bell pepper DCM extracts corresponded to various fatty acids. All in all, the edible plant extracts with strong anti-obesity potential contained various bioactive phytochemicals that may be used in nutraceutical applications.

Bariatric Surgery: Preparations and Quality of Life Consequences

Introduction: Obesity is a major threat to global health. When more conventional methods have failed, obesity can be addressed via bariatric surgery. Here we examine the reasons why patients choose bariatric surgery and the behavioral consequences thereafter. Methods: A qualitative study with a phenomenological design was used to analyze detailed interview responses from recipients of bariatric surgery. Results: Before surgery, (a) bariatric surgery was chosen for obvious reasons: patients had been overweight, had obesity-related health problems and had difficulties moving; (b) Information was obtained from medical practitioners and online discussion groups; (c) Fear, anxiety and apprehension were common. Friends and family were supportive and disapproving. After surgery: (1) many chronic health problems disappeared or eased significantly; (2) Subjects experienced difficulties adjusting with changed food tastes and small portions; (3) Physical activity increased; (4) Self-esteem increased but the worry of regaining the weight remained; (5) As before surgery, there were supportive and condemning attitudes by relatives, friends and society; (6) A desire for further nutritional and psychological counseling after surgery was indicated; (7) Relationships and quality of sex improved in most cases but not always. Single women, particularly, became more active in potential relationships. Discussion: With a few exceptions, our results agree with the literature, supporting the idea that bariatric surgery leads to extensive physical, psychological and social changes. Hence, patients ought to be better prepared for these changes and medical practitioners ought to be aware of the magnitude of the changes this surgery will bring about in their patients’ lives.

The complexity of obesity-related health problems after bariatric surgery: The patient perspective

BackgroundBariatric surgery aims to improve quality of life by means of weight loss. Obesity-related physical and psychological health problems should improve, but long-term data are scarce. ObjectivesTo evaluate preoperative physical and mental health problems perceived by the patient and the association with weight loss and quality of life, 5 years after bariatric surgery. Methods101 persons (response rate 67%) who had had bariatric surgery an average of 4.6 years before this study completed a written survey on obesity-related physical and psychological health problems and three psychological questionnaires collecting information on eating behavior and quality of life. Over half of the participants (55%) had had a laparoscopic adjustable gastric banding. ResultsPreoperatively reported health problems improved but were not necessarily associated with weight loss. Minimal improvement in tiredness, shame and weight instability were associated with significantly less weight loss. Preoperative type 2 diabetes mellitus (T2D) improved but participants had significantly less weight loss and more dissatisfaction regarding the bariatric trajectory than participants without T2D. Eating concerns, emotional eating and external eating improved but not restrained eating. Compared to the Dutch population reference, most quality of life scores of the participants were lower. ConclusionIn this analysis, participants did report satisfaction although from a patients’ perspective, improvements of weight and health did not necessarily lead to satisfaction regarding the bariatric trajectory. Participants with postoperative reported fatigue and shame as well as participants with preoperative T2D showed significant less weight loss. More long-term research is necessary to close the current knowledge gap.

The relationship of active consideration of health outcomes and intertemporal preferences to choice process variables and nutrition: evidence from an experiment on food choice

IntroductionUnderstanding drivers of individuals' food choices is critical to be able to address the public health epidemic of obesity-related health problems. A robust literature documents relationships between intertemporal preferences and body mass index (BMI). However, work on cognition differentiates resource investment in decision-making, with processes frequently categorized as habitual (low investment) vs. model-based (high investment).MethodsWe integrate variables related to cognition with intertemporal preferences to examine how discount rates and active consideration of health impacts of foods faced during choice relate to the nutritional quality of foods selected.ResultsOur results show that participants who actively consider health outcomes choose products with significantly higher nutritional quality compared to those who do not consider the health impacts of choices, even while controlling for discount rates. We also find that participants with lower discount rates selected foods with higher nutritional quality compared to high discount-rate participants, corroborating previous literature. Further, we find that participants who actively considered health during the choice process spent significantly more time making choices, while discount rates did not predict differences in decision times, suggesting a role for habitual vs. model-based decisions.DiscussionThese findings suggest that active consideration of the health consequences during food choice is an important predictor of the nutritional quality of choices even while accounting for intertemporal preferences, which may provide new opportunities to intervene in the decision-making process.

Chronic Kidney Disease and it’s link to obesity: a short review

The coexistence of obesity and chronic kidney disease(CKD) has become increasingly common and hasbecome a significant public health concern. Thisliterature review aims to explore the relationshipbetween obesity and CKD, highlighting the potentialmechanisms underlying this association. The reviewincludes several studies that demonstrate that obesityis an independent risk factor for the development andprogression of CKD. Obesity-induced metabolicdisturbances such as hypertension, diabetes, anddyslipidemia are believed to play a crucial role in thepathogenesis of CKD. The review also suggests thatlifestyle interventions, including weight management,may be essential in preventing and managing thecomplications of these conditions. The study concludesthat early identification and management of theseconditions are critical to reducing the burden of CKDand obesity-related health problems.

Cardiometabolic risk factors among children who are affected by overweight, obesity and severe obesity.

The increasing severity of obesity is expected to lead to more serious health effects. However, there is limited information on the prevalence and clinical characteristics of cardiometabolic risk factors in severely children affected by obesity in Malaysia. This baseline study aimed to investigate the prevalence of these factors and their association with obesity status among young children. In this study, a cross-sectional design was employed using the baseline data obtained from the My Body Is Fit and Fabulous at school (MyBFF@school) intervention program involving obese school children. Obesity status was defined using the body mass index (BMI) z-score from the World Health Organization (WHO) growth chart. Cardiometabolic risk factors presented in this study included fasting plasma glucose (FPG), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood pressure, acanthosis nigricans, insulin resistance (IR), and MetS. MetS was defined using the International Diabetes Federation (IDF) 2007 criteria. Descriptive data were presented accordingly. The association between cardiometabolic risk factors, such as obesity status, and acanthosis nigricans with MetS was measured using multivariate logistic regression, which was adjusted for gender, ethnicity, and strata. Out of 924 children, 38.4% (n = 355) were overweight, 43.6% (n = 403) were obese, and 18% (n = 166) were severely obese. The overall mean age was 9.9 ± 0.8 years. The prevalence of hypertension, high FPG, hypertriglyceridemia, low HDL-C, and the presence of acanthosis nigricans among severely children affected by obesity was 1.8%, 5.4%, 10.2%, 42.8%, and 83.7%, respectively. The prevalence of children affected by obesity who were at risk of MetS in <10-year-old and MetS >10-year-old was observed to be similar at 4.8%. Severely children affected by obesity had higher odds of high FPG [odds ratio (OR) = 3.27; 95% confdence interval (CI) 1.12, 9.55], hypertriglyceridemia (OR = 3.50; 95%CI 1.61, 7.64), low HDL-C (OR = 2.65; 95%CI 1.77, 3.98), acanthosis nigricans (OR = 13.49; 95%CI 8.26, 22.04), IR (OR = 14.35; 95%CI 8.84, 23.30), and MetS (OR = 14.03; 95%CI 3.97, 49.54) compared to overweight and children affected by obesity. The BMI z-score, waist circumference (WC), and percentage body fat showed a significant correlation with triglycerides, HDL-C, the TG: HDL-C ratio, and the homeostatic model assessment for IR (HOMA-IR) index. Severely children affected by obesity exhibit a higher prevalence of and are more likely to develop cardiometabolic risk factors compared to overweight and children affected by obesity. This group of children should be monitored closely and screened periodically for obesity-related health problems to institute early and comprehensive intervention.

Sedentary lifestyle with increased risk of obesity in urban adult academic professionals: an epidemiological study in West Bengal, India

Ectopic fat deposition is more strongly associated with obesity-related health problems including type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), hypothyroidism, arthritis, etc. Our study aimed at identifying the cumulative role of several risk factors in developing obesity and the role of ectopic fat (visceral fat) in predicting cardiovascular disease risk in varied age groups among urban adult academic professionals in West Bengal. 650 adults (Male = 456; Female = 194) associated with the academic job (age 20–65 years) in urban West Bengal were randomly selected for anthropometric, blood biochemical, and questionnaire-based analyses. Body Mass Index and Visceral Fat% exhibited comparable association with all the other anthropometric parameters (e.g. Whole body Subcutaneous fat%: male-Linear Regression Comparison: F = 11.68; P < 0.001; female-F = 6.11; P < 0.01). Therefore, VF% acts as a risk factor alongside BMI in instances where BMI fails alone. The presence of T2DM, hypertension, and hypothyroidism in the case groups confirmed their obesity-associated longitudinal pattern of inheritance. Unhealthy diet pattern indicates improper liver function, vitamin D deficiency, and increased erythrocytic inflammation. An overall sedentary lifestyle with parental history of obesity was found to be significant in the longitudinal transmission of the disease.

Impact of educational attainment and economic globalization on obesity in adult females and males: Empirical evidence from BRICS economies.

Obesity has considerably increased since 1980 and become a global epidemic. Obesity-related health problems and the negative social and economic implications of obesity have led international institutions and countries to combat it. This study investigates the role of educational attainment and economic globalization in the global prevalence of obesity in samples of adult females and males in BRICS economies for 1990-2016 through causality and cointegration tests. The results of the causality tests reveal that educational attainment and economic globalization have a significant influence on obesity in both adult females and males in the short run. Furthermore, cointegration analysis indicates a negative effect of educational attainment on obesity in all BRICS economies in the long run, but the influence of economic globalization on obesity differs among the BRICS economies. Furthermore, the negative influence of educational attainment on obesity is revealed to be relatively higher in females than males.

Effectiveness of Fit and Trimmed Staffs (FATS) program on weight management among the healthcare providers at Simpang Health Clinic, Perak: A pre-post interventional study.

Obesity is associated with an increased risk for non-communicable diseases. Local studies have shown that 33.1% of healthcare providers (HCPs) are overweight, while 21.1% are obese. Interventions that consist of diet, physical exercise and cognitive behavioural training have been shown to be successful in reducing weight. We designed a weight loss programme for our HCPs named the 'Fit and Trimmed Staff programme, which consisted of 3 months of group education on obesity-related health problems led by a doctor, a pharmacist, a nutritionist and an occupational therapist among HCPs. Monthly individual dietary counselling by a nutritionist was also provided for 6 months. We measured the body weight, body mass index, percentage of body fat, visceral fat and percentage of skeletal muscle of the HCPs before and after the intervention. Forty-five (56.25%) HCPs at Simpang Health Clinic were either overweight or obese; the majority of them were drivers and administrative clerks (100%), followed by health attendants (69.2%) and medical assistants (63.6%). At 6 months post-intervention, there was a trend towards a non-significant reduction in the fat percentage (median=-0.8%, P=0.423). Approximately 42% (n=19) of the HCPs lost weight, while 58% gained weight. Weight loss was observed more commonly in the male HCPs (>50%) than in the female HCPs. A weight loss programme solely consisting of health discussion and nutritional advice is inadequate to induce weight reductions. A multimodal approach may be considered in managing weight among HCPs.

Effects of long-term childhood exercise and detraining on lipid accumulation in metabolic-related organs.

The preventive effects of regular exercise on obesity-related health problems are carried over to the non-exercise detraining period, even when physical activity decreases with aging. However, it remains unknown whether regular childhood exercises can be carried over to adulthood. Therefore, this study aimed to investigate the effects of long-term childhood exercise and detraining on lipid accumulation in organs to prevent obesity in adulthood. Four-week-old male Otsuka Long-Evans Tokushima Fatty (OLETF) rats were used as obese animals. OLETF rats were allocated into sedentary and exercise groups: exercise from 4- to 12-week-old and detraining from 12- to 20-week-old. At 12-week-old immediately after the exercise period, regular exercise completely inhibited hyperphagia, obesity, enlarged pancreatic islets, lipid accumulation and lobular inflammation in the liver, hypertrophied adipocytes in the white adipose tissue (WAT), and brown adipose tissue (BAT) whitening in OLETF rats. Additionally, exercise attenuated the decrease in the ratio of muscle wet weight to body weight associated with obesity. Decreased food consumption was maintained during the detraining period, which inhibited obesity and diabetes at 20-week-old after the detraining period. Histologically, childhood exercise inhibited the enlargement of pancreatic islets after the detraining period. In addition, inhibition of lipid accumulation was completely maintained in the WAT and BAT after the detraining period. However, the effectiveness was only partially successful in lipid accumulation and inflammation in the liver. The ratio of muscle wet weight to body weight was maintained after detraining. In conclusion, early long-term regular exercise effectively prevents obesity and diabetes in childhood, and its effectiveness can be tracked later in life. The present study suggests the importance of exercise during childhood and adolescence to inhibit hyperphagia-induced lipid accumulation in metabolic-related organs in adulthood despite exercise cessation.

Time Course of Fat Accumulation in Various Organs of Young OLETF Rats

PurposeExcessive fat accumulation induces chronic inflammation in the white adipose tissue (WAT), which leads and accelerates to obesity‐related health problems such as glucose intolerance, insulin resistance, and dyslipidemia. Determination of the time course of fat accumulation in obesity might allow identification of target tissues to treat the health problems in each stage. The purpose of the present study was to investigate the relationship between inflammatory changes and time course of fat accumulation in various organs.MethodsMale Otsuka Long‐Evans Tokushima fatty (OLETF) rats were used as spontaneous obesity animals. All rats were fed a standard diet containing 55.3% carbohydrate and water ad libitum. From 4‐ to 20‐week‐old, blood samples from vena cava and samples of the epididymal adipose tissue, retroperitoneal adipose tissue, mesenteric adipose tissue, and inguinal subcutaneous adipose tissue as WAT, brown adipose tissue (BAT) from interscapular region, liver, pancreas, and plantaris muscles were analyzed histologically every 2 weeks. Collected serum was used to detect triglyceride (TG) and free fatty acid (FFA) concentrations. Tissue samples were sliced and stained with hematoxylin and eosin or oil red O for histological observation.ResultsBody weight in OLETF rats increased linearly from 4‐ to 20‐week‐old. Although the wet weight and adipocyte diameter of the epididymal adipose tissue also increased throughout the experimental period, the values of inguinal subcutaneous adipose tissue increased by 10‐week‐old and were almost the same after 10‐week‐old. The liver TG levels increased from 4‐ to 8‐week‐old. However, hypertriglyceridemia, BAT whitening, and hepatic steatosis were not observed at this period. The serum TG levels increased after 10‐week‐old. Additionally, the number of whitened unilocular adipocytes with a diameter &gt;10 μm in the BAT increased after 10‐week‐old and oil red O positive lipid droplets were usually observed in the liver at this period. Not only the serum TG levels but also the serum FFA levels increased after 18‐week‐old. Additionally, enlarged adipocytes with a diameter &gt;130 μm and crown like structure indicating inflammatory change were often observed in the epididymal adipose tissue and retroperitoneal adipose tissue, not in mesenteric adipose tissue and inguinal subcutaneous adipose tissue, at this period. Fatty pancreas and intramuscular fat deposition were not observed throughout the experimental period.ConclusionAdipocyte hypertrophy in the visceral WAT and fatty liver could precede dyslipidemia in young OLETF rats and continuous obesity subsequently proceed to ectopic fat accumulation including BAT whitening and chronic inflammation in the epididymal adipose tissue and retroperitoneal adipose tissue with higher FFA levels. Hyperphagia mainly on carbohydrate could contribute to ectopic fat accumulation in the liver and BAT whitening, not to fatty pancreas and intramuscular fat deposition in young stage.

Investigation of Behavior and Plasma Levels of Corticosterone in Restrictive- and Ad Libitum-Fed Diet-Induced Obese Mice.

Diet-induced obesity (DIO) mice models are commonly used to investigate obesity-related health problems. Until now, only sparse data exist on the influence of DIO on behavior and stress hormones in mice. The present study investigates high-fat DIO with two different feeding regimes on behavioral parameters in mice. Various behavioral tests (open field, elevated plus maze, social interaction, hotplate) were performed with female BALB/c and male C57BL/6 mice after a feeding period of twelve weeks (restrictive vs. ad libitum and normal-fat diet vs. high-fat diet) to investigate levels of anxiety and aggression. BALB/c mice were DIO-resistant and therefore the prerequisite for the behavior analyses was not attained. C57BL/6 mice fed a high-fat diet had a significantly higher body weight and fat mass compared to C57BL/6 mice fed a control diet. Interestingly, the DIO C57BL/6 mice showed no changes in their aggression- or anxiety-related behavior but showed a significant change in the anxiety index. This was probably due to a lower activity level, as other ethological parameters did not show an altered anxiety-related behavior. In the ad libitum-fed DIO group, the highest corticosterone level was detected. Changes due to the feeding regime (restrictive vs. ad libitum) were not observed. These results provide a possible hint to a bias in the investigation of DIO-related health problems in laboratory animal experiments, which may be influenced by the lower activity level.

Menopausal obesity

This narrative review paper aims at highlighting the menopausal obesity-related health problems in women, their effects on physical and mental health, the mechanism of its development and its impact on the functionality of the female hormones. Furthermore, we also try to understand the lifestyle behaviour patterns that cause deleterious health consequences, thus disrupting the production of estrogen and increasing hyperandrogenaemia (high levels of androgens) in postmenopausal females. Also, we have addressed some healthier lifestyle alternatives and the use of hormonal substitution treatment, if applicable. Menopause is characterized by a change in the hormonal structure in women, wherein, there is a rapid decline in estrogen levels, which is a major contributor to the central abdominal fat accumulation, reduction in subcutaneous fat and increase in total adiposity. Women after menopause are thus thrice as likely as premenopausal women to develop obesity and metabolic syndrome. There is a stark difference in the way the eastern and western societies perceive menopause.

A Mild Causal Relationship Between Tea Consumption and Obesity in General Population: A Two-Sample Mendelian Randomization Study.

Evidence from observational studies for the effect of tea consumption on obesity is inconclusive. This study aimed to verify the causal association between tea consumption and obesity through a two-sample Mendelian randomization (MR) analysis in general population-based datasets. The genetic instruments, single nucleotide polymorphisms (SNPs) associated with tea consumption habits, were obtained from genome-wide association studies (GWAS): UK Biobank, Nurses’ Health Study, Health Professionals Follow-up Study, and Women’s Genome Health Study. The effect of the genetic instruments on obesity was analyzed using the UK Biobank dataset (among ∼500,000 participants). The causal relationship between tea consumption and obesity was analyzed by five methods of MR analyses: inverse variance weighted (IVW) method, MR-Egger regression method, weighted median estimator (WME), weighted mode, and simple mode. Ninety-one SNPs were identified as genetic instruments in our study. A mild causation was found by IVW (odds ratio [OR] = 0.998, 95% confidence interval [CI] = 0.996 to 1.000, p = 0.049]), which is commonly used in two-sample MR analysis, indicating that tea consumption has a statistically significant but medically weak effect on obesity control. However, the other four approaches did not show significance. Since there was no heterogeneity and pleiotropy in this study, the IVW approach has the priority of recommendation. Further studies are needed to clarify the effects of tea consumption on obesity-related health problems in detail.

Tennessee Academy of Science Executive Committee Meeting Minutes, May 2020

Tennessee Academy of Science Executive Committee Meeting Minutes, May 2020

The association between binge eating disorder and weight management in overweight and obese adults: A systematic literature review.

Aim: Weight loss is shown to improve obesity-related health problems as long as it is maintained for a long term. The purpose of this systematic review was to investigate the association between binge eating disorder and weight management in overweight and obese adults. Methods: A systematic search following the preferred reporting items for systematic reviews and meta-analyses guidelines was conducted across PubMed, Ebsco and Cochrane Library from inception through December 2020 to identify studies that assessed the association between binge eating disorder and weight management (e.g., weight loss, weight gain and weight loss maintenance) in overweight and obese adults. We included studies that examined adults (≥18 years old) being overweight and obese with and without binge eating behaviour. Two authors independently screened and evaluated studies for methodological quality. Results: Nine articles were selected, including 3685 participants. Three of the included studies were randomised control trials and the remaining were observational studies. The majority of the studies included support that people who have binge eating disorder may have an additional barrier maintaining their weight loss compared to people who do not suffer from binge eating disorder. Conclusion: Our systematic review revealed that binge eating disorder may have a negative association with weight loss maintenance. Further well-conducted prospective cohort studies and randomised clinical trials are required to investigate the possible mechanisms and whether any such mechanisms are modifiable. These will lead us to more efficient strategies targeting weight management.

The Effect of Obesity on Insulin Resistance in Terms of Cytokines and Hormones

With the increasing incidence and mortality of obesity, obesity-related health problems have become a worldwide priority. Clinical observation shows that obesity related to adipocyte differentiation is an important pathogenic factor of insulin resistance, and weight loss can reduce insulin resistance, indicating that obesity is related to insulin resistance. As the understanding of mechanism between obesity, cytokines, hormones and insulin resistance becomes clear, it is possible that these cytokines or hormones could be used in the use of biomarkers and the design of targeted therapies for insulin resistance. This review provides an overview of how obesity effect adipokines ， hepatokines and inflammatory cytokines whose changes result in or exacerbate insulin resistance.

Research progress on the effect of late bedtime on children’s mental and physical development

Sleeping timely plays a key and complex role in maintaining health and optimal function. This review analyzed the relationship between late bedtime and children’s growth and development and its physiological mechanism, and proposed some strategies. Staying up late was associated with brain structure/cortical function, cognitive ability, academic performance, behavioral problems, emotional regulation, obesity-related indicators and other health problems. The mechanism might include direct or indirect effects os staying up late on brain structure/cortical function (by circadian rhythm disorder and sleep loss) through the interference of light and external environmental signals, thus affecting the growth and development. Sleep education, establishment of sleep norms and training of self-control are effective strategies to promote sleep timely. 【摘要】 适时就寝在维持健康和最佳功能方面起着关键而复杂的作用。该综述分析了晚睡与儿童生长发育某些指标之 间的关系及其生理机制, 并提出简要改善策略。晚睡与大脑结构/皮质功能、认知能力、学习成绩、行为问题、情绪调节能 力、肥胖指数及其他健康问题相关。影响机制可能是晚睡通过光和外部环境信号的干扰直接或间接 (昼夜节律失调和睡 眠缺失) 影响大脑结构/皮质功能等进而影响生长发育。睡眠宣教、建立睡眠规范、训练自控力等均是促进适时就寝的有 效策略。

Service evaluation project: the effects of healthy weight commissioning for quality and innovation (CQUIN) interventions on metabolic parametrs of service users in a medium secure forensic ward

AimsService users of secure forensic units can be prone to weight gain due to various reasons including medications, physical illnesses, sedentary habits and mental health difficulties. They in turn are at greater risk of obesity related health problems like Diabetes, Hypercholesterolaemia, Ischaemic Heart Disease, Depression among others.Our project was aligned with government's plan to improve prevention and screening for the obesity and metabolic syndrome among the patients of medium secure facilities by 2020.Our primary objective was to gather and analyse the data on current metabolic parameters such as weight, body mass index (BMI), blood pressure (BP) and biochemistry markers of the service users on a 18 bedded Male medium secure long term rehabilitation ward.Our secondary objective was to suggest healthy weight interventions that would help patients to loose weight and to explore the effects of these interventions on biochemistry markers and vital signs parameters.MethodWe collected cross sectional data in given period of time (mid-March 2020). Seventeen service users were included in the final sample. Following initial data collection, we suggested various healthy weight interventions for the patients and repeated data collection after four months (July 2020).Interventions offered:Healthy eating group1:1 sessions with doctors and pharmacistsGym referralsDietician referralsRelaxation groupResultBaselineFourteen patients on the ward (n = 14) were found to be either overweight or obese. Two patients (n = 2) had high BP, twelve patients (n = 12) had deranged lipid profile, six (n = 6) had high blood glucose (existing Diabetes).Following interventionFourteen patients (n = 14) remained either overweight or obese. Nine patients (n = 9) lost weight following the intervention. Eight patients (n = 8) gained weight over 4 months. In both of the patients (n = 2) with raised BP the readings came back to normal after the intervention. One (n = 1) patient with normal BP at the baseline had high blood pressure following intervention.ConclusionOur service evaluation projects revealed that majority of the patients on the ward had deranged metabolic parameters such as increased BMI, abnormal blood tests and high BP.Following our intervention more than a half of the patients lost weight whilst other half gained weight during the period of observation, which we suspect is associated with significant physical activity restrictions during the coronavirus pandemic. In both patients with high BP at the baseline it has improved following the intervention.We would continue implementing healthy weight interventions on the ward and across the unit.