Obesity-related Health Problems Research Articles

Optimal cutoff values for anthropometric indices of obesity as discriminators of metabolic abnormalities in Korea: results from a Health Examinees study

BackgroundObesity is well known as a risk factor for cardiovascular disease. We aimed to determine the performance of and the optimal cutoff values for obesity indices to discriminate the presence of metabolic abnormalities as a primary risk factor for cardiovascular diseases in a Health Examinees study (HEXA).MethodsThe current study analyzed 134,195 participants with complete anthropometric and laboratory information in a Health Examinees study, consisting of the Korean population aged 40 to 69 years. The presence of metabolic abnormality was defined as having at least one of the following: hypertension, hyperglycemia, or dyslipidemia. The area under the receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs) were calculated for body mass index, waist to hip ratio, waist to height ratio, waist circumference, and conicity index.ResultsThe AUC of metabolic abnormalities was the highest for waist-to-height ratio (AUC [95% CIs], 0.677 [0.672–0.683] among men; 0.691 [0.687–0.694] among women), and the lowest for the C index (0.616 [0.611–0.622] among men; 0.645 [0.641–0.649] among women) among both men and women. The optimal cutoff values were 24.3 kg/m2 for the body mass index, 0.887 for the waist-to-hip ratio, 0.499 for the waist-to-height ratio, 84.4 cm for waist circumference and 1.20 m3/2/kg1/2 for the conicity index among men, and 23.4 kg/m2 for the body mass index, 0.832 for the waist-to-hip ratio, 0.496 for the waist-to-height ratio, 77.0 cm for the waist circumference and 1.18 m3/2/kg1/2 for the conicity index among women.ConclusionThe waist-to-height ratio is the best index to discriminate metabolic abnormalities among middle-aged Koreans. The optimal cutoff of obesity indices is lower than the international guidelines for obesity. It would be appropriate to use the indices for abdominal obesity rather than general obesity and to consider a lower level of body mass index and waist circumference than the current guidelines to determine obesity-related health problems in Koreans.

Laparoscopic Roux-en-Y Gastric Bypass After Failed Vertical Banded Gastroplasty: 2-Year Follow-up of 102 Patients

Vertical banded gastroplasty (VBG) is now discarded from being a restrictive procedure for morbid obesity due to its many drawbacks, doubtful efficacy, and lots of post-operative complications. Roux-en-Y gastric bypass (RYGB) is the most commonly performed procedure for VBG revision. So we aimed at reporting our experience in conversional RYGB for a failed VBG. Analyzing follow-up records of 102 patients who underwent revisional RYGB after failed VBG in the period from April 2014 to January 2018. A total of 102 laparoscopic revisions of failed VBGs to RYGB were performed. The mean operating time was 161.9 min ±29.2 and the mean length of the hospital stay was 1.5 days ±1.2. Fourteen patients (13%) developed early post-operative complications (gastrojejunostomy leak 5; bleeding 9). Four patients (4.7%) developed late complications (Port site hernia 2; internal hernia 1; Stomal ulcer 1). The mean BMI pre-RYGB was 46.6 ± 5.9 kg/m2, and the mean %EBWL (percent excess body weight lost) of the patients at 12 and 24 months post-revision were 56.2% and 64.3%, respectively. Our patients had immediate post-revision resolution of VBG-related complications like dysphagia and vomiting. We also report improvement in all obesity-related health problems with (75.7%) complete remission rate and (24.3%) partial remission or improvement rate of diabetes mellitus. Conversion of VBG to RYGB is a feasible procedure and is associated with acceptable early morbidity rates and reduced lengths of hospitalization also it provides acceptable weight loss and improvement in obesity-related health problems. Graphical Abstract.

Effect of obesity on several types of cancer

Currently, both trends of obesity and awareness of the possible adverse effects of obesity are rising in our population. According to the World Health Organization, about one third of the world's population is suffering from obesity-related health problems. Cancer, a severe progressive disease that is becoming more and more common, is among them. However, the association between obesity and cancer is not informed very well by the public. In this paper, the first part will briefly introduce present situations of obesity and common complications of obesity. The following two parts will explain the mechanisms of cancer formation and discuss the relationship between obesity and cancer in an understandable way.

Physical Activity Among Low-Income Food Pantry Patrons: Improving the Role of a Rural Food Pantry

Obesity and obesity-related health problems are of growing concern in the United States, particularly among low-income and minority groups. Food pantries have been utilized to reduce barriers to healthy eating; however, challenges still exist with providing physical activity (PA) services. A needs assessment was conducted among rural food-pantry patrons to determine PA behaviors, knowledge, self-efficacy, and perceived barriers to PA. Data were used to infer the health education needs and services of food pantry patrons. Fifty percent of participants indicated that providing fitness classes and PA education materials could help them overcome barriers such as time, money, and childcare.

Analysis of nutrients and compounds potentially reducing risks of overweightness and obesity-related diseases in raw and roasted Adenanthera pavonina seeds from Samoa

Recently, Samoans have faced to alarming increase in the prevalence of obesity related diseases, which are connected to the consumption of imported calorie-rich and nutrient-poor food products. It is believed that the re-introduction of native diet may mitigate these negative trends. In Samoa, the seeds of Adenanthera pavonina, an underutilized leguminous tree, are popularly eaten when roasted. Although the seeds are also used in traditional medicine to treat inflammatory and cardiovascular diseases, information on their nutrients and any compounds potentially reducing risks of related health disorders is very limited. Therefore, the objective of this study was to analyse the nutrients and compounds potentially reducing risks of overweight- and obesity-related health problems in raw and roasted A. pavonina seeds from Samoa. The standard analytical and microbiological methods, namely gas chromatography–mass spectrometry, inductively coupled plasma optical emission spectrometry, high-performance liquid chromatography with fluorescence detection, ultrahigh-performance liquid chromatography-tandem mass spectrometry, and Czech technical standard methods, were used for the determination of fatty acids, minerals, tocopherols, phenolic compounds, and B vitamins, respectively. The analyses showed that the lignoceric (17.59% and 18.24%), linoleic (39.80% and 37.88%), and oleic acids (14.67% and 14.75%) were the most abundant in the oil of raw and roasted seeds, with the unsaturated forms present in higher amounts than saturated. The seeds were found to be rich of vitamin E (33.09 and 15.94 mg/100 g), whereas the contents of vitamins B1, B2, B3, and B6 were rather low. Calcium, magnesium, phosphorus, potassium, and sulphur were the minerals found in the highest concentrations. Salicylic acid (201.01 and 151.95 µg/100 g) has been detected in higher amounts than other phenolic compounds. In summary, the findings of this study indicate that the both raw and roasted seeds of A. pavonina are good sources of various health-beneficial nutrients, including those reducing the negative effects of obesity.

Izazovi i komplikacije gojaznosti majke u trudnoći

The prevalence of obesity and obesity-related health problems is increasing worldwide, especially among woman and man of reproductive age where obesity is designated as one of the most important global health threats in 21st century. Pregnancy in obese woman is considered as a high-risk pregnancy. Pre-pregnancy obesity and excessive gestational weight gain (GWG) are distinct risk factors with differing associated adverse outcomes, and they could also carry a cumulative negative impact on pregnancy course. Pre-pregnancy obesity is the anthropometric parameter most strongly correlated with perinatal complications. Maternal complications following obesity include antepartum, intrapartum and postpartum complications, such as pregnancy related hypertension, preeclampsia, gestational diabetes mellitus, preterm birth, venous thromboembolism, labor dystocia, labor induction, instrumental and cesarean delivery. Fetal complications related to maternal obesity might include increased prevalence of congenital anomalies, growth abnormalities, prematurity and stillbirth. Prepregnancy overweight and obesity is a potentially modifiable risk factor compromising pregnancy outcome. Among all complications that might arise during pregnancy and that could not be predicted and therefore prevented, pre-pregnancy overweight and obesity management control can significantly reduce potential pregnancy complications. Pre-conceptual counseling should provide an awareness of this arising medical condition in a timely manner and provide risk reduction of complications following pre-pregnancy obesity and excessive GWG.

A Market Research Of Obesity And Bariatric Surgery In Turkey And Tunisia

This article aims to discuss four topics according to the recent scientific data a) to overview the frequency of obese and overweight individuals among Tunisia and Turkey populations; b) to examine health technology assessment of bariatric surgery (BS) report (HTA) in Tunisia and Turkey; c) to evaluate the cost and cost reimbursements by social health systems for bariatric surgery in Turkey and Tunisia; d) to examine the total number of bariatric surgical procedures and their costs in state and private health organizations in Tunisia and Turkey. The OECD (2011-2017) Turkey report was included for the data for the frequency of obese and over-weighted people among the general population Turkey, while the WHO report of «Diabetes Prevalence and Diabetes Risk Factors» of 2016 was included for Tunisia. Also supporting data on the overweight and obese population in Tunisia was provided from the news site named Middle East Monitor and the «Tunisian Health Examination Survey» conducted in 2016. Surgery cost and reimbursement of cost, analyses of bariatric surgery in Turkey published in 2014 was included as well. The data about the patient profile to whom bariatric surgery can be applied, the indications for bariatric surgery, and centers where it can be applied in Turkey are obtained from the Cost-Effectiveness of Obesity Surgery in Turkey and Economic Value Study (CEVOS-T) and Turkey Bariatric Surgery HTA Report. The Turkey Health Management Center website has been used for the total bariatric surgery performed. The authors analyzed the general status of bariatric operations in Turkey and Tunisia. The overweighted and obese individuals constitute 64.4% of Turkey’s population while this frequency is obtained as 62.8% of the Tunisian population. The rate of increase in obesity was obtained by 10.8% between 2014 to 2017 in Turkey. According to the results of CEVOS-T study the total economic burden attributable to an obesity rate of 1.16% of GDP in 2004, the proportion of the GDP in 2012 was seen as 1.73%. A total of 15,800 bariatric surgical procedures were performed in Turkey in 2018. The operational cost of a tube stomach surgery in the health unit of the Turkish Union of Public Hospitals (TKHK) was found to be 8930 TL. The cost of bariatric surgery in Tunisia including hospitalization is £ 3950. As the majority of the population is overweighted and obese in both Turkey and Tunisia, it can be interpreted as the occurrence of obesity-related health problems that can be increased. When the complications and advantages of bariatric surgery were examined it was decided that these two countries should give importance to bariatric surgery. Turkey’s interest in this subject is revealed with HTA and CEVOS-T report. Health economics analyses such as bariatric surgery HTA reports, number of bariatric surgery operations, the cost-effectiveness of BS in Tunisia could not be reached due to lack of statistics and resources. Turkey and Tunisia made with these investigations demonstrated a general situation in bariatric surgery. Keywords: bariatric surgery, health technology, market of bariatric surgery, obesity, overweight population.

Obesity and body image

Abstract Introduction: The opinion prevailing in western culture is that overweight people should be ashamed of their weight and looks. The idea is supported by the way the society perceives overweight people. Evidence that obesity is associated with chronic illness and a short life span is the main justification. However, the distorted body image does not seem to facilitate weight control. Source and method: The purpose of the thesis is to present obese people body image. To present the data, the following electronic databases have been searched: PubMed, Elsevier, Cochrane Library. The bibliographic analysis of the selected studies has also been performed. The systematic literature search has been performed with the use of the following key words: “obesity” OR “overweight” AND “body image” OR “body dissatisfaction” OR “body acceptance” OR “body image”. Discussion: We present a discussion of the results obtained. Conclusions: The research indicates that negative body image can actually contribute to obesity-related health problems. Overweight and obese people, who accept their body weight, experience less physically and mentally “bad” days than people who are dissatisfied with their weight. Body dissatisfaction was identified as a psychological corellator of obesity related with eating disorders, low self-esteem and depression. However, not all obese people are equally affected by these correlates. “Normative dissatisfaction” also occurs in people with normal body weight. In this context, the complex correlation between body image and individual body weight seems to be a valuable research direction.

Social anxiety symptoms moderate the link between obesity and metabolic function

BackgroundObesity is a well-known risk factor for elevated inflammation and insulin resistance. Social anxiety may moderate this relationship, such that individuals who areboth obese and socially anxious may have an even greater risk for elevated inflammation and insulin resistance than those who are obese but not socially anxious; the combination of obesity and social anxiety is markedly stressful. MethodsThe current paper reports secondary analyses from the Biomarker wave of the Mid-Life in the United States (MIDUS) study (N = 1255), a publicly available dataset of American adults. Participants completed a standard scale measuring social anxiety symptoms and had their waist circumference, height, and weight measured by a staff member. They also provided a fasting blood sample that was assayed for CRP, IL-6, HOMA-IR, glucose, and insulin. ResultsThe interaction between obesity and social anxiety symptoms was significant. People with a larger waist circumference and more social anxiety symptoms had greater inflammation and insulin resistance relative to those with a larger waist circumference but less social anxiety symptoms. These results were similar for both measures of inflammation and were robust across both the unadjusted and adjusted models. The results were also largely replicated in models using body mass index (BMI) rather than waist circumference as the measure of obesity. ConclusionsThe current findings build on existing work about the health risks of obesity, extending it in an important new direction by demonstrating that these health risks are stronger among those who are also socially anxious. In fact, the magnitude of the relationship between obesity and metabolic function is 1.5 times stronger among those with more social anxiety symptoms. Thus, knowing whether a person is obese only provides one piece of the puzzle; knowing information about both obesity and social anxiety symptoms is critical for understanding who is most at risk for obesity-related health problems. Thus, a critical next step is for intervention scientists to examine health programs tailored to people who are both obese and socially anxious.

How did the tobacco ban increase inmates’ body weight during incarceration in Canadian federal penitentiaries? A cohort study

ObjectiveThis study aimed to determine how inmates’ body weight changed during incarceration in Canadian federal penitentiaries, based on their history of tobacco use. Since tobacco was banned from all Canadian...

Canadian federal penitentiaries as obesogenic environments: a retrospective cohort study.

Very little is known about how incarceration influences a person's weight in Canada. We sought to determine how inmates' weights change during their incarceration in Canadian federal penitentiaries. We performed a retrospective, longitudinal cohort study to examine weight change in Canadian federal penitentiaries. To participate, inmates had to have been incarcerated for at least 6 months at the time of the study. Current anthropometric data were measured or taken from medical records, then compared with anthropometric data from the beginning of incarceration (mean follow-up of 5.0 ± 8.3 yr). We examined 3 outcomes: change in weight (kg), change in body mass index (BMI) and rate of weight change (kg/yr) during incarceration. A total of 1420 inmates participated in this study. Almost three-quarters (73.0%, n = 1037)) of participants gained weight during incarceration. Inmates gained a median of 6.2 (95% confidence interval [CI] 5.6-6.9) kg, and BMI increased by 2.0 (95% CI 1.8-2.2). Obesity rates increased by 71%, from 26.6% of participants (n = 378) on admission to 45.4% of participants at follow-up (n = 645). The proportion of inmates with a BMI in the normal range (18.5-24.9) decreased by 52%. Weight gain was found to be associated with older age, region (Ontario v. Atlantic), ethnicity (Aboriginal inmates showed the highest weight gain), longer incarceration, and longer total sentence. However, weight gain was not associated with sex, feeding system or spoken language. The Canadian correctional environment can be considered obesogenic, with most inmates experiencing undesirable and rapid weight gain during their incarceration. Rates of obesity increased dramatically during incarceration, and could put inmates at increased risk of obesity-related health problems.

Health Self-Empowerment Theory: Predicting Health Behaviors and BMI in Culturally Diverse Adults.

Health Self-Empowerment Theory asserts that 5 controllable psychological variables predict engagement in health-promoting behaviors. This study tests the theoretical integrity of Health Self-Empowerment Theory and its usefulness in predicting health-promoting behaviors and body mass index. Results from surveying 189 predominantly low-income, overweight/obese, and culturally diverse adults showed that most Health Self-Empowerment Theory variables were positively correlated. Structural equation modeling showed that 4 variables significantly predicted engagement in health-promoting behaviors, which mediated the relationships between body mass index and (a) motivation, (b) health self-efficacy, and (c) self-praise. Results support creating psychologically informed interventions to increase engagement in health-promoting behaviors and decrease body mass index among low-income adults, particularly racial/ethnic minorities, at risk for obesity-related health problems.

Overweight and Undernutrition in the Cases of School-Going Adolescents in Wolaita Sodo Town, Southern Ethiopia: Cross-Sectional Study.

Background This study aimed to assess the prevalence of malnutrition and associated factors among school adolescents in Wolaita Sodo town, Southern Ethiopia. Methods A school-based cross-sectional study was conducted from May 18–June 10, 2015. A multistage sampling was used to select a random sample of 690 adolescents from selected schools. Data on sociodemographic information were collected by using an interviewer-administered questionnaire, and anthropometric measurements were made by using a digital Seca scale and height measuring board by trained data collectors. Data were entered into Epi-Data version 3.1 software and exported to SPSS version 20. World Health Organization (WHO) Anthro-plus software was used to analyze anthropometric data. Both binary and multinomial logistic regression analyses were done to identify factors associated with the malnutrition of adolescents. Result The overall prevalence of thinness, stunting, and overweight/obesity among school adolescents was 4.7% (95% CI: 3%–6.4%); 5.2% (95% CI: 3.4%–7%); and 5.0% (95% CI: 3.4%–6.7%), respectively. Being male (AOR = 4.07; 95% CI: 2.35–7.02), learning at a government school (AOR = 0.37; 95% CI: 0.20–0.65), mothers with no formal education (AOR = 4.03; 95% CI: 1.82–8.92), owning no cattle (AOR = 4.92; 95% CI: 2.08–11.64), skipping meals (AOR = 1.70; 95% CI: 1.05–2.74), and illness in 2 weeks prior to survey (AOR = 2.67; 95% CI: 1.49–4.78) were significantly associated with thinness. However, males, students who had their house, and no cattle were more likely to develop overweight/obesity. Maternal education of secondary school (AOR = 0.214; 95% CI: 0.054–0.846) was significantly associated with the stunting. Conclusion The study showed the coexistence of undernutrition and overnutrition among school adolescents in the study area. There needs to implement evidence-based school nutrition education and health policies and programs to improve nutritional status of adolescents and timely taking action to limit obesity-related health problems.

Everyday discrimination in a racially diverse sample of patients with obesity.

Weight discrimination affects a significant proportion of individuals with obesity and contributes to poor mental and physical health. Prior research on weight discrimination has been limited by a lack of racial diversity in samples and has not considered other potential forms of discrimination that individuals with obesity may experience. The current study assessed different reasons for discrimination in a racially diverse sample of treatment-seeking individuals with obesity (N = 122, 66.4% black, mean body mass index = 38.5 ± 6.2 kg/m2 ). Results showed that over half of participants reported experiencing at least one form of repeated discrimination, and 30% reported two or more reasons for discrimination. Race and weight were the most commonly reported reasons for repeated, everyday instances of discrimination. Among participants who reported experiencing weight discrimination (28.7%), over 80% reported experiencing at least one other form of discrimination, with 60% reporting discrimination due to race. These findings indicate that individuals with obesity may face multiple forms of discrimination in their daily lives. Further research is needed to understand how all forms of discrimination contribute to obesity-related health problems.

Academic-Community Partnership Development to Enhance Program Outcomes in Underserved Communities: A Case Study.

A community-academic partnership was developed to assess community needs and restructure a variety of community-based programs that provide services to underserved communities in New Orleans, Louisiana. The community and academic partners utilized five phases to assess community needs and restructure programs: 1) meetings; 2) narrowing the scope of community programs; 3) data collection and analysis; 4) emphasizing target programs; and 5) improving sustainability through grant submissions and grant development training. Survey data were collected and analyzed pre- and post-community-academic partnership between November 2014-November 2016 in New Orleans, Louisiana. The data supported the need for community-based programs run by a community organization known as the Dillard University Office of Community and Church Relations (OCCR). The survey results showed that community members expressed interest in: screenings for chronic diseases, such as diabetes; attending exercise classes at local churches; attending financial management workshops; and health fairs run by the community organization. In the future, screenings, workshops, health fairs, as well as exercise and diet programs, will take place at all churches participating in the community-based, umbrella program, Churches in Unity program. A formal community-academic partnership, involving the assignment of an academic liaison, restructured programs for a community partner to better serve the needs of a community that is at-risk for a multitude of obesity-related health problems faced by underserved communities.

Combination therapy efficacy of catgut embedding acupuncture and diet intervention on interleukin-6 levels and body mass index in obese patients

Obesity is a major health problem worldwide, affecting more than 500 million adults with an additional 1.5 billion adults classified as overweight. Acupuncture has been recognized as an adjunctive therapy for obesity, and recent evidence suggests its potential to reduce the inflammatory response in adipose tissue, a condition believed to be responsible for obesity-related health problems. Interleukin-6 (IL-6) has been proposed as an important mediator of the inflammatory response in adipose tissue, but the number of studies addressing the issue is still limited. A double-blind, randomized, placebo-controlled trial was conducted with36 obese patients currently receiving dietary intervention. The patients were randomly allocated into the catgut embedding acupuncture group with diet intervention or the sham (placebo) embedding acupuncture group with diet intervention. Catgut embedding therapy was given twice at CV12 Zhongwan, ST25 Tianshu, CV6 Qihai, and SP6 Sanyinjiao acupoints with two week intervals between procedures. The study endpoints were the IL-6 levels in the blood plasma and body mass index (BMI), measured before and after the intervention. We observed a reduction in the IL-6 levels (mean reduction 0.13 pg/mL, 95% CI: 0.03–0.23) and BMI (mean reduction 0.66, 95% CI 0.43–0.88) in the accupuncture group. The average difference in mean reduction of BMI between the accupuncture and sham groups was 0.34 (95% CI: 0.17–0.52). No difference was found in mean IL-6 reduction between the two groups (95% CI: -0.17 to 0.06). The results suggest that acupoint catgut embedding therapy may help reduce IL-6 levels and BMI in obese patients receiving dietary intervention.

Criminal Justice Contact, Stressors, and Obesity-Related Health Problems Among Black Adults in the USA.

Criminal justice contact-defined as lifetime arrest, parole, or incarceration, seems to exacerbate chronic conditions, and those who are most likely to have had contact with the criminal justice system, such as Black adults, often already have pre-existing disproportionately high rates of stress and chronic conditions due to the social determinants of health that affect underrepresented minorities. Findings from this study suggest that there is a mechanism that links the stressors among Black adults manifested by such factors as family, financial, neighborhood, and personal problems with criminal justice contact to obesity-related health status. Using the National Survey of American Life (NSAL), modified Poisson regression analyses were used to determine the association between criminal justice contact, stressors, and obesity-related health problems among a national sample of Black adults (n = 5008). In the full model, the odds of experiencing obesity-related health problems for Black adults who had criminal justice contact was reduced (PR, 1.23 to 1.14) and not statistically significant. Black adults who reported experiencing family stressors (PR, 1.21; 95% CI, 1.08, 1.36), financial stressors (PR, 1.30; 95% CI, 1.16, 1.47), and personal stressors (PR, 1.16; 95% CI, 1.02, 1.31) were statistically significant and higher than those who reported not experiencing any of these stressors; neighborhood stressors was not statistically significant. The evidence suggests a relationship between the stressors associated with criminal justice contact and obesity-related health status. These findings emphasize the need to further explore the family, financial, and personal stressors for Black adults with criminal justice contact in order to further our understanding of their obesity-related health problems.ᅟ.

Lifestyle factors and co-morbidities associated with obesity and overweight in Nkonkobe Municipality of the Eastern Cape, South Africa

BackgroundObesity is a global epidemic that affects 500 million people worldwide and is predicted to increase to one billion people by 2030. The prevalence of obesity is increasing across populations in South Africa. However, questions still remain surrounding the predisposing factors and obesity-related health problems especially in the rural areas. This study evaluated several lifestyle factors such as dietary habits, physical activity, smoking, alcohol intake, co-morbidities and their association with the prevalence of obesity and overweight in Nkonkobe Municipality of the Eastern Cape.MethodsA cross-sectional, population-based survey was conducted among 118 residents in four rural/sub-urban townships of the study area. Measurements including weight, height, body mass index (BMI), physical activity and dietary habits were determined using a validated questionnaire.ResultsThe overall prevalence of obesity and overweight was 38 and 19%, respectively. The highest prevalence of obesity (70%) was observed among those who do not undertake any physical activity. Close to half (48.48%) of the respondents who eat fast foods always were obese, and 30.30% were overweight; when combined, the prevalence for obesity is 78.78%. A negative association with obesity was observed among regular smokers (26.92%) and consumers of alcohol (4.00%). Arthritis, hypertension and tuberculosis were co-morbidities significantly (P < 0.05) associated with obesity in the study area.ConclusionsThe findings of this study reveal that lack of physical activity, overindulgence on fast and fried foods, low fruit and vegetable consumption as well as arthritis, hypertension and tuberculosis were significant risk factors of obesity in Nkonkobe Municipality.

Does bariatric surgery have benefits for people with intellectual disability?

Obesity rates are high among people with learning disabilities. They also often face barriers in achieving weight loss due to the challenges of engaging in regular exercise and maintaining a healthy diet. Bariatric surgery aims to reduce obesity and minimise obesity-related health problems.

Androgen and Estrogen Shifts in Men Before and After Bariatric Surgery and Links to Vitamins and Trace Elements.

Androgens and estrogens play a key role regarding sexual life and reproduction. Along with hypotestosteronemia, obese men exhibit a 2-fold increase in estradiol concentration, adversely infl uencing these parameters. Estrogens and adipokines also infl uence bone metabolism, exerting a direct effect on vitamin D, calcium homeostasis and bone health. Bariatric procedures normalize some sex hormones, and may reverse several obesity-related conditions. Estrogens levels may remain elevated postoperatively, and despite its protective effect on the skeleton, bariatric patients are more prone to fractures when compared to the general population. Multiple nutritional defi cits are common after bariatric interventions, and hypozincemia is the most likely to negatively infl uence reproductive parameters. Zinc is an essential element for normal spermatogenesis, and severe hypozincemia is associated with infertility in both sexes. Vitamin D also acts as a regulator of several enzymes involved in steroid hormone production, and its defi ciency could impair reproductive function. Few studies have addressed changes in sex hormones and in reproductive function in the male bariatric population, as they represent a minority of surgical candidates. Although obesity rates and burden are similar for both sexes, society is more lenient with the obese male. Moreover, 73 % of overweight/obese men are satisfi ed with their health, causing body weight and obesity-related health problems to increase when they opt for bariatric surgery. In the present article, we discuss shifts of sex hormones before and after bariatric surgery, surgery impact on semen quality, skeletal health and nutrients, and new research directions regarding links between vitamin D, zinc, androgens and reproduction.