Overweight Group Research Articles

Effect of diet combined with exercise intervention on tumor necrosis factor α in overweight or obese groups: Based on the exercise dose-response relationship

Background: Chronic low-grade systemic inflammation, often linked to obesity or being overweight, is associated with various complications and an increased risk of disease development. Tumor necrosis factor α (TNF-α) is a key inflammatory factor that significantly impacts various body functions. Objective: 1) To assess whether combined interventions are more effective than single interventions in combining diet and exercise. 2) To assess the effectiveness of exercise dose in different interventions on tumor necrosis factor (TNF-α) levels in obese or overweight patients. Methods: A thorough search was conducted across four electronic databases of randomized controlled trials that focus on exercise or dietary interventions for patients with obesity or overweight. This comprehensive review encompasses data collected up to August 2024. Two independent researchers conducted a thorough evaluation of the literature's quality. Network and dose-response analyses were performed using random effects models to examine the impact of diverse interventions on TNF-α. Results: A total of 19 randomized controlled trials with 1479 patients with obesity or overweight were included. The meta-analysis showed that the hypocaloric diet combined with aerobic training (HDAT) possessed the highest ranking (SMD= -1.00,95%CI -1.51 to -0.49), followed by the hypocaloric diet (HD) (SMD= -0.40,95%CI -0.89 to 0.09), hypocaloric diet combined with resistance training (HDRT) (SMD= -0.48,95%CI- 1.43 to 0.48), and aerobic training combined with resistance training (ART) (SMD= -0.18,95%CI -0.92 to 0.57). Additionally, a notable improvement in TNF-α levels was observed in individuals adhering to a hypocaloric diet in conjunction with exercise when the cumulative exercise volume reached 150 metabolic equivalent of task minutes per week. Conclusion: Based on the GRADE rating guidelines, moderate-quality research evidence indicates that a hypocaloric diet combined with aerobic training (HDAT) is the most effective intervention for enhancing tumor TNF-α levels in individuals with obesity or overweight. Additionally, the dose-response relationship was observed between the total exercise dose and TNF-α levels. Future research should investigate the specific effects of various aerobic exercise modalities on TNF-α levels in obese or overweight patients to develop a more personalized approach to exercise prescription.

Burden of Non-Communicable Disease and It’s Association with Weight Status: A Cross-Sectional Study in a Rural Community of Bangladesh

Background: Non-Communicable Diseases (NCDs) are now the leading causes of morbidity and mortality worldwide. Bangladesh has also experienced a rapid epidemiological shift from communicable diseases to non-communicable diseases due to growing urbanization and lifestyle alteration over the last few decades and this transition is also prominent in rural community of the country. Among all modifiable factors, overweight or obesity is the key risk factor for NCDs. This study aimed to determine the burden of NCD and its link to the body weight status of the rural population of Bangladesh. Materials and methods: This cross-sectional study was conducted in a village of Gomostapur Upazila under Chapainawabganj district from February to April 2024 among 135 people. The data were collected with face-to-face interview and Body Mass Index was measured. The data were compiled and tabulated according to key variables and analyzed with IBM SPSS 29.0.2. Results: Majority 44.5% of the study people belonged to age group 21-40 years. Among them 47.4% were male and 52.6% were female. Maximum respondents were of low-middle socioeconomic condition. Among them around 3/4th of the population was suffering from NCDs. Most of the respondents 24.4% had bone and joint pain followed by Hypertension, Asthma, COPD, Diabetes and Heart Disease at 20.7%, 17.0%, 14.1% and 10.4% respectively. Hypertension, Diabetes, Cardiovascular Disease, Stroke and Cancers were more prevalent in the older age group. Hypertension, Diabetes, Stroke and Bone-Joint Pain were seen more in female participants whereas male respondents had more prevalence of Asthma, COPD. Most of the study population had BMI above 25 kg/m2 and the study showed maximum NCDs were prevalent considerably in overweight and obese groups. Conclusion: The study revealed that, NCDs are highly prevalent among obese older rural population of Bangladesh while management, prevention, awareness and research are low. The integrated programs must be designed and implemented through a primary health care approach and high risk-group targeted interventions should be procurable to combat the rising burden of NCDs. IAHS Medical Journal Vol 7(1), June 2024; 74-79

Abstract 4125500: Obesity-Related Left Atrial Functional Change Becomes Apparent in Infancy

Background: Impaired left atrial (LA) function is observed in obese patients, however, there is little information on when LA dysfunction begins to appear. To clarify this issue, we assessed LA volume and function in obese infants. Methods: Two-dimensional speckle-tracking echocardiography was performed in 96 infants aged 4 months. Subjects were divided into 3 groups according to body mass index (BMI): normal (n=53), <17 kg/m 2 ; overweight (n=28), 17 to 19.9 kg/m 2 ; obese (n=15), ≧20 kg/m 2 . LA maximal volume, LA minimal volume, and LA pre-atrial contraction volume and LA longitudinal strain (reservoir, conduit, and booster) were measured. LA total emptying fraction, passive emptying fraction, and active emptying fraction were calculated. Results: Systolic blood pressure was significantly higher in the obese group than in the normal group (Table). LA maximal volume, minimal volume, and pre-atrial contraction volume increased significantly with increasing BMI (r = 0.53, 0.54, and 0.63, respectively, p <0.01). Compared with the normal group, reservoir LA strain was significantly lower in the overweight and obese groups. Conduit LA strain and passive emptying fraction were significantly lower in the overweight and obese groups than those in the normal group (Table). Reservoir LA strain, conduit LA strain, and passive emptying fraction decreased significantly with increasing BMI (r = -0.28, -0.27, and -0.33, respectively, p <0.01). There was no significant difference in booster LA strain among the 3 groups. Compared with the normal group, LA active emptying fraction was significantly higher in the obese group (Table). Conclusions: Higher BMI is associated with impaired reservoir and conduit LA function and higher booster LA pump function, which may be compensatory. Thus, obesity-related changes in LA functional begin to appear in infancy. Our data support prevention of obesity in early childhood because higher BMI is responsible for significant changes in LA function in early life.

Social isolation during the covid-19 pandemic impaired vitamin d concentrations, motor performance and physical fitness in adolescents

This study aims to verify the effect of social isolation arising from the Coronavirus pandemic (COVID-19) severe acute respiratory syndrome (SARS-CoV-2) on vitamin D (25(OH)D) concentrations, motor performance, and cardiorespiratory fitness (CRF) in adolescents. This research method is Case-control study, which included 34 boys, aged 12-16 years. In the pre-pandemic period, 17 schoolchildren were evaluated in December 2019, classified according to body mass index Z-score (BMI-z) as: eutrophic (n=8) and overweight (n=9). The post-pandemic group was composed of 17 boys, evaluated in March 2022, matched with the same BMI-z characteristics. Stature, body mass, fat mass (FM), fat free mass (FFM), flexibility (FLEX), 25(OH)D, absolute CRF (CRFabs) and relative (CRFrel) were assessed. The Supine-to-Stand test (STSTIME) execution time was used to assess motor performance and motor competence by the motor patterns used in execution (STSMC). considering p<0.05 significant. The results showed that, post-pandemic, there were impairment on 25(OH)D, FLEX, STSTIME e CRF (p<0.05). Both eutrophic and overweight groups reduced 25(OH)D concentrations (p<0.001) and increased STSTIME (p=0.02) but did not modify STSMC. Regarding CRF, eutrophic individuals showed lower CRFabs and CRFrel values (p≤ 0.005), however no changes in the overweight group. We conclude that social isolation impaired the 25(OH)D concentrations and motor performance of adolescents. However, it stands out that the eutrophic were the most impacted with social isolation, as they showed unfavorable effect also on CRF.

Higher BMI Is Associated With Wound Breakdown Following Resection of Haglund Deformity.

Haglund deformity is characterized by an enlarged posterosuperior calcaneus, often with inflammation of the retrocalcaneal bursa and Achilles tendon. This study aims to determine if obesity is associated with an increased rate of complications after Haglund resection. A retrospective review was conducted on patients who underwent surgical resection for Haglund deformity from January 2015 to December 2023 at a single academic center. The patient cohort was initially stratified by body mass index (BMI) into normal (BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). For those classified as obese, further subclassification was performed using the standard system: obesity class I (mild obesity) = BMI 30.0-34.9; obesity class II (moderate obesity) = BMI 35.0-39.9; and obesity class III (severe obesity) = BMI ≥40.0. Data on demographics, surgical techniques, and weightbearing were collected and analyzed. Postoperative complications were compared between groups. Of the 370 patients included in this study, 20 (5.4%) were classified as normal, 77 (20.8%) were overweight, and 273 (73.8%) were obese. Within the cohort of patients with obesity, 96 (35.2%) were classified as obesity class I, 96 (35.2%) as obesity class II, and 81 (29.7%) as obesity class III.The obese group had a higher proportion of females (70.0%) and Black/African American race (24.5%), and a higher prevalence of diabetes mellitus (22.0%) and American Society of Anesthesiologists scores compared with other groups. Additionally, analysis within the obesity subclassifications revealed significant differences in smoking status, with a higher proportion of nonsmokers as obesity class increased (58.3% in class I, 76.0% in class II, and 79.0% in class III; P = .01). Follow-up duration averaged 10.5 months, with wound breakdown rates significantly higher in the obese group vs the overweight or normal groups (11.0% vs 2.6% vs 0.0%, P = .02). No significant differences in wound complications or outcomes were observed between patients based on different obesity subclassifications. Our findings demonstrate that after Haglund resection, obese patients have a higher risk of complications, particularly wound breakdown. This underscores the necessity of careful patient selection and perioperative optimization.

Body mass index and type 2 diabetes mellitus as metabolic determinants of immune checkpoint inhibitors response in melanoma

BackgroundImmune checkpoint inhibitors (ICIs) have improved survival outcomes in melanoma. Studies exploring the correlations between body mass index (BMI), type 2 diabetes (T2DM) and the outcomes of ICI treatment have...

Body composition differences in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease

BackgroundAlthough body composition (BC) has been associated with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), there is little evidence of differences in BC in patients with MASLD regarding body mass index (BMI). The aim of this study was to determine differences in BC in terms of BMI and metabolic comorbidities in patients with MASLD.Materials and methodsIt is a cross-sectional study with patients who attended the check-up unit. Liver steatosis was evaluated by controlled attenuation parameter, and patients were classified into five groups according to BMI, presence of MASLD, and metabolic characteristics: &amp;lt;25 kg/m2 non-MASLD; &amp;lt;25 kg/m2-MASLD; Overweight-MASLD; Metabolically Healthy Obese (MHO)-MASLD; and Metabolically Unhealthy Obese (MUO)-MASLD. BC was assessed by bioelectrical impedance and a Bioimpedance Vectorial Analysis (BIVA) was carried out. Differences in BC were analyzed by a One-Way ANOVA test. Univariate and multivariate analyses were performed for factors associated with abnormal BC.ResultsA total of 316 patients were included. 59% (n = 189) were male, with a mean age of 49 ± 10 years. Fat% significantly higher according to BMI was not different between BMI &amp;lt;25 kg/m2-MASLD and Overweight-MASLD groups. Skeletal muscle mass (SMM) was significantly lower in obesity groups with respect to overweight and normal weight groups (p &amp;lt; 0.05); however, no differences were observed in the post-hoc analysis. Extracellular Water/Intracellular Water ratio was significantly higher in the MHO-MASLD group and MUO-MASLD group compared with the BMI &amp;lt;25 kg/m2 non-MASLD group and with the BMI &amp;lt;25 kg/m2-MASLD group. Abnormal Waist Circumference (WC) and liver steatosis were independent factors associated with abnormal BC.ConclusionBC in MASLD patients varies according to BMI increase; changes could be explained by loss of SMM and not necessarily by the presence of metabolic abnormalities. High WC and the presence of steatosis are independent factors associated with altered BC.

Paradoxıcal effect of body mass index ranges on pedobarographic evaluatıon

Although there is evidence suggesting that obesity alters plantar pressure distribution, the specific effects of certain body mass index (BMI) ranges on pedobarographic measures in healty individuals has been poorly investigated. A cross-sectional study with 167 healthy participants was conducted to assess plantar pressure changes across 4 BMI ranges: Under/normal weight (NW), overweight (OW), obese (OB), severe obese (SO). Subjects walked on the Footscan® pressure plate at a self-selected speed, and peak plantar pressure (PPP), load rate, and contact area values were recorded. The foot was divided into 10 zones: hallux (T1), toes 2–5 (T2-5), metatarsals 1–5 (M1-M5), midfoot (MF), medial hindfoot (MH) and lateral hindfoot (LH). PPP underneath M2-M4 was lowest in the NW group (p = 0.011), and although PPP values for the SO group were lower than those for the OW and OB groups, these differences were not statistically significant. Load rate values of M2-M3 were lower in both the NW and SO groups (p = 0.008) compared to the OW and OB groups. In addition, the metatarsal load rate values for the SO group were generally lower than those for the NW group. The total metatarsal contact area of both the NW and SO groups was lower (p = 0.019) than that of the OW and OB groups in both feet. These findings suggest that as BMI increases, PPP, load rate, and contact area in the middle metatarsal region initially increase, stabilize early in obesity, and then decrease at advanced stages, indicating a shift of the load to the midfoot.

Parental Feeding Practices, Weight Perception, and Children's Appetitive Traits Are Associated with Weight Trajectories in Preschoolers: A Longitudinal Study in China.

This study aimed to examine the trajectories of body mass index-for-age z-score (BAZ) in preschoolers and its association with parental feeding practices, weight perception, and children's appetitive traits. A total of 433 preschoolers and their parents from eight public kindergartens in Shanghai were assessed annually over two years. A group-based trajectory model was employed to identify distinct BAZ patterns. Logistic regression was utilized to investigate the baseline factors associated with the BAZ trajectories. Three distinct BAZ trajectories were identified among the preschoolers: "low-stable group" (n = 154, 37.3%), "moderate-stable group" (n = 214, 47.3%), and "progressive overweight and obesity group" (n = 65, 15.4%). The children perceived as overweight and obese by parents (OR = 10.57, 95% CI: 4.89-22.86), and those with lower satiety responsiveness at baseline (OR = 0.86, 95%CI: 0.76-0.97) were more likely to fall into the progressive overweight and obesity group as opposed to the moderate-stable group. Conversely, the children perceived as underweight by parents (OR = 457, 95%CI: 2.71-7.70) had a higher likelihood of being in the low-stable group rather than the moderate-stable group. This study unveiled three unique body weight trajectories among preschool children. Parental perception of children's weight and lower satiety responsiveness were associated with preschoolers' subsequent weight change, while parental feeding practices were not associated.

Exploring The Relationship Between Body Mass Index and Body Fat Percentage Across Age and Gender: A Cross – Sectional Study

Background: In today’s fast-paced world, the prevalence of non- communicable diseases (NCDs) is rising due to work, academic and personal pressures. Obesity, a preventable disease, is often underestimated in clinical settings. The ‘obesity paradox’ where NCDs occur in individuals with normal body mass index (BMI), complicates health assessments. This study evaluates the relationship between BMI and body fat percentage (BFP) by age and gender and assesses if BMI alone is a good predictor of body adiposity. Methods: A cross-sectional observational study was conducted on 385 normal healthy subjects aged 18-67 years, attending an annual temple festival in Kerala during 2016. Subjects were selected based on the inclusion and exclusion criteria, after obtaining the ethical clearance. Using an Omron Body fat analyser, we measured BFP. Statistical analysis was done using Independent T test, ANOVA and Chi square test on SPSS version 20. Results: A significant increase in BMI and BFP with age in both genders, with BFP changes starting at a younger age. Females showed higher increases in both BMI and BFP. Among participants, 34% had normal BMI. 29% had normal BFP and only 20% had both normal. We also found many ‘invisible’ obese individuals within the normal BMI group and some ‘muscle obese’ individuals in the overweight BMI group. Conclusions: To conclude, as BMI and BFP increase with age, the quality of fat free mass likely deteriorates. BFP is a better predictor of adiposity compared to BMI. For early NCD detection, both BMI and BFP should be included in routine clinical screenings.

Evaluation of the Impact of Body Mass Index on the Outcomes of Supine Percutaneous Nephrolithotomy

Objective: This study aimed to evaluate the impact of obesity on the outcomes of supine percutaneous nephrolithotomy (PCNL) in a tertiary care center. Understanding surgical outcomes in obese patients, given their rising prevalence and urolithiasis risk, is crucial for optimizing treatment strategies. Materials and Methods: This retrospective study included data from 256 patients aged 18 and older who underwent PCNL in the Galdakao-Valdivia position between July 2021 and July 2024 at a tertiary care hospital. Patients were categorized into three groups based on their body mass index (BMI): normal weight (BMI: 18-24.9 kg/m²), overweight (BMI: 25-29.9 kg/m²), and obese (BMI: 30-34.9 kg/m²). Demographic data, stone characteristics, operative time, fluoroscopy time, hospital stay, nephrostomy duration, stone-free rates (SFR), and complications were analyzed and compared across the three groups. Results: There was no significant difference between the groups regarding age, sex, stone laterality, location, or size (p&gt;0.05). Median BMI values were significantly different between the groups (p&lt;0.001). The stone-free rates were 79.2%, 77%, and 75% for the normal, overweight, and obese groups, respectively (p&gt;0.05). No significant differences were found in operative time, fluoroscopy time, hospital stay, or nephrostomy time among the groups (p&gt;0.05). Minor and major complication rates were similar across all groups (p&gt;0.05). Conclusion: Obesity does not appear to significantly impact the outcomes of supine PCNL, including operative time, stone-free rates, or complication rates. These findings suggest that with experienced surgeons, supine PCNL is a safe and effective treatment option for obese patients, though further prospective studies are needed to confirm these results.

Effects of prognostic nutritional index and obesity on 1-year mortality in patients with acute heart failure

Abstract Background Increased body mass index (BMI) has paradoxically been linked to improved survival rates among patients with acute heart failure (AHF). However, the impact of different nutritional statuses on this obesity paradox on 1-year mortality remains unclear. The prognostic nutritional index (PNI) is a simple tool to assess nutrition status. Recently, landmark findings such as the STEP-HFpEF (Semaglutide Treatment Effect in People With Obesity and HFpEF) trial showed at 1-year, semaglutide not only reduced weight considerably, but also significantly improved health-related quality of life, functional status, and CRP levels. Also, the semaglutide effects on heart disease and stroke in patients with overweight or obesity (SELECT) trial demonstrated a 20% reduction in cardiovascular outcomes. Purpose To investigate the association between obesity and AHF on all-cause mortality according to nutritional status. Methods The cohort study comprised 7258 patients with a cardiopulmonary condition, all of whom were admitted and included on-site at the Emergency Department (ED) in a large University Hospital in Denmark, between March 2020 and March 2022. The follow-up time was at least 365 days. 408 patients with AHF were identified by chart review by trained cardiologists for analysis. PNI was calculated according to the formula: 10×serum albumin (g/ dL) + 5×total lymphocyte count×109/L. A value ≥ 38 is considered well-nourished, and a value &amp;lt; 38 is considered malnourished. Patients were divided into High-PNI (≥38) and Low-PNI (&amp;lt;38) according to cut-off value of PNI. The Kaplan-Meier (KM) curves were used to analyze cumulative survival in each subgroup, and the log-rank test was used to compare differences between groups. Cox regression models were used to analyze associa­tions between BMI, nutritional status and outcomes, expressed as hazard ratios (HR) and relative 95% confi­dence intervals (CI). Results Amongst 408 hospitalized AHF patients, 384 (mean age 75.6 ±11.7) with available PNI scores were enrolled into this study. 55.7% (n=214) were male, 56.4% (n=93) died in the Low-PNI group and 34.2% (n=75) died in the High-PNI group within 1 year. After adjusting for potential confounders in the High-PNI population, compared with the under/normal and overweight BMI group, obesity was negatively associated with 1-year mortality, with adjusted HR of 0.47, 95% CI (0.24–0.94), P = 0.033. However, this correlation disappeared in the Low-PNI group (obese BMI: HR 1.2, 95% CI 0.71–2.1, P = 0.457). In addition, those who were overweight in the Low-PNI group had an 80% increase in 1-year risk of death. Conclusion Obesity (BMI&amp;gt;30) was associated with reduced 1-year mortality only in AHF-patients with good nutritional status. However, this association disappeared in malnourished patients. Consequently, additional research is essential to formulate weight loss recommendations for malnourished obese patients with AHF.

Association of High-sensitivity C-reactive Protein Level with Obese Normal individuals in North Indian Population.

One of the major inflammatory markers, C-reactive protein (CRP), is often elevated in people who have had a heart attack, vascular problems, stroke, or sudden cardiac death. Obesity is associated with higher CRP levels because adipose tissue activates cytokines. Obesity and overweight increase the risk of heart disease, as does an elevated CRP level. The purpose of this study was to evaluate the association of high-sensitivity CRP (hs-CRP) level with obese normal individuals in North Indian population. This cross-sectional study included 50 individuals between the ages of 18 and 50 years who were overweight or obese. The degree of obesity was determined by anthropometric measurements. The patients' height, weight, waist circumference (WC), hip circumference, and blood pressure were measured. Enzyme-linked immunosorbent assay-based CRP level was determined from the blood. The mean WC (cm) was significantly higher in the obese (103.42 ± 9.79) than in the overweight (89.00 ± 8.72). The mean hip circumference (cm) was also significantly smaller in the obese group (99.95 ± 8.07) than in the overweight group (131.29 ± 15.82). The waist-to-hip ratio (WHR) was significantly more in the obese group (88.37%) than in the overweight group (0.00%). WC (cm), hip circumference (cm), WHR, systolic blood pressure (mmHg), and diastolic blood pressure (mmHg) were not significantly correlated with hs-CRP in overweight and obese participants. Compared with obesity, hs-CRP was not related to obesity. A relationship between hs-CRP and WC, hip circumference, and WHR was not found.

Impact of body mass index on mortality, limb amputation, and bleeding in patients with lower extremity artery disease undergoing endovascular therapy.

The relation between Body Mass Index (BMI) and adverse outcomes after endovascular therapy (EVT) for patients with lower extremity artery disease (LEAD) remains incompletely understood. From April 2010 to March 2020, 199 consecutive patients who underwent EVT for LEAD were retrospectively analyzed. The patients were divided into three groups based on BMI; underweight < 18.5 kg/m2, normal weight ≥ 18.5 and < 25.0 kg/m2, and overweight ≥ 25.0 kg/m2. The endpoint of this study was a composite of all-cause mortality, major amputation, and major bleeding. Patients who were underweight often exhibited anemia (53.3 vs. 22.3 vs. 15.4%, respectively; p = 0.001) and severe chronic kidney disease (50.0 vs. 30.8 vs. 20.5%, respectively; p = 0.03). Furthermore, these patients had higher incidences of Trans-Atlantic Inter-Society Consensus class C or D lesions (40.0 vs. 20.0 vs. 10.3%, respectively; p = 0.01). During the median follow-up duration of 3.6 years (interquartile range: 1.2 to 6.7 years), there were 73 incidents of the composite endpoint. When the overweight group was assigned as the reference group, the adjusted hazard ratios for the composite endpoint for the underweight and normal weight patients were 3.67 (95% confidence interval [CI] 1.39-10.83, p = 0.008) and 2.35 (95% CI 1.06-6.23, p = 0.03), respectively. Kaplan-Meier curve demonstrated that the freedom from the composite endpoint for underweight, normal weight, and overweight patients was 41.6%, 60.0%, 83.8%, respectively (p < 0.001). These results suggest that there was an inverse association between BMI and adverse outcomes composed of mortality, limb amputation, and bleeding in patients with LEAD undergoing EVT.

Association Between Prenatal Exposure to Organochlorine Pesticides and Telomere Length in Neonatal Cord Blood

Objectives: Environmental exposure may affect the telomere length (TL) of newborns, which is considered as an early biomarker indicating susceptibility for later life diseases. However, the effects of prenatal organochlorine pesticide (OCP) exposure on newborn TL remain unclear. This study aimed to investigate the association between prenatal exposure levels of OCPs during pregnancy and TL in neonatal cord blood. Methods: A total of 168 mother–infant pairs from a birth cohort in Wuhan, China, were included this study. The concentrations of hexachlorocyclohexanes (HCHs, including β-HCH, α-HCH, and γ-HCH), p,p’-dichlorodiphenyltrichloroethane (p,p’-DDT) and its metabolites (p,p’-dichlorodiphenyldichloroethane, p,p’-DDD; p,p’-dichlorodiphenyldichloroethylene, p,p’-DDE) were measured in cord blood. The associations between the OCPs and the TL in newborns were analyzed by a generalized linear regression model. Stratified analyses by newborn sex, maternal gestational weight gain, and pregnancy body mass index (BMI) were performed to evaluate if the associations were modified by these factors. Results: The detection rates of various OCPs ranged from 50.9% to 100.0%. The median concentration of p,p’-DDE was the highest (33.90 ng/g lipid), followed by β-HCH (8.67 ng/g lipid), and the median concentrations of the other OCPs were between 0.12 and 0.33 ng/g lipid. Among the all newborns, a two-fold increase in the γ-HCH concentration in the cord blood was significantly associated with a 0.024 (95% CI: −0.041, −0.007) decrease in the TL. After stratification by newborn sex, the inverse association between γ-HCH and the TL was only statistically significant in boys, but not in girls (P for interaction &lt;0.05). In addition, after stratification by pre-pregnancy BMI, β-HCH and p,p’-DDT concentrations were significantly associated with a decreased TL in the overweight pre-pregnancy BMI group [−0.111 (95% CI: −0.203, −0.018) and −0.036 (95% CI: −0.049, −0.023), respectively]. Conclusions: Prenatal exposure to OCPs during pregnancy was associated with a decreased neonatal telomere length, which may be affected by the newborn sex and pre-pregnancy BMI. These findings may provide new insights into the mechanisms underlying OCP-induced adverse health effects.

Evaluation of retinal nerve fiber layer and choroidal structure in obese children and adolescents

Aim: Obesity-related vascular damage and endothelial dysfunction have deleterious effects on the ocular vasculature. It was aimed to examine optical coherence tomography (OCT) parameters in obese and overweight children and to define their relationship with metabolic markers in this study. Methods: The patient group consisted of 26 obese, 24 overweight patients aged between 8 and 18 years. The control group consisted of 25 healthy children with normal body mass index (BMI). This was a cross-sectional observational study. Serum glucose, lipid parameters, and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated. Measurement of choroidal thickness was performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA). Retinal nerve fiber layer (RNFL) thickness was determined by an automatic computer algorithm without the need for user measurement. Results: There were no differences in subfoveal, nasal, temporal choroidal thickness, and RNFL between obese, overweight, and control groups (p&gt;0.05). A positive (linear) moderate relationship was found between RNFL and the HOMA-IR of 26 patients in the obese group (r=0.389) (p=0.049). A positively weak correlation was found between height and RNFL in obese patient group (r=0.264, p=0.028). Conclusion: In the study, RNFL thickness increased as HOMA-IR level increased in obese children and adolescents. RNFL decreased as the height increased in obese children and adolescents. We believe that more comprehensive data about the effect of obesity on RNFL and choroidal thickness will be obtained with prospective studies in which the obese patient group with insulin resistance is taken separately and disease durations are defined, and long-term patient follow-up is performed.

Maternal weight status at conception predicts offspring body fat at age 11 years: population data from the Japan Kids Body Composition Study using dual-energy X-ray absorptiometry

BackgroundMaternal preconception overweight status has been reported to be associated with an increased risk of overweight offspring. However, there are no published population-based studies on the association between maternal preconception weight and offspring body fat measured by dual-energy X-ray absorptiometry (DXA). The present population-based retrospective cohort study aimed to examine the association between maternal weight at conception and offspring body fat measured by DXA.MethodsThe source population consisted of 5th-grade students (1244 students aged 11 years) registered at 8 municipal elementary schools in Kitakata, Fukuroi, Hamamatsu, and Himeji in Japan. The present analyses included 964 participants who provided complete information. Maternal body mass index (BMI) at conception was calculated using records in the Mother and Child Health Handbook (MCHH). Offspring body fat at age 11 years was measured with the same QDR-4500A DXA instrument in a mobile test room that was brought to each school. With regard to the prediction of excess fat in offspring, the area under the curve (AUC) calculated with receiver operating characteristic curve analysis was used to quantify the diagnostic accuracy of maternal BMI at conception.ResultsAdjusted odds ratios for excess body fat in offspring of the overweight mother group (odds ratios, 4.93 to 15.32) were significantly higher than those in the non-overweight mother group. For the prediction of excess offspring fat, AUCs and 95% confidence intervals for maternal BMI at conception were greater than 0.5.ConclusionMaternal overweight status at conception might be a risk factor for excess body fat in offspring. Maternal BMI values calculated using MCHH data have the potential to distinguish between the presence and absence of excess fat in the next generation.

Association between BMI and increased time-to-pregnancy in planned pregnancy couples: a cohort study in Guangzhou, China

BackgroundThis study examines the relationship between overweight and obesity and fertility in the context of China’s fertility. Given the inconsistent results in previous research, which mostly focused on females, our study targets couples in Guangzhou. We investigate the relationship between Body Mass Index (BMI) and time-to-pregnancy (TTP) to provide evidence-based strategies for enhancing reproductive outcomes in China.MethodsThis cohort study, utilizing the National Free Pre-pregnancy Checkups Project (NFPCP), employs a Cox regression model to assess the associations between different BMI categories and TTP. Heatmaps are utilized to investigate the association between various BMI combinations of couples and TTP. Additionally, restricted cubic spline (RCS) curves were used to explore the impact of different ranges of male and female BMI on TTP.ResultsThe results showed that females and males classified as overweight and obese (fecundability ratios (FR) 0.78, 95% CI 0.64, 0.95 for females; FR 0.86, 95% CI 0.76, 0.97 for males) had longer TTP compared with those in the normal weight category, regardless of controlled covariates, while those classified as underweight also had longer TTP, but the difference was not statistically significant (P > 0.05). Across all BMI combinations, couples in the overweight and obese groups exhibited the longest TTP, experiencing a 34% increase in TTP compared to couples in the normal BMI combination (FR 0.66; 95% CI 0.50, 0.85). After adjusting for all covariates in the RCS model, a male BMI within the range of 23.40 to 29.44 was significantly associated with an increase in TTP (FR<1).ConclusionsIncreased BMI in both females and males is associated with a certain predictive effect on prolonged TTP. Scientific BMI management is crucial for couples preparing to conceive.

Prediction of the ideal gestational weight gain for reducing the risk of macrosomia/large for gestational age in women with gestational diabetes mellitus in northern Taiwan

BackgroundAppropriate weight gain reduces the risk of fetal macrosomia and large for gestational age (LGA) in women with gestational diabetes mellitus (GDM), especially in the second and third trimester. This study aims to identify the optimal weight g–ain for such women across several pre-pregnancy body mass index (BMI) categories to lower the risk of macrosomia and LGA. MethodsThis retrospective cohort study enrolled women with GDM in north Taiwan who delivered between January 2012 and July 2022. BMI cut-offs were based on Chinese-specific guidelines and used to classify the participants as underweight (<18.5 kg/m2), normal weight (18.5–24.0 kg/m2), overweight (24.0–28.0 kg/m2), or obese (>28 kg/m2). Receiver operator curve analysis was used to determine the optimum GWG cut-off ranges to predict macrosomia / LGA, and uni- and multivariate analyses were used to analyze risk factors. In addition, a multivariable model predicting macrosomia and LGA in infants was developed. ResultsA total of 963 participants was included in our analysis. Optimal mean weekly rates of GWG in the second and third trimesters were 0.43 kg/week and 0.61 kg/week, respectively, in the underweight and normal weight group, and 0.33 kg/week and 0.32 kg/week, respectively, in the overweight and obesity group. ConclusionThe 2009 IOM guidelines, offering weight gain recommendations for pregnant women, appear to be applicable to Asian women diagnosed with GDM. This indicates that it is essential for such women to maintain an adequate total GWG throughout pregnancy. Physicians should address GWG using the IOM guidelines and trigger intervention when it is required to reduce macrosomia and LGA occurrence.

Association Between Body Mass Index Changes and All-Cause Mortality in Parkinson's Disease.

Whether body weight changes are associated with Parkinson's disease (PD) mortality remains uncertain. To investigate the association between changes in body mass index (BMI) and all-cause mortality in patients with PD. This nationwide cohort study enrolled 20,703 individuals with new-onset PD (ICD-10 code: G20 and a rare intractable disease registration code: V124) who underwent health screening program by the Korean National Health Insurance Service within two years from pre- and post-PD diagnosis. We identified nine BMI change groups based on three BMI status: underweight (BMI < 18.5 kg/m2), normal or overweight (18.5 kg/m2≤BMI < 25 kg/m2), and obese (BMI≥25 kg/m2). Of 20,703 individuals, 3,789 (18.0%) died during the follow-up period. Excessive weight loss to underweight in the obese group (hazard ratio [HR] = 3.36, 95% CI:1.60-7.08), weight loss in the normal to overweight group (HR = 2.04, 95% CI:1.75-2.39), sustained underweight status (HR = 2.05, 95% CI:1.67-2.52), and weight gain from underweight to normal or overweight (HR = 1.52, 95% CI:1.15-2.02) were associated with increased mortality. Sustained obese status (HR = 0.80, 95% CI:0.74-0.87) and weight gain in the normal to overweight group (HR = 0.82, 95% CI:0.71-0.95) were associated with reduced mortality. We found that BMI change at diagnosis was associated with mortality in patients with PD. Specifically, being underweight either before or after diagnosis as well as experiencing weight loss, were associated with increased mortality. These findings provide valuable insights for weight management planning in PD, highlighting the importance of individualized approach that consider pre-diagnosis BMI.