Overweight OR Research Articles

In Patients Presenting with an ST-Elevation Myocardial Infarction, Overweight and Obese Patients Have the Lowest Inpatient Mortality whereas Cachexia Patients Have the Highest Inpatient Mortality Followed by Patients with Morbid Obesity

Introduction: The obesity paradox has been observed in patients with cardiovascular disease. The goal of this study was to evaluate whether obesity has a protective effect in patients presenting with an ST elevation myocardial infarction (STEMI). Method: Using the large Nationwide Inpatient (NIS) sample database, we evaluated the mortality in patients with a STEMI based on weight categories. Results: A total of 2,161,640 STEMI patients were found in the database over age 18. We found that overweight and obesity had the lowest mortality using univariate (overweight mortality of 5% vs. obesity mortality of 6.5% vs. 10.9% for normal weights) and multivariate analyses (overweight OR: 0.52, CI: 0.43–063; p < 0.001 and obesity OR: 0.7, CI: 0.67–0.74; p < 0.001), whereas cachexia was associated with the highest mortality in the univariate (cachexia 24.5%) and multivariate (OR: 2.28, CI: 2.13–2.44; p < 0.001) analyses, followed by morbid obesity in the multivariate analysis (OR: 1.07, CI: 1.02–1.12; p = 0.004). Conclusions: We observed a partial obesity paradox in patients with a STEMI showing that overweight have the best survival rates followed by obesity. Cachexia followed by morbid obesity had the lowest survival rates.

Bayesian spatial-temporal analysis and determinants of cardiovascular diseases in Tanzania mainland

BackgroundCardiovascular Diseases (CVDs) are health-threatening conditions that account for high mortality in the world. Approximately 23.6 million deaths due to CVD is expected in the year 2030 worldwide. The CVD burden is more severe in developing countries, including Tanzania.ObjectivesThis study analyzed the spatial-temporal trends and determinants of cardiovascular diseases in Tanzania from 2010 to 2019.MethodsIndividual data were extracted from Jakaya Kikwete Cardiac Institute (JKCI), Mbeya Zonal Referral Hospital (MZRH), Kilimanjaro Christian Medical Centre (KCMC) and Bugando hospitals and the geographical data from TMA. The model containing spatial and temporal components was analyzed using the Bayesian hierarchical method implemented using Integrated Nested Laplace Approximation (INLA).ResultsThe results found that the incidence of CVD increased from 2010 to 2014 and decreased from 2015 to 2019. The southern highlands, lake, central and coastal zones were more likely to have CVD problems than others. It was also revealed that people aged 60–64 years OR = 1.49, females OR = 1.51, smokers OR = 1.76, alcohol drinkers OR = 1.48, and overweight OR = 1.89 were more likely to have CVD problems. Additionally, a 1oC increase in the average annual air maximum temperature was related to a 14% risk of developing CVD problems. The study revealed that the model, which included spatial and temporal random effects, was the best-predicting model.ConclusionThe study shows a decreased CVD incidence rate from 2015 to 2019. The CVD incidences occurred more in Tanzania’s coastal and lake areas between 2010 and 2019. The demographic, lifestyle and geographical risk factors were significantly associated with the CVD.

The Efficacy of Pharmacotherapy in the Treatment of Obesity in Patients With Type 2 Diabetes: A Systematic Review.

Obesity is a global public health challenge that poses a significant threat to the effective control and management of type 2 diabetes mellitus (T2DM). Being overweight/obese with T2DM is associated with a wide range of comorbidities, including cardiovascular, cerebrovascular, and renal diseases. This systematic review aimed to investigate the drug therapy used globally among this type of patients in the period between 2014 and 2024. Four databases (PubMed, Web of Science, Scopus, and Cochrane) were searched using the keywords "(Drug Therapy OR Pharmaceutical Preparations OR Pharmacotherapy) AND (Diabetes Mellitus, Type 2) AND (Obesity OR Overweight OR Weight Loss OR Weight reduction) in the title and abstract. All papers assessing the efficacy of any drug class on blood sugar and body weight (BW) were included in the systematic review. Out of 5,206 papers extracted through the database search, 25 randomized clinical trials (RCTs) were considered suitable for the systematic review. The articles included 8,208 participants who tested different drug classes, e.g., glucagon-like peptide-1 (GLP-1) and sodium-glucose co-transporter-2 (SGLT2), with or without metformin. All the reviewed drugs showed significant weight loss over 12-52 weeks. However, the magnitude of weight loss was modest, and the long-term health benefits and safety remain unclear. Interventions that combine pharmacologic therapy with lifestyle modifications may be more effective but need additional research. Continued development of new treatment options for obesity in T2DM is crucial to reduce morbidity and mortality among these patients.

Effects of dietary seaweed on obesity-related metabolic status: a systematic review and meta-analysis of randomized controlled trials.

Seaweed is a promising source of anti-obesity agents, including polysaccharides, proteins, polyphenols, carotenoids, and n-3 long-chain polyunsaturated fatty acids. The anti-obesity effects of such compounds may be due to several mechanisms, including inhibition of lipid absorption and metabolism, effect on satiety, and inhibition of adipocyte differentiation. The aim of this study was to assess the evidence from human randomized controlled trials for the effects of seaweed on body-weight status as well as lipid and nonlipid parameters in adults with overweight and obesity. Four databases-Medline, Scopus, Web of Science, and Cochrane Library-were searched from December 2022 to June 2023 using the following key words: Seaweed OR fucoxanthin OR alginates OR fucoidans OR phlorotannin's OR macroalgae OR marine algae AND obesity OR overweight OR BMI OR body mass index. Eleven interventional studies (10 parallel and 1 crossover) were extracted. Meta-analysis showed a significant effect, favoring the intervention group for BMI (body mass index) (standardized mean difference [SMD]: -0.40; 95% CI: -0.65 to -0.16 kg/m2; P = 0.0013) and percentage of fat mass (SMD: -1.48; 95% CI: -2.66% to -0.30%, P = 0.0138). The results were seen when refined or extracted brown seaweed (BMI) or only refined brown seaweed (% fat mass) were administered to participants for at least 8 weeks. Moreover, a significant overall effect of seaweed supplementation on total cholesterol (SMD: -7.72; 95% CI: -12.49 to -2.95 mg/dL; P = 0.0015) and low-density-lipoprotein cholesterol (SMD: -7.33; 95% CI: -11.64 to -3.02 mg/dL; P < 0.001) was noted. Any significant effects of seaweed on glucose metabolism were not shown. Edible seaweed supplementation shows potential for managing obesity and disorders of the blood lipid profile when administered to participants for at least 8 weeks. PROSPERO registration no. CRD42022378484 (www.crd.york.ac.uk/PROSPERO).

Pancreatic Beta Cell Function in Infants Varies by Maternal Weight.

The Asian Indian Beta Cell function (ABCs) in Infants Study examined the associations of maternal weight on infant pancreatic beta cell function across 7 months postpartum. Pregnant women aged 18-35 years were recruited in Hyderabad, India. Women were classified by first trimester weight as underweight (UW), BMI < 18.5 kg/m2; normal weight (NW), BMI 18.5-22.9 kg/m2; or overweight (OW), BMI 23.0 through <28.5 kg/m2. At age > 7 months, infants had an oral glucose tolerance test (OGTT, 1.75 g glucose/kg bodyweight) following a 3 h fast. Infant blood samples were assayed for C-peptide and glucose. Infant beta cell function (HOMA2-B; disposition index, DI) and insulin resistance (HOMA2-IR) were compared across maternal weight groups. Mothers (UW n = 63; NW n = 43; OW n = 29) had similar age at delivery and second trimester 50 g glucose challenge test results. Cord HOMA2-B values were 51% greater for IUW (83.5, SD 55.2) and 44% greater for IOW (79.9, SD 60.8) vs. INW (55.4, SD 51.5), forming a U-shaped relationship between maternal weight and HOMA2-B. No qualitative differences in HOMA2-IR were found at birth. However, at 7 months postpartum, HOMA2-IR changed most within IUW (-64% median reduction) and changed the least in IOW (-7% median reduction). At seven months postpartum, DI was higher in IUW vs. the other groups (geometric mean IUW 1.9 SD 2.5; INW 1.3 SD 2.6 or vs. IOW mean 1.2 SD 3.7), reflecting a +49% difference in DI. Evidence from this study illustrates adaptations in the pancreatic functional response of infants associated with the maternal nutritional environment.

Restricted cubic spline model analysis of the association between anal fistula and anorectal abscess incidence and body mass index.

The epidemiological profile of anal fistula and anorectal abscess has not been well studied. Based on the results of a retrospective cross-sectional survey, we aimed to investigate the potential influential factors associated with anal fistula and anorectal abscess. We conducted a retrospective analysis of outpatients who visited the proctology department at China-Japan Friendship Hospital between January 2017 and May 2022. A comprehensive questionnaire was designed to collect potential influential factors, and according to formal anorectal examination and the corresponding diagnostic criteria, all the participants were divided into patients with anal fistula or perianal abscess and healthy control group. Multiple logistic regression was used to identify factors in significant association with anal fistula and perianal abscess. Additionally, we combined restricted cubic spline regression to examine the dose-response relationship between factors and the risk of developing anal fistula or anorectal abscess. The present study included 1,223 participants, including 1,018 males and 206 females, with 275 anal fistulas, 184 anorectal abscesses, and 765 healthy controls. We found no statistically significant differences between patients and controls in basic information and preoperative assessment of life factors, except for body mass index. It was indicated that people with overweight or obesity were more prone to anal fistula (OR overweight = 1.35, 95% CI: 1.00-1.82, P = 0.047; OR obesity = 3.44, 95% CI: 2.26-5.26, P < 0.001) or anorectal abscess (OR overweight = 1.41, 95% CI: 1.00-1.99, P = 0.05; OR obesity: 2.24, 95% CI: 1.37-3.67, P = 0.001) than normal-weight individuals. The dose-response research indicated the J-shaped trend between the ascending BMI levels and the higher risk of suffering from anal fistula and anorectal abscess. Our findings indicate that overweight and obesity are risk factors for anal fistula and anorectal abscess, which plays a role in the prevention of anorectal diseases. This provides some theoretical basis for clinicians to provide health education to their patients.

Association of behavior pattern with overweight and obesity in South Korean adults-A multi correspondence analysis (KNHANES-2018-2020).

The objective was to determine the association between health-related behaviour with overweight and obesity in South Korean adults by using the Korean National Health and Nutritional Examination Survey (KNHANES) 2018-2020. The study participants were 16,784 aged ≥ 20years. The variables were socio-demographic, lifestyle, food habits and metabolic conditions. The logistic regression analysis performed to find the association by the odds ratio (OR, 95% CI). MCA performed to identify risk factors were computed for overweight and obesity. Overweight and obesity were significantly associated with health behaviour, high income (OR = 1.26; 95% CI: 1.15-1.39), smoking(OR = 1.29; 95% CI: 1.08-1.53), low physical activity(OR = 3.23; 95% CI: 1.79-4.69), diabetes(OR = 2.70; 95% CI: 1.62-4.50), high cholesterol and low HDL(OR = 3.98; 95%CI:2.65-5.97). The high discriminant variables of MCA were aged over 60years, lower education, high income, diabetes, lack of physical activity, and high cholesterol. The findings confirm that the OR of obesity and overweight was likely associated with health behaviour patterns. Besides, it indicates the MCA would be very effective to identify the population-based data context than individual data and it may suggest that more research on association between health behaviours and obesity prevention interventions should be developed for each age group for better health outcomes.

A systematic evaluation and meta-analysis of early prediction of post-thrombotic syndrome.

Post-thrombotic syndrome (PTS) is the most common long-term complication in patients with deep venous thrombosis, and the prevention of PTS remains a major challenge in clinical practice. Some studies have explored early predictors and constructed corresponding prediction models, whereas their specific application and predictive value are controversial. Therefore, we conducted this systematic evaluation and meta-analysis to investigate the incidence of PTS and the feasibility of early prediction. We systematically searched databases of PubMed, Embase, Cochrane and Web of Science up to April 7, 2023. Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included articles, and the OR values of the predictors in multi-factor logistic regression were pooled to assess whether they could be used as effective independent predictors. We systematically included 20 articles involving 8,512 subjects, with a predominant onset of PTS between 6 and 72 months, with a 2-year incidence of 37.5% (95% CI: 27.8-47.7%). The results for the early predictors were as follows: old age OR = 1.840 (95% CI: 1.410-2.402), obesity or overweight OR = 1.721 (95% CI: 1.245-2.378), proximal deep vein thrombosis OR = 2.335 (95% CI: 1.855-2.938), history of venous thromboembolism OR = 3.593 (95% CI: 1.738-7.240), history of smoking OR = 2.051 (95% CI: 1.305-3.224), varicose veins OR = 2.405 (95% CI: 1.344-4.304), and baseline Villalta score OR = 1.095(95% CI: 1.056-1.135). Meanwhile, gender, unprovoked DVT and insufficient anticoagulation were not independent predictors. Seven studies constructed risk prediction models. In the training set, the c-index of the prediction models was 0.77 (95% CI: 0.74-0.80) with a sensitivity of 0.75 (95% CI: 0.68-0.81) and specificity of 0.69 (95% CI: 0.60-0.77). In the validation set, the c-index, sensitivity and specificity of the prediction models were 0.74(95% CI: 0.69-0.79), 0.71(95% CI: 0.64-0.78) and 0.72(95% CI: 0.67-0.76), respectively. With a high incidence after venous thrombosis, PTS is a complication that cannot be ignored in patients with venous thrombosis. Risk prediction scoring based on early model construction is a feasible option, which helps to identify the patient's condition and develop an individualized prevention program to reduce the risk of PTS.

Effects of Physical Activity, Fruit and Vegetables Intake, and Alcohol Consumption on Overweight or Obesity: Meta-Analysis

Background: Overweight or obesity is a public health problem worldwide which is increasing both in the general population and in people with chronic diseases. Overall both children and adults are vulnerable to overweight or obesity. This study aims to examine the effect of physical activity, consumption of vegetables and alcohol on overweight or obesity using a meta-analysis.Subjects and Method: Meta-analysis was carried out using the PRISMA flowchart and the PICO model. Population: age 6 to 64 years. Intervention: low physical activity, low vegetable and fruit consumption, and high alcohol. Comparison: high physical activity, high vegetable and fruit consumption, and alcohol low. Outcome: overweight or obese. The databases used are Google Scholar, PubMed, and Proquest with keywords (Overweight OR Obesity OR "BMI Status") AND (“Physical Activity” OR Exercise OR Sport OR Inactive) AND (Vegetable AND Fruit) AND Alcohol AND "Cross Sectional" AND aOR. There were 22 cross-sectional studies published in 2012-2022 that met the inclusion criteria. Analysis was performed with RevMan 5.3.Results: A meta-analysis was conducted on 22 articles with a cross-sectional study design originating from Indonesia, Ghana, Arab Emirates, Texas, Ethiopia, Uganda, Botswana, Congo, Bahir Dar, North Western, Toronto, Zambia, Cameroon and Tanzania involving 91,031 ages 6-64 years. The results of the meta-analysis showed that someone with low physical activity had a risk of being overweight or obese 1.35 times compared to high physical activity (aOR= 1.35; 95% CI= 1.09 to 1.68; p&lt;0.001), someone with high consumption of vegetables and fruit have a risk of experiencing overweight or obesity 1.40 times compared to high consumption of vegetables and fruits (aOR= 1.40; 95%CI= 0.94 to 2.08; p&lt;0.001), and someone with high alcohol has a risk of experiencing overweight or obesity 1.47 times compared low alcohol (aOR= 1.47; 95% CI= 1.31 to 1.65; p&lt;0.001).Conclusion: Low vegetable and fruit consumption, high alcohol consumption and low physical activity can increase the risk of being overweight or obese. Keywords: social support, self-efficacy, social cognitive theory, hypertension, medication adherence Correspondence: Dena Tri Solehaini. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: dena35tri@gmail.com. Mobile: +6282329210977.

Maternal Preconception Body Mass Index Overtakes Age as a Risk Factor for Gestational Diabetes Mellitus.

Introduction-The purpose of this study was to determine the relative impact of modifiable and non-modifiable risk factors in the development of gestational diabetes mellitus (GDM), with a particular focus on maternal preconception body mass index (BMI) and age, two important determinants of insulin resistance. Understanding the factors that contribute most to the current escalation of GDM rates in pregnant women could help to inform prevention and intervention strategies, particularly in areas where this female endocrine disorder has an elevated prevalence. Methods-A retrospective, contemporary, large population of singleton pregnant women from southern Italy who underwent 75 g OGTT for GDM screening was enrolled at the Endocrinology Unit, "Pugliese Ciaccio" Hospital, Catanzaro. Relevant clinical data were collected, and the characteristics of women diagnosed with GDM or with normal glucose tolerance were compared. The effect estimates of maternal preconception BMI and age as risk factors for GDM development were calculated through correlation and logistic regression analysis by adjusting for potential confounders. Results-Out of the 3856 women enrolled, 885 (23.0%) were diagnosed with GDM as per IADPSG criteria. Advanced maternal age (≥35 years), gravidity, reproductive history of spontaneous abortion(s), previous GDM, and thyroid and thrombophilic diseases, all emerged as non-modifiable risk factors of GDM, whereas preconception overweight or obesity was the sole potentially modifiable risk factor among those investigated. Maternal preconception BMI, but not age, had a moderate positive association with fasting glucose levels at the time of 75 g OGTT (Pearson coefficient: 0.245, p < 0.001). Abnormalities in fasting glucose drove the majority (60%) of the GDM diagnoses in this study. Maternal preconception obesity almost tripled the risk of developing GDM, but even being overweight resulted in a more pronounced increased risk of developing GDM than advanced maternal age (adjusted OR for preconception overweight: 1.63, 95% CI 1.320-2.019; adjusted OR for advanced maternal age: 1.45, 95% CI 1.184-1.776). Conclusions-Excess body weight prior to conception leads to more detrimental metabolic effects than advanced maternal age in pregnant women with GDM. Thus, in areas in which GDM is particularly common, such as southern Italy, measures aiming to counteracting maternal preconception overweight and obesity may be efficient in reducing GDM prevalence.

Factores de riesgo asociados a diabetes mellitus gestacional en la región norte de México

ObjectiveTo determine the risk factors associated with gestational diabetes mellitus in northern México. DiseñoObservational, analytical case-control study. SiteFamily Medicine Unit No. 33 in Reynosa, Tamaulipas, México. ParticipantsPregnant women between 24 to 28 gestational weeks. Interventions363 cases and 587 controls underwent a one-step test with an oral intake of 75 grams of glucose with basal determination, at one hour and 2 hours to determine the presence or absence of gestational diabetes. From the electronic medical record; sociodemographic, anthropometric, gynecologic, obstetric, pathological and non-pathological variables were collected. Main measurementsA univariate exploratory analysis was performed using the sample mean and standard deviation to find out the centrality and dispersion. Subsequently, a bivariate analysis was performed to determine association and correlation of the variables of interest with the presence or absence of gestational diabetes mellitus. Lastly, an integral logistic model was performed with the independent variables to determine its effects and statistical significance. ResultsAge of the cases was 30.46 years, 4 years older than the controls; weight of 78.82 kilograms, 10 kilograms more than controls. Obstetric risk of 6.34 in cases and 4.69 in controls. Age older than 30 years had an OR 5.15 (CI 1.77-15) for gestational diabetes. Overweight OR 4.53 (CI 2.56-8.03), obesity class I OR 10.03 (CI 5.59-18), obesity class II OR 16.11 (CI 8.36-31.04) and obesity class III OR 16.91 (CI 6.86-41.68). ConclusionsWomen with gestational diabetes have a higher age, weight and obstetric risk. The main risk factors associated with gestational diabetes were age and obesity.

Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents.

The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

Correlation between Overweight and Mental Health in Adolescents: A Meta Analysis

Background: Adolescence is a critical period in human life because of the various changes that occur during this stage of life. Overweight and obesity in adolescents is a major public health problem in all developing countries, in addition to affecting physical health, can have a negative impact on mental health. This study aims to analyze the primary study of the effect of being overweight and obese on mental health in adolescents with a meta-analysis. Subjects and Method: This study is a meta-analysis with the following PICO, Population: teenagers. Intervention: overweight and obese. Comparison: normal weight. Outcome: mental health. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles [(adolescent OR teenager OR children) AND (“body mass index” OR BMI OR overweight OR obesity) AND (depression OR “depression symptom”) AND (anxiety OR “anxiety symptom”)]. The included articles are full text in English in 2010 to 2022 with cohort study design and report on aOR in multivariate analysis. The selection of articles is done by using PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application.Results: Nine studies were included in this study, six studies from the Americas, two studies from the European continent, and one study from the Australian continent. The data collected showed an increased risk for depression and anxiety in adolescents who were overweight and obese than adolescents who had normal weight. Obese adolescents had a higher risk of depression (aOR= 1.64; 95% CI= 1.42 to 1.90; p&lt;0.001) than overweight adolescents (aOR= 1.09; 95% CI= 1.00 to 1.18; p= 0.050). Adolescents who were obese had a higher risk of anxiety (aOR= 1.27; 95% CI= 1.08 to 1.49; p= 0.003) than adolescents who were overweight (aOR= 1.10; 95% CI= 1.01 to 1.19; p= 0.020).Conclusion: Overweight and obesity can have an influence on the mental health of adolescents. Keywords: adolescent, overweight, obese, depression, anxiety, meta-analysis. Correspondence:Riski Anisa. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: riskianisa93@gmail.com. Mobile: +6285749027212.

The 100 top-cited articles on childhood obesity: a bibliometric analysis

BackgroundChildhood obesity (CHO) is a serious global health challenge affecting both developed and developing nations. The feats attained in addressing this global health challenge can be reflected through the top-cited studies. The study's aim was to analyze the features of the 100 top-cited articles concerning CHO. MethodsWe used a bibliometric analysis, and searched for relevant articles from the Web of Science (December 1, 2021), using an appropriate keyword search-strategy ((child OR childhood OR children OR adolescent) AND (obese OR obesity OR overweight)). The retrieved documents were analysed based on the citation number, publication year, authorship, institution, journal and country. The analyses were performed mainly by the Bibliometrix application (using R-studio cloud) and HistCite. ResultsThe 100 top-cited articles were published between 1976 and 2018, their citations ranged from 365 to 10 789, with a mean citation of 1 146.2 and 31 studies had more than 1 000 citations. The articles were published in 31 journals, with the “Pediatrics” journal having the most publications (n = 18). The studies were from 12 countries, with the most-productive being the USA (n = 68), followed by the United Kingdom (n = 12) and France (n = 3). The leading institution was the University of Bristol (n = 8), while Dietz WH (n = 12), and Flegal KM (n = 8) were the most productive authors. The most common research fields covered by these articles were; “General Internal Medicine” (n = 34), “Pediatrics” (n = 29), and “Nutrition Dietetics” (n = 18). The study noted significant correlations between the total article citation and the number of authors (R = 0.203), countries involved (R = 0.407), institutions (R = 0.407), and the publication year (R = 0.847), all with P < 0.001. ConclusionsThrough these top-cited articles, this analysis provides discernment into the historical advancements, including the prime roles performed by various stakeholders in addressing the issue of CHO. However, Asian countries’ contribution is not adequately reflected in these articles, and thus more focus and funding for CHO research are needed for effectual prevention and control.

Meta-analysis of case-control studies on obesity risk factors in children aged 3-6 years in China

To explore the risk factors of obesity in children aged 3-6 years in China. Using search terms, preschooler, obesity, risk factors/influence factors, case-control studies, and language limited to Chinese and English, search databases(CNKI, Wanfang, VIP, CBM, PubMed, Web of science, Embase, The Cochrane library). To collect domestic and foreign literature on the case-control study design of obesity risk factors in preschool children in China published from January 1, 2000 to June 30, 2021. Stata 14.0 software was used for Meta-analysis of the included literature, and publication bias test and sensitivity analysis were performed. A total of 11 770 people were included in 12 papers, including 4092 in the case group and 7678 in the control group. Meta analysis shows: birth weight ≥4000 g OR=2.176, 95% CI 1.507-3.143; strong appetite OR=3.860, 95%CI 2.991-4.980; fast eating OR=2.836, 95%CI 2.552-3.152; mother overweight and obesity OR=1.903, 95%CI 1.213-2.986; mother&apos;s low level of education OR=1.744, 95%CI 1.100-2.766; Physical inactivity OR=1.488, 95%CI 1.267-1.748. Birth weight ≥ 4000 g, fast eating speed, strong appetite, mother overweight and obesity, mother&apos;s low level of education, and physical inactivity are risk factors for obesity in children aged 3-6 years.

Effectiveness of active video games in overweight and obese adolescents: a systematic review and meta-analysis of randomized controlled trials.

PurposeThe purpose of this review was to assess the effect of active video games among overweight and obese adolescents.MethodsA systematic review and meta-analysis were conducted using records from the English-language electronic databases MEDLINE, the Web of Science, and PubMed. These databases were searched from January 2010 to December 2020 using the keywords (adolescent*) AND (overweight OR obese *) AND (active video games OR exergaming * OR video game*).ResultsFive articles met the inclusion criteria. Four studies were conducted in the United States of America and 1 study was conducted in Canada. In addition, all included articles had a randomized controlled trial study design. It was determined that the sample size of the studies was 30–46 participants and there were a total of 195 overweight and obese adolescents across the included studies. Active video gaming was negatively associated with changes in body mass index percentile (mean difference [MD], -1.77; 95% confidence interval [CI], -2.55 to -0.99; P<0.001) and total cholesterol (MD, -11.16; 95% CI, -16.64 to -5.68; P<0.001).ConclusionsPlaying active video games can reduce both the body mass index percentile and total cholesterol in overweight and obese adolescents. Active video games can provide a different method for combating childhood obesity. High-quality randomized controlled trials are recommended to assess the impact of game-based interventions.

0226 Circadian influence on food intake among adolescents with overweight and healthy weight

Abstract Introduction Meal timing has been linked to obesity in adults and children; however, evidence for an endogenous influence of the circadian system on food intake is unknown. We measured food intake during forced desynchrony (FD) in adolescents with healthy weight (HW) or overweight (OW), hypothesizing that circadian timing would affect food intake independent of the environmental cycle and that the food intake rhythm would be delayed in adolescents with OW compared to HW. Methods Participants were 51 (29m) adolescents (12-15yr); 24 were HW and 27 OW determined by CDC norms. Participants completed seven, 28h-FD cycles; 6 meals occurred at fixed times each cycle with foods selected ~1h before meals and weighed before and after. Each meal’s energy intake was computed relative to total energy consumed in that FD cycle. Endogenous circadian period was determined using salivary dim-light melatonin onset (DLMO) phases (DLMO=0°). Time awake effect was assessed using mixed effect models and circadian phase with multilevel cosinor that included time awake as a categorical covariate. Results Circadian period was not significantly different between OW and HW (mean, StDev; HW =24.19h,0.22; OW=24.22h,0.14). Overall, participants consumed more calories on the cycles’ first meals (22.0% [21.3;22.6]) compared to the last meal (12.4% [11.8;13.0]). Adolescents with OW vs. HW consumed a higher proportion of calories later in the wake episode (F(5,2081)=2.63,p=.02). As hypothesized, circadian phase influenced caloric intake with an amplitude of 2.66% [2.19;3.14] percent daily calories and an acrophase of 301°[291;310], equivalent to ~17:52 in this population. The circadian influence differed by weight category (likelihood ratio test of both amplitude and acrophase; χ2(2)=10.7,p&amp;lt;.01), with those with OW showing a lower amplitude (OW = 2.11%[1.40;2.82], HW=3.53%[2.94;4.12] and later acrophase (OW=301° [287;314], HW=290° [278;302]). Conclusion Results show for the first time an independent influence of the endogenous circadian timing system on caloric intake of humans that differed as a function of body weight: caloric intake for adolescents with OW had a circadian rhythm with blunted amplitude and delayed peak phase. These observations show circadian control of food intake that may be stronger in HW than OW adolescents. Support (If Any) P20GM139743; R01DK101046; R01HL153969

Relationship between parental reproductive age and the risk of overweight and obesity in offspring

Objective: To explore the role of parental reproductive age on the risk of overweight and obesity in offspring. Methods: The participants were derived from physical examination data of students aged 6-18 years in seven provinces in China, and questionnaire survey was used to collect demographic characteristics and lifestyle information of the students and their parents. A total of 41 567 children with complete data were included. According to the restricted cubic spline curve, maternal reproductive age was divided into three categories, 14-23, 24-28, and 29-38 years, and paternal reproductive age was divided into 14-23, 24-30, and 31-42 years. Multivariate logistic regression model was used to analyze the association between parental reproductive age and parental nutritional status and the risk of overweight and obesity in offspring. Results: The mean age of 41 567 children was (10.6±3.2) years, and the mean paternal and maternal age were (27.9±4.4) years and (25.8±4.0) years, respectively. The detection rate of overweight and obesity was 23.4%. After adjusting factors of children diet and behaviors, the OR(95%CI)of offspring overweight and obesity in groups of fathers aged 24-30 years and mothers aged 24-28 years was 1.11 (1.04-1.18) and 1.16 (1.08-1.24), respectively. When none parents were overweight and obese, the difference of obesity risk was not statistically significant. When both parents were overweight and obese, the OR(95%CI)of offspring overweight and obesity in groups of fathers aged 24-30 years and mothers aged 14-28 years old was 1.27 (1.00-1.62) and 1.33 (1.07-1.65) respectively. Conclusion: Parental reproductive age and parental overweight and obesity status may both increase the risk of overweight and obesity in offspring, with a significant interaction effect.

Association of Cesarean Delivery with Trajectories of Growth and Body Composition in Preschool Children.

This study aimed to examine the association of cesarean delivery with trajectories of growth and body composition in preschool children. This ambidirectional cohort study was conducted between 2017 and 2020 in China. Information on the delivery mode, weight, and length/height of the children measured at routine healthcare visits was obtained from maternal and child health records. For three years while in kindergarten, children’s body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and percentage of body fat (FM%) were repeatedly measured. A BMI z score (zBMI) was calculated and standardized to WHO measures, and overweight and obesity were defined using the WHO reference. After adjustment for maternal age, maternal education, annual family income, prepregnancy BMI, gestational weight gain, gravidity, parity, gestational age, child sex, birthweight, breastfeeding duration, and the parent-reported dietary intake of the children, children born via cesarean delivery (n = 1992) versus those born vaginally (n = 1578) had higher zBMI growth rates beyond 36 months (β: 0.003; 95% CI: 0.001, 0.005 SD units/month) and elevated levels of FMI (β: 0.097; 95% CI: 0.026, 0.168 kg/m2), FM% (β: 0.402; 95% CI: 0.058, 0.745%) and zBMI (β: 0.073; 95% CI: 0.012, 0.133 units), but not FFMI (β: 0.022; 95% CI: −0.022, 0.066 kg/m2). The adjusted OR of overweight and obesity was 1.21 (95% CI: 1.04, 1.40). Cesarean delivery likely elevated zBMI growth rates and increased the risk of overweight and obesity in preschool children, with the elevation of fat mass but not fat-free mass.

Validation of the nutrient-rich foods index estimated by 24-h dietary recall method among adults in Henan province of China.

A family of nutrient-rich food (NRF) indices was validated against the mean adequacy ratio (MAR) and their associations with obesity were tested. Cross-sectional study. NRF indices include nutrients to encourage ranging from 6-11 (protein; fibre; vitamin A, vitamin C, vitamin E and vitamin B12; Ca; Fe; K; Mg; Zn) and two nutrients to limit (saturated fat and Na), described as NRFn.2 (where n 6-11), based on reference amount of 100 g or 100 kcal using the NRF index family of algorithms. The percentage of variation in MAR (R2) was the criteria of index performance. Logistic regression models were applied to predict the association between NRF index and obesity. Three communities in Zhengzhou city, Henan province, China. A total of 656 adults were recruited from Henan as the subjects. The NRF9·2 index, based on nine beneficial nutrients and two nutrients to limit, using the algorithm based on sums and 100 kcal, had the higher R2 values (R2 = 0·232). The OR for overweight (defined by BMI) in the 4th quartile (Q4) v. the 1st quartile (Q1) of the NRF9·2 index was 0·61 (95 % CI = 0·37, 0·98) after multiple adjustments. NRF9·2 index using the algorithm based on sums and 100 kcal gave the best predicted model for diet quality. NRF9·2 index score was associated with overweight defined by BMI, but it was not associated with central obesity. The NRF9·2 index is a valid tool to assess the overall diet quality among adults in Henan province of China.