Reduction Of Overweight Research Articles

P546: EFFECTS OF CHEMOTHERAPY DOSE REDUCTIONS IN OVERWEIGHT AND OBESE PATIENTS WITH ACUTE MYELOID LEUKEMIA – A DANISH NATIONWIDE COHORT STUDY

Background: The majority of chemotherapeutic agents are dosed according to a body weight derived variable. Studies in solid cancers have shown that overweight patients frequently receive dose reduction (DR) of chemotherapy, despite no evidence corroborates increased toxicity of full dosing. Rather, DR to ≤95% of actual weight-based dose, has been shown to result in shortened overall survival (OS). Consequently, the American Society of Clinical Oncology does not recommend up-front dose reduction based on body mass index (BMI) or body surface area (BSA) in overweight patients. Current evidence regarding DR and outcome among overweight patients with acute myeloid leukemia (AML) receiving induction chemotherapy (IC) is limited. Aims: The purpose of this study was to investigate the association between DR and outcome in overweight patients with AML. Methods: We utilized the Danish National Acute Leukemia Registry to conduct a retrospective cohort study. Overweight (BMI≥25) AML patients aged 18-75 years and treated with IC between 2000-2012 were included. We defined DR as ≤95% of actual BSA-based chemotherapy dose. Relative risks (RR) for DR, complete remission (CR) rates, and 30- and 90-day mortality were modeled, and OS and relapse-free-survival (RFS) were calculated and compared using the 5-year restricted mean survival time difference (Δ5y-RMST). Results: The study population included 536 overweight AML-patients of whom 54 patients (10.1%) were categorized as DR (mean reduction 11.2%). Risk factors for DR in univariate analysis were increasing BMI (30-34.9: RR, 2.52 [95% CI, 1.32-4.71]; ≥35: RR, 4.66 [95% CI, 2.37-8.91]), increasing BSA (2.0-2.2: RR 4.61 [95% CI, 1.96-12.6]; ≥2.2: RR 15.21 [95% CI, 6.75-40.67]), therapy-related AML (RR 2.85 [95% CI, 1.12-7.24]) and favorable risk cytogenetics (RR 2.20 [95% CI, 1.02-4.33]). No significant differences were observed for rates of CR, 30- and 90-day mortality between patients receiving DR and non-DR IC. Dose reduction did not affect median RFS (DR, 14.5 [95% CI, 9.0 to 41.7] months; non-DR, 15.0 [12.3 to 19.3]) with an adjusted Δ5y-RMST of 0.2 (-8.4 to 8.8) months nor median OS (DR, 17.0 [11.9-45.5] months; non-DR, 17.5 [14.8-20.5]) with an adjusted Δ5y-RMST of 0.8 (-5.7 to 7.3) months (figure panel A+C). We constructed a case-matched cohort matched on age, sex, AML subtype and BMI (figure panel B+D) and performed a sensitivity analysis using ≤90% cut-off to define DR which led to the same conclusions. Image:Summary/Conclusion: This study demonstrates that ~10% of Danish overweight AML-patients treated with IC are dose reduced ≥5% compared to full BSA-based doses. Risk factors were increasing BMI and BSA in addition to therapy-related AML and favorable cytogenetic risk. Importantly, our results suggest that IC dose reduction does not adversely impact AML outcomes including 30- and 90-day mortality, rates of CR, RFS and OS. However, we encourage future prospective clinical studies to address this question with specific and uniform standards or protocol specifications for dose reduction or dose capping in overweight and obese patients with AML.

The relationship of life-course patterns of adiposity with type 2 diabetes, depression, and their comorbidity in the Northern Finland Birth Cohort 1966

ObjectivesType 2 diabetes (T2D) and comorbid depression challenges clinical management particularly in individuals with overweight. We aim to explore the shared etiology, via lifecourse adiposity, between T2D and depression.MethodsWe used data from birth until 46years from Northern Finland Birth Cohort 1966 (n = 6,372; 53.8% females). We conducted multivariate analyses on three outcomes: T2D (4.2%), depression (19.2%) and as comorbidity (1.8%). We conducted (i) Path analysis to clarify time-dependent body mass index (BMI) related pathways, including BMI polygenic risk scores (PRS); and (ii) Cox regression models to assess whether reduction of overweight between 7years and 31years influence T2D, depression and/or comorbidity. The models were tested for covariation with sex, education, smoking, physical activity, and diet score.ResultsThe odd ratios (OR) of T2D in individuals with depression was 1.68 [95% confidence interval (CI): 1.34–2.11], and no change in estimate was observed when adjusted for covariates. T2D and comorbidity showed similar patterns of relationships in the path analyses (P < 0.001). The genetic risk for obesity (PRS BMI) did not show direct effect on T2D or comorbidity in adulthood but indirectly through measures of adiposity in early childhood and mid-adulthood in the path analysis (P < 0.001). Having early-onset of overweight at 7years and 31years showed highest risk of T2D (OR 3.8, 95%CI 2.4–6.1) and comorbidity (OR 5.0, 95%CI 2.7–9.5), with mild-to-moderate attenuation with adjustments. Depression showed no significant associations.ConclusionsWe found evidence for overweight since childhood as a risk factor for T2D and co-morbidity between T2D and depression, influenced moderately by lifestyle factors in later life. However, no shared early life adiposity related risk factors were observed between T2D and depression when assessed independently in this Finnish setting.

Effect of soy-based meal replacement on weight loss: A systematic review and meta-analyses protocol.

Background: Obesity is a complex and multifactorial disease that is strongly associated with multiple comorbidities and mortality. Weight reduction in overweight and obese patients was highly desired to minimize future complications. Meal replacement is emerging as one of the effective tools to promote weight loss. Isoflavones and soy protein present in soybean are able to promote weight loss and alleviate obesity. Aim: Our systematic review aims to investigate the weight loss effect of soy-based meal replacement among the overweight and obese population. Methods: We will conduct a systematic review of RCTs that evaluated the effect of a soy-based meal replacement on weight loss in overweight and obese patients. The primary outcome of this review is weight loss. Besides that, we will assess BMI, body fat, waist circumference and hip circumference as the secondary outcome. We will search PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. Two reviewers will independently screen titles and abstracts, review full texts, extract information and assess the risk of bias of individual studies. We will conduct meta-analyses using a random-effect model if sufficient data are available. If meta-analysis is not performed, we will present a systematic qualitative synthesis. Summary: This systematic review will identify the weight loss effect of soy-based meal replacement among the overweight and obese adult population. We expect the result may strengthen the evidence on the role of soy-based meal replacement in optimal body weight management.

Efficacy and Sustainability of Diabetes-Specific Meal Replacement on Obese and Overweight Type-2 Diabetes Mellitus Patients: Study Approaches for a Randomised Controlled Trial and Impact of COVID-19 on Trial Progress

Meal replacement (MR) is widely used in weight and diabetes management programs due to its ease of compliance and handling. However, little is known about its impact on outcomes other than glycaemic control and weight loss. Furthermore, not many studies evaluate its cost-effectiveness and sustainability. This study aimed to evaluate the efficacy of a diabetes-specific MR for the weight reduction and glycaemic controls of overweight and obese T2DM patients, as compared to routine dietary consultation. Other health outcomes, the cost effectiveness, and the sustainability of the MR will also be evaluated. Materials and Methods: This randomised controlled clinical trial will involve 156 participants who have been randomised equally into the intervention and control groups. As a baseline, both groups will receive diet consultation. Additionally, the intervention group will receive an MR to replace one meal for 5 days a week. The duration of intervention will be 12 weeks, with 36 weeks of follow-up to monitor the sustainability of the MR. The primary endpoints are weight and Hemoglobin A1c (HbA1c) reduction, while the secondary endpoints are anthropometry, biochemical measurements, satiety, hormone changes, quality of life, and cost-effectiveness. The impact of the COVID-19 pandemic on study design is also discussed in this paper. This study has obtained human ethics approval from RECUKM (JEP-2019-566) and is registered at the Thai Clinical Trials Registry (TCTR ID: TCTR20210921004).

Scoping Review of School-Based Obesity Interventions among Children and Adolescents in Arabic Speaking Countries

BACKGROUND: Childhood and adolescent obesity globally presents a huge public health problem and the dramatic increase in its prevalence and associated poor health outcomes pose serious concerns among Arabic-speaking countries.&#x0D; &#x0D; AIM: This scoping review seeks to identify the characteristics and assess the effectiveness of school-based health promotion interventions on prevention or reduction of overweight/obesity among children and adolescents. This review further describes the implementation and evaluation of nutrition and physical activity interventions and their measured health outcomes for schools in Arabic speaking countries. &#x0D; &#x0D; METHODS: We searched 10 electronic databases (PubMed MEDLINE, Scopus, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), ERIC, EMBASE, ProQuest, EBSCO Host and Global Health) from 2010 to 2020 for studies evaluating school-based health promotion interventions on obesity or overweight among children and adolescents in Arab speaking countries. Sixteen studies met the inclusion criteria for this review and narrative synthesis was conducted. &#x0D; &#x0D; RESULTS: The 16 articles reported on eight discretely different interventions which were largely school-based and examined physical activity and/or nutritional changes as well as changes in knowledge and attitude in regard to physical activity and nutrition. &#x0D; &#x0D; CONCLUSION: Our review demonstrates an inconclusive and mixed effect of behavioural and physical activity intervention on prevention or reduction of obesity and/or overweight. While the strengths and limitations of the various interventions may have influenced the outcomes, long-term school-based interventions with rigorous methodological and theoretical frameworks are necessary to assess the true impact of these interventions on childhood and adolescent obesity in Arab speaking countries.

Determinants and Distribution of Waiting Time for First Conception among Ever Married Women in Bangladesh

Early age at first cohabitation has a major effect on childbearing because women, who marry early, have a longer period of exposure to the risk of becoming pregnant and higher fertility. In a traditional Bangladeshi society it is an urgent need to explore the timing of first conception because it plays a vital role in the determination of reproductive process and fertility. Therefore, the main purpose of this study is to explore meticulously the determinants and distribution of first conception wait among ever married women in Bangladesh, extracting data from Nationally Representative BDHS-2014 data set. In this study the overall first mean conception interval is found to be 19.13±20.80 months with substantial variations by independent variables. The mean time required to conceive for the first time is found relatively low (15.54) among the respondents living in Chittagong division. The mean conception delay is found longer among those who have cohabited below age 15 years (24.36) and shorter (15.57) for the older marriage cohort. The results display that the distribution of first conception wait is positively skewed (β1= 2.22) and leptokurtic (γ2= 6.65). Life table analysis shows that 76% women become conceived within only three years of their first cohabitation. The tri-mean (T) and spread (S) of the first conception interval are found 16 and 24 months respectively. The findings of this study recommend that strict implementation of significant variables-legal age at first marriage; increase the literacy rate, improvement of socioeconomic status and reduction of overweight would be fruitful for normal timing of first conception and further reduction of fertility in Bangladesh. The Chittagong Univ. J. Sci. 43(1): 75-92, 2021

Effect of Standardized Hydrangea serrata (Thunb.) Ser. Leaves Extract on Body Weight and Body Fat Reduction in Overweight or Obese Humans: A Randomized Double-Blind Placebo-Controlled Study.

Obesity is a major health problem that is caused by body fat accumulation and that can lead to metabolic diseases. Owing to several side effects of the currently used antiobesity drugs, natural plants have risen as safe and potential candidates to alleviate obesity. We have previously reported the antiobesity effect of Hydrangea serrata (Thunb.) Ser. leaves extract (WHS) and its underlying mechanisms. As an extension of our preclinical studies, this study aimed to investigate the effect of WHS on body weight and body fat reduction in overweight or obese humans. A total of 93 healthy overweight or obese males and females, aged 19–65 years, with body mass indexes (BMIs) ≥ 25 and <32 kg/m2, were recruited and received either an oral administration of 600 mg of WHS, or placebo tablets for 12 weeks. Daily supplementation with WHS decreased body weights, body fat masses, and BMIs compared with the placebo-treated group. The hip circumferences, visceral fat areas, abdominal fat areas, and visceral-to-subcutaneous ratios decreased after WHS supplementation. No significant side effects were observed during or after the 12 weeks of WHS intake. In conclusion, WHS, which has beneficial effects on body weight and body fat reduction, could be a promising antiobesity supplement that does not produce any side effects.

Can Unearned Income Make Us Fitter? Evidence from Lottery Wins

Although lower income is associated with overweight (and obesity), such an association is explained by a number of other confounding effects such as omitted variables (e.g., time preferences) explaining that income effect on overweight. We study the effect of unearned income shocks resulting from a lottery win (windfall income) on both overweight (alongside obesity and body mass index) distribution. We draw upon longitudinal data from the United Kingdom, a country where about half of a population plays the lottery. Our results suggest no evidence of contemporaneous effects of income on overweight, but a significant lagged effect. We find a reduction in overweight 12 months after a lottery win. A 10,000-sterling win reduces overweight by 2-3 percentage points. Furthermore, we document a nonlinear effect up to 36 months after the lottery win, suggesting that small wins increase overweight and large wins reduce it. The effect of a lottery win varies depending on an individual’s working hours and educational attainment. A lottery win among low education individuals decreases the risk of overweight.

Effect of Sodium-Glucose Cotransporter 2 Inhibitors on Weight Reduction in Overweight and Obese Populations without Diabetes: A Systematic Review and a Meta-Analysis.

BackgroundWe aimed to evaluate the efficacy of sodium-glucose cotransporter 2 (SGLT2) inhibitors for managing obesity in non-diabetic overweight or obese patients.MethodsFor purposes of this study, PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials were searched through May 2021. Randomized controlled trials published in English that compared SGLT2 inhibitors with placebo in overweight and obese patients without diabetes were included in the primary analysis. The random effects standardized mean difference ±95% confidence interval (95% CI) was calculated as the effect size.ResultsFive randomized controlled trials were included to evaluate body weight change, four trials to assess body mass index (BMI), and three trials to assess waist circumference were included. Results showed that the mean body weight loss on SGLT2 inhibitors in obese patients without diabetes was −1.62 kg (95% CI, −2.38 to −0.85 kg) when compared with placebo. Treatment with SGLT2 inhibitors was also associated with a greater reduction in BMI than placebo (weighted mean difference, −0.47 kg/m2; 95% CI, −0.62 to −0.31 kg/m2). The mean reduction in waist circumference with SGLT2 inhibitors versus placebo was 1.29 cm (95% CI, −2.62 to 0.04 cm), which was not statistically significant. There were no significant changes in fat mass, blood pressure, low-density lipoprotein cholesterol or high-density lipoprotein cholesterol with SGLT2 inhibitor treatment.ConclusionA meta-analysis demonstrated that although the weight lowering effect was mild, SGLT2 inhibitors significantly reduced body weight in obese patients without diabetes.

Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy

BackgroundWe developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of alternative fiscal policies on childhood overweight and obesity in Italy.MethodsMICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the Italian EU-SILC 2010 data. Secondly, module 2 (M2) exploits data provided by the Italian birth cohort called Nascita e Infanzia: gli Effetti dell’Ambiente (NINFEA), translated as Birth and Childhood: the Effects of the Environment study, and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages. Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios.ResultsBoth universal benefits, such as universal basic income (BI), and targeted interventions, such as child benefit (CB) for poorer households, have a significant effect on childhood overweight, with a prevalence ratio (PR) in 10-year-old children—in comparison with the baseline fiscal system—of 0.88 (95%CI 0.82–0.93) and 0.89 (95%CI 0.83–0.94), respectively. The impact of the fiscal reforms was even larger for child obesity, reaching a PR of 0.67 (95%CI 0·50–0.83) for the simulated BI and 0.64 (95%CI 0.44–0.84) for CB at the same age. While both types of policies show similar effects, the estimated costs for a 1% prevalence reduction in overweight and obesity with respect to the baseline scenario is much lower with a more focalised benefit policy than with universal ones.ConclusionsOur results show that fiscal policies can have a strong impact on childhood health conditions. Focalised interventions that increase family income, especially in the most vulnerable populations, can help to prevent child overweight and obesity. Robust microsimulation models to forecast the effects of fiscal policies on health should be considered as one of the instruments to reach the Health in All Policies (HiAP) goals.

Improving local food environments and dietary habits in adolescents by engaging with stakeholders in the Netherlands

The purpose of this article is to describe a series of recent studies from the authors and many of their colleagues aimed at improving the food environments of adolescents in the Netherlands and thereby improving their food choices. These studies are performed in the wider context of national and local strategies for the prevention of overweight and obesity in the Netherlands. Interventions were developed with local stakeholders and carried out in schools, supermarkets and low-income neighbourhoods. We conclude that current national policies in the Netherlands are largely ineffective in reducing the prevalence of overweight and obesity. Local integrated programmes in the Netherlands, however, seem to result in a reduction of overweight, especially in low-income neighbourhoods. It is impossible to say which elements of such an integrated approach are effective elements on their own. We found very little evidence for the effectiveness of separate interventions aimed at small changes in the food environment. This suggests that such interventions are only effective in combination with each other and in a wider systems approach. Future studies are needed to further develop the practical methodology of implementation and evaluation of systems science in combination with participatory action research.

Breastfeeding and Overweight in European Preschoolers: The ToyBox Study.

The benefits of breastfeeding (BF) include risk reduction of later overweight and obesity. We aimed to analyse the association between breastfeeding practices and overweight/obesity among preschool children participating in the ToyBox study. Data from children in the six countries, participating in the ToyBox-study (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) 7554 children/families and their age is 3.5–5.5 years, 51.9% were boys collected cross-sectionally in 2012. The questionnaires included parents’ self-reported data on their weight, height, socio-demographic status, and infant feeding practices. Measurements of preschool children’s weight and height were done by trained researchers using standard protocols and equipment. The ever breastfeeding rate in the total sample was 85.0% (n = 5777). Only 6.3% (n = 428) of the children from the general sample were exclusively breastfed (EBF) for the duration of the first six months. EBF for four to six months was significantly (p < 0.001) less likely among mothers with formal education < 12 years (adjusted Odds Ratio (OR) = 0.61; 95% Confidence interval (CI) 0.44–0.85), smoking throughout pregnancy (adjusted OR = 0.39; 95% CI 0.24–0.62), overweight before pregnancy (adjusted OR = 0.67; 95%CI 0.47–0.95) and ≤25 years old. The median duration of any breastfeeding was five months. The prevalence of exclusive formula feeding during the first five months in the general sample was about 12% (n = 830). The prevalence of overweight and obesity at preschool age was 8.0% (n = 542) and 2.8% (n = 190), respectively. The study did not identify any significant association between breastfeeding practices and obesity in childhood when adjusted for relevant confounding factors (p > 0.05). It is likely that sociodemographic and lifestyle factors associated with breastfeeding practices may have an impact on childhood obesity. The identified lower than desirable rates and duration of breastfeeding practices should prompt enhanced efforts for effective promotion, protection, and support of breastfeeding across Europe, and in particular in regions with low BF rates.

Effects of Sitagliptin as Monotherapy and Add-On to Metformin on Weight Loss among Overweight and Obese Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Sitagliptin is known as an antidiabetic agent inhibiting the dipeptidyl peptidase-4. Although sitagliptin may influence weight, controversial results have been reported, and there is no general agreement on this issue. Therefore, this study assessed the effect of sitagliptin as monotherapy and add-on therapy to metformin on weight reduction in overweight or obese cases with type 2 diabetes. We reviewed the following databases to identify all relevant papers published until 1st April 2021: Web of Science, MEDLINE, Embase, Scopus, Cochrane Central Register of Controlled Trials Cochrane Library, and Google Scholar. The research included all clinical trials investigating the effect of sitagliptin in obese or overweight adult patients with type 2 diabetes without any language restriction. In total, eighteen randomized controlled trials with 2009 participants were included in our meta-analysis. Results showed supplementation of sitagliptin has led to weight loss for sitagliptin treated (MD -0.99; 95% CI; (-1.87, -0.12); p=0.026)) and sitagliptin+metformin treated groups (MD -1.09; 95% CI; (-1.69, -0.49); p<0.001)). Also, the intervention has influenced body mass index in sitagliptin treated (MD -0.23; 95% CI; (-0.45, 0.02); p=0.033)) and sitagliptin+metformin treated groups (MD -0.52; 95% CI; (-0.96, 0.08); p=0.020)) comparing to placebo. Our results demonstrated that sitagliptin administration with or without metformin might reduce the body weight and body mass index if these drugs are taken for more than 6 months.

Trend and Causes of Overweight and Obesity among Pre-School Children in Kuwait.

Identifying life risk factors of obesity early will help inform policymakers to design evidence-based interventions. The following study aims to assess the trend of overweight and obesity over four years among pre-school Kuwait children, and to examine their association with breakfast skipping (BF), sugary and sweetened beverage (SSB) consumption, and screen time. Children aged 2–5 years (n = 5304) were selected from 2016 to 2019 national surveys. Overweight and obesity were defined according to the World Health Organization references. The children’s mothers were asked about the BF of their children the day of the survey, their frequency of SSB consumption, and their weekly screen time use. Logistic regression was used to identify the risk factors associated with overweight/obesity. No significant decline (p values ≥ 0.12) was found for both overweight and obesity. Contrastingly, BF skipping, SSB consumption, and screen time declined (p < 0.0001). The BF skippers were found to have a 31% lower risk of being overweight. Daily TV watching, for 2–3 h, increases the odds of obesity by 5.6-fold. Our findings are encouraging regarding the decline in risky behaviours over time. However, more effort should be made both at the micro- and macro-level for a sustainable reduction in overweight and obesity.

Diabetes remission after malabsorptive bariatric surgery

Obesity and diabetes are two closely related disorders. Lifestyle changes and drug treatment do not achieve successful diabetes remission. A treatment option for these patients is bariatric surgery (BS). The partial and complete remission rates vary, depending on the type of technique used (restrictive or malabsorptive), with malabsorptive surgery being more effective in terms of both weight reduction and diabetes remission (DR). Different scales (DiaRem, Ad-DiaRem or 5y-Ad-DiaRem) predict the probability of DR after BS, particularly after gastric bypass surgery. Some studies report higher DR rates in surgery with a greater malabsorptive component. Our aim was to study the benefits of BS at one year and 5 years in terms of the weight and blood glucose profile in patients with obesity and type 2 diabetes mellitus; assess percentage DR according to ADA criteria; determine the DR predictive capacity of different scores; and examine which variables predict DR at one and five years after biliopancreatic diversion (BPD). Percentage overweight reduction and the decrease in both blood glucose and HbA1c were greater with BPD. Complete diabetes remission was approximately 80% at one and 5 years after BS. In general, the scores that determine the probability of DR show poor discriminative capacity in malabsorptive surgery. Presurgery HbA1c predicts DR at one and 5 years after BPD. The type of surgery performed should be individualized, based on the severity of diabetes and the specific characteristics of each patient.

Comparative assessment of overweight/obesity among rural and urban reproductive-age women in Ethiopia: Evidence from a cross-sectional 2016 national survey.

Overweight/obesity has become a global health problem for both developed and developing regions. Nowadays, overweight/obesity among childrearing-age women has become rapidly increasing in both urban and rural areas. This study aimed to assess the variation of overweight/obesity among urban and rural reproductive-age women in Ethiopia. For this study, the 2016 Ethiopia Demographic and Health Survey data were used. The survey was a community-based cross-sectional study, which used a two-stage stratified cluster sampling technique to select the participants. A total of 13,451 reproductive-age women were included in the analysis. Both descriptive and analytical analysis was performed. A p-value of less than 0.05 was used as the measure of statistical significance. The prevalence of overweight/obesity among urban reproductive-age women was statistically higher (p = 21.5%; 95% confidence interval (CI): 18.2-25.1) than the rural women (p = 3.5%; 95% CI: 2.9%-4.2%). Women who attend secondary or above education, women in the age groups 25-34 and ≥ 35 years, and high wealth index (rich) had higher odds of overweight/obesity in both urban and rural women. Moreover, women who were married, who had a large family size, and who have a history of alcohol intake had higher odds of overweight/obesity among urban women. Overweight/obesity among reproductive-age women is a public health problem in Ethiopia, especially for women who are living in urban settings. Therefore, it is important to establish targeted overweight reduction programs with particular emphasis on urban, older aged, educated, and married women. Additionally, encouraging the limitation of the number of family size and alcohol intake can reduce women's overweight/obesity.

Eficácia da telenfermagem na redução do peso e qualidade de vida de adultos: revisão integrativa

Objetivo: Identificar na literatura o conhecimento produzido sobre a eficácia da telenfermagem na qualidade de vida e na redução de peso de adultos sobrepesados e obesos. Método: Revisão integrativa de literatura, que incluem ensaios clínicos controlados randomizados publicados nas seguintes bases de dados: CINAHL, BVS, PUBMED, Web of Science, Embase e Google Scholar. A busca dos artigos, seleção, extração dos dados e avaliação metodológica pela ferramenta do risco de avaliação da JBI, foram realizados por dois revisores de forma independente. Resultados: Foram identificados 363 estudos, sendo cinco selecionados. Todos eles testaram a eficácia da telenfermagem na redução do peso, sendo que em três foi realizada a combinação desta ferramenta com equipamentos de telemonitoramento. Um estudo avaliou a telenfermagem na qualidade de vida. A maioria dos estudos apresentou baixo risco metodológico (n=4; 80%). Conclusão: A telenfermagem é uma ferramenta eficaz na redução do peso de adultos, sendo os resultados potencializados quando as ligações são realizadas com frequência mínima semanal, porém, a limitada quantidade de estudos que avaliaram a qualidade de vida de adultos sobrepesados e obesos, foi insuficiente para afirmar a eficácia desta intervenção.

Remisión de diabetes tras cirugía bariátrica malabsortiva

Obesity and diabetes are two closely related disorders. Lifestyle changes and drug treatment do not achieve successful diabetes remission. A treatment option for these patients is bariatric surgery (BS). The partial and complete remission rates vary, depending on the type of technique used (restrictive or malabsorptive), with malabsorptive surgery being more effective in terms of both weight reduction and diabetes remission (DR). Different scales (DiaRem, Ad-DiaRem or 5y-Ad-DiaRem) predict the probability of DR after BS, particularly after gastric bypass surgery. Some studies report higher DR rates in surgery with a greater malabsorptive component. Our aim was to study the benefits of BS at one year and 5 years in terms of the weight and blood glucose profile in patients with obesity and type 2 diabetes mellitus; assess percentage DR according to ADA criteria; determine the DR predictive capacity of different scores; and examine which variables predict DR at one and five years after biliopancreatic diversion (BPD). Percentage overweight reduction and the decrease in both blood glucose and HbA1c were greater with BPD. Complete diabetes remission was approximately 80% at one and 5 years after BS. In general, the scores that determine the probability of DR show poor discriminative capacity in malabsorptive surgery. Presurgery HbA1c predicts DR at one and 5 years after BPD. The type of surgery performed should be individualized, based on the severity of diabetes and the specific characteristics of each patient.

Body Weight Loss Before Allogeneic Hematopoietic Stem Cell Transplantation Predicts Survival Outcomes in Acute Leukemia Patients

Most acute leukemia patients receive consecutive intensive chemotherapy, which usually takes several months before allogeneic hematopoietic stem cell transplantation (allo-HCT). Intensive chemotherapy often induces gastrointestinal adverse events. These adverse events leave patients in a state of malnutrition, leading to a reduction in body weight. In this study, we analyzed the impact of body weight loss before allo-HCT on survival outcomes of acute leukemia patients (acute myeloid leukemia, acute lymphoid leukemia and mixed phenotype acute leukemia). A loss of body weight (LBW), which was a reduction of body weight from diagnosis or relapse to transplantation, was calculated in 182 acute leukemia patients who received first allo-HCT at our center between June 2006 and September 2019. A receiver operating characteristics curve for nonrelapse mortality (NRM) was plotted for defining the cut-off value of LBW. The cutoff value of LBW was defined as 13.2%. A higher LBW was significantly associated with inferior NRM and overall survival (OS) (2-year [2y] NRM 36.1% versus 11.5%, P=.0025; 2y-OS 39.9% versus 65.8%, P=.020). The adverse impact of LBW was also confirmed in multivariate analyses for NRM and OS (HR of NRM 2.74 [1.25-6.03], P=.0012; HR of OS 2.06 [1.00-3.07], P=.0049). The main cause of death included disease progression (n=34) and infection (n=35). Death cause by infection was more frequently observed in the high-LBW group (15 cases [35.7%] versus 20 cases [14.3%]; P=.0035). In addition, subgroup analyses based on a combination of the body mass index at diagnosis and LBW were performed. When the non-overweight-low LBW group (body mass index [BMI] ≤25 and LBW ≤13.2%) was used as a reference in multivariate analysis, the overweight-high LBW group (BMI >25 and LBW >13.2%) showed an increased risk of poor survival outcomes (HR of NRM 4.27 [95% confidence interval {CI}, 1.82-10.0], P < .001; HR of OS 1.93 [95%, CI 1.00-3.71], P=.050). High LBW was significantly associated with inferior survival outcomes, and the adverse effect of malnutrition might be greater than the favorable effect of the reduction in overweight.

Obesity in patients with established coronary artery disease over a 20-year period (1997-2017).

Body mass reduction in overweight and obese people so as to reduce blood pressure, low‑density lipoprotein cholesterol level, and the risk of type 2 diabetes as well as to lower the risk of recurrent cardiovascular events is strongly recommended in current guidelines. To evaluate changes in body mass index (BMI) and waist circumference in patients with established coronary artery disease over a 20‑year period (1997-2017). Consecutive patients younger than 71 years of age and hospitalized for acute coronary syndrome or myocardial revascularization procedures were recruited and interviewed 6 to 18 months after their discharge from hospital. Weight, height, and waist circumference were measured in 1997 to 1998, 1999 to 2000, 2006 to 2007, 2011 to 2013, and 2016 to 2017. The same 5 hospitals took part in the surveys each time. We examined 412 patients in 1997 to 1998 (survey 1), 427 in 1999 to 2000 (survey 2), 422 in 2006 to 2007 (survey 3), 462 in 2011 to 2013 (survey 4), and 272 in 2016 to 2017 (survey 5). The proportion of obese patients was 24.5% in survey 1, 27.2% in survey 2, 34.1% in survey 3, 35.9% in survey 4, and 40.4% in survey 5 (P <0.001). The proportion of patients with central obesity also increased significantly (32.5% in survey 1, 40.5% in survey 2, 51.4% in survey 3, 48.6% in survey 4, and 61.3% in survey 5; P <0.001). BMI increased significantly in men, but not in women, whereas the mean waist circumference increased in both sexes. BMI and waist circumference increased irrespective of age and education. The analysis of 5 multicenter surveys showed a gradual increase in BMI and waist circumference in patients with established coronary artery disease over the course of 2 decades.