Risk In Obese Women Research Articles

Effects of time-restricted feeding in weight loss, metabolic syndrome and cardiovascular risk in obese women

BackgroundThe increasing prevalence of overweight and obesity among the worldwide population has been associated with a range of adverse health consequences such as Type 2 diabetes and cardiovascular diseases. The metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities that occur more commonly in overweight individuals. Time-restricted feeding (TRF) is a dietary approach used for weight loss and overall health. TRF may be an option for those subjects who struggle with extreme restriction diets with foods that generally do not belong to an individual's habits.ObjectiveThe purpose of this study was to determine the effect of TRF on body composition and the association of weight loss with metabolic and cardiovascular risks in obese middle-aged women.MethodsA non-randomized controlled clinical trial was performed over 3 months in obese women (TRF group, n = 20, BMI 32.53 ± 1.13 vs. Control n = 12, BMI 34.55 ± 1.20). The TRF protocol adopted was 16 h without any energy intake followed by 8 h of normal food intake.Main outcomes and measuresAnthropometric measurements, body composition, blood biomarkers, cardiovascular risk in 30 years (CVDRisk30y), and quality of life were evaluated at baseline and after the 3 months.ResultsTRF was effective in reducing weight (~ 4 kg), BMI, % of body fat (%BF), waist circumference from baseline without changes in blood biomarkers associated with MetS. TRF promoted a reduction in CVDRisk30y (12%) wich was moderately correlated with %BF (r = 0.62, n = 64, p < 0.001) and %MM (r = − 0.74, n = 64, p < 0.001).ConclusionsTRF protocol reduces body weight without changes in biomarkers related to MetS. In addition, the anthropometric evaluation that predicts %BF and %MM could be used as an approach to follow individuals engaged in the TRF regimen since they correlate with cardiovascular risk.

Effects of obesity on NK cells in a mouse model of postmenopausal breast cancer

Obesity is a widely spread disease and a crucial risk factor for malign disorders, including breast cancer of women in the postmenopause. Studies demonstrated that in case of obesity crucial natural killer (NK) cell functions like combating tumor cells are affected. This study aims to analyze NK cells and NK cell receptor expression of obese mice in a model for postmenopausal breast cancer. Therefore, female BALB/c mice were fed either a high fat or a standard diet. Thereafter, ovaries were ectomized and a syngeneic and orthotopical injection of 4T1-luc2 mouse mammary tumor cells into the mammary adipose tissue pad was performed. Obese mice showed increased body weights and visceral fat mass as well as increased levels of leptin and IL-6 in plasma. Moreover, compared to the lean littermates, tumor growth was increased and the NKp46-expression on circulating NK cells was decreased. Furthermore, the activating NK cell receptor NKG2D ligand (MULT1) expression was enhanced in adipose tissue of obese tumor bearing mice. The present study gives novel insights into gene expression of NK cell receptors in obesity and aims to promote possible links of the obesity-impaired NK cell physiology and the elevated breast cancer risk in obese women.

Illness spillovers of lethal police violence: the significance of gendered marginalization

ABSTRACT Police violence is a pressing public health problem. To gauge the illness associations of police killings – the most severe form of police brutality, we compile a unique multilevel dataset that nests individual-level health data from the 2009–2013 New York City Community Health Survey (nij = 39,267) within neighbourhood-level data from 2003 to 2012 EpiQuery Vital Statistics (nj = 34). Using weighted hierarchical generalized linear models, we assess main and gendered associations between neighbourhood exposures to lethal policing and five illnesses. Holding all else constant, living in lethally surveilled areas is linked to a greater risk of high blood pressure and obesity for all neighbourhood residents and to a greater risk of obesity for women. Furthermore, illness risks are also gendered: Women face a 30–54 percent greater risk of diabetes, high blood pressure, and obesity compared to men. Lethal police brutality is an important neighbourhood risk factor for illness and, especially, for women’s health.

Biomarkers of Cardiovascular Risk in Obese Women and their Relationship with Zinc Status

Background: Excessive adipose tissue, in the case of common obesity, has been associated with an endocrine-metabolic alteration that contributes to a manifestation of dyslipidemia. To identify mechanisms which are involved in disorders of lipid metabolism, several nutrients have been studied, especially zinc, which act by regulating transcription factors that are important for synthesis and oxidation of lipids and act as an anti-inflammatory and antioxidant nutrient. Thus, the study makes an assessment of the zinc status and biomarkers of cardiovascular risk in obese women. Methods: A case-control study enrolling obese (body mass index (BMI) ≥35 kg/m²) and eutrophic (BMI 18.5-24.9 kg/m²) Brazilian women was conducted. Dietary zinc intake was assessed by the three-day food registry. Plasma, erythrocyte and urinary zinc concentrations were determined by inductively coupled plasma optical emission spectrometry. Cardiovascular risk was assessed by plasma concentrations of lipid fractions, and by anthropometric measures. Results: Both groups showed a dietary zinc intake above the recommendations, with no statistical difference between them (p &gt;0.05). Mean plasma and erythrocyte zinc concentrations were significantly reduced in obese women, compared to the control group (p &lt;0.05). Urinary zinc excretion was significantly higher in obese women (p &lt;0.05), who also had a significantly higher cardiovascular risk when compared to the control group (p &lt;0.05). An inverse correlation between dietary zinc intake and waist-hip ratio was found in obese women. Conclusion: Obese women presented zinc redistribution characterized by reduced concentrations in plasma and erythrocytes, dietary zinc intake above the recommended, and increased zinc excretion in the urine. This study shows dyshomeostasis of zinc in obesity, a possible role in adiposity control and, consequently, its protective role against cardiovascular risk, due to its influence on risk biomarkers, such as waist-hip ratio.

Association Between Organic Food Consumption and Risk of Obesity in Women

Abstract Objectives Organic food consumption has been inversely associated with obesity in cross-sectional studies. Few have investigated this with prospective data. We examined whether organic food consumption was associated with the risk of obesity. Methods We used data from 37,706 eligible Sister Study (2003–2009) participants aged 35–74 years who provided information on frequency of organic food consumption. Participants reported their consumption of organic produce, meat, and dairy during the past 12 months as never, less than half the time, about half the time, or more than half the time. An organic diet score (ODS) was calculated by assigning scores of 0, 1, 2 and 3 for increasing consumption proportions and summing across food groups (maximum score 9). Prevalent obesity was based on measured general obesity (body mass index [BMI]≥30.0) and central obesity (waist circumference [WC] ≥88 cm, waist-to-height ratio [WHtR] ≥0.5). To evaluate incident overweight and obesity, self-reported BMI at enrollment was compared to self-reported BMI during follow-up (mean, 8.3 years). We used generalized log-linear models with robust error variance to estimate multivariable-adjusted prevalence ratios (PRs) and relative risks (RRs) for prevalent and incident obesity, respectively. Results At baseline, 62% of women reported eating organic food in the last 12 months. Compared with no consumption of organic food, higher ODS (≥3) was associated with a lower prevalence of obesity at baseline (PR for BMI = 0.98; 95% CI, 0.97–0.99; PR for WC = 0.94; 95% CI, 0.92–0.97; and PR for WtHR = 0.95; 95% CI, 0.93–0.98), after adjusting for socioeconomic, demographic, and lifestyle factors, including physical activity and other dietary measures. Higher ODS was inversely associated with gaining ≥5 kg (RR = 0.87; 95% CI, 0.82–0.92; P-trend &amp;lt; .001), a BMI increase ≥10% (RR = 0.88; 95% CI, 0.82–0.94; P-trend &amp;lt; .001). Among those who were not overweight or obese at enrollment, higher ODS was associated with becoming overweight (RR = 0.81; 95% CI, 0.73–0.91; P-trend &amp;lt; .001) or obese (RR, 0.84; 95% CI, 0.74–0.96; P-trend = .007). Associations did not differ by diet quality or socio-demographic factors. Conclusions Organic food consumption was associated with decreased risk of weight gain and decreased risk of becoming overweight or obese. Funding Sources National Institute of Environmental Health Sciences.

Do physical activity, sitting time and body mass index affect fertility over a 15-year period in women? Data from a large population-based cohort study.

Do physical activity (PA), sitting time (ST) and body mass index (BMI) affect fertility over a 15-year period in Australian women? Moderate and high levels of PA confer advantages for fertility in women with normal BMI, but increased risk of infertility was observed in obese women. Higher BMI is positively associated with higher rates of problems with fertility, but the effects of physical activity and sitting time on fertility are less well understood. Participants in The Australian Longitudinal Study of Women's Health (ALSWH) completed mailed surveys in 2000, with follow-ups in 2003, 2006, 2009, 2012 and 2015 (N= 6130). Participants were aged 22 to 27 in 2000. They were asked to report their physical activity levels, sitting time and fertility problems in each survey from 2000 to 2015. BMI was calculated from self-reported weight and height. Cumulative incidence of fertility problems was calculated from 2000 to 2015 and hazard ratios (HR) and 95% CIs were calculated using survival analysis. From 2000 to 2015, the cumulative incidence of fertility problems was 15.4% (95% CI: 14.5-16.4). High levels of PA were associated with reduced risk of problems with fertility [HR 0.82 (95% CI: 0.69-0.98)], and higher BMI was positively associated with fertility problems [overweight: HR 1.18, (95% CI 0.99-1.39); obese: HR 1.36, (95% CI 1.14-1.63)]. In survival analyses, incidence rates were highest in every survey interval in women who reported low PA levels and in women who were obese. Overall, ST was not associated with fertility problems. In stratified models, high levels of PA attenuated the risk of problems with fertility in women who were in the normal BMI category [HR 0.64, (95% CI 0.49-0.82)]. The ALSWH relies on self-reported data, which may be subject to recall bias. The study provides estimates of problems with fertility in a cohort of young adult Australian women, and the results indicate that these are inversely associated with physical activity levels and positively associated with BMI. However, the high infertility risk in obese women was not attenuated by high levels of PA. The protective effects of PA were only observed in women with normal BMI. As rates of developing problems with fertility were highest in every survey interval among women who reported low levels of physical activity and in women who were obese, these findings suggest that improving physical activity levels could be an affordable strategy to reduce problems with fertility in women who are trying to conceive. These findings should be considered by clinical and public health practitioners. The ALSWH is funded by the Australian Government. Funding for these analyses was provided by a University of Queensland (UQ) International Postgraduate Research Scholarship and a UQ International Development Fellowship. The authors declare no conflicts of interest.

Energy balance and occupational activity as predictors of obesity risk in women.

AbstractReduced occupational energy expenditure and increased energy intake are important contributors to the increasing prevalence of obesity. The aim of this study was to examine whether sedentary occupations, and specific indicators of energy intake and expenditure are associated with obesity risk in Australian women. Data were from 3,444 participants in the Australian Longitudinal Study on Women's Health, who reported their weight, dietary intake, physical activity and occupation in 2009 (at age 31–36), and weight in 2012. Participants were categorised as having a ‘less sedentary’ or ‘sedentary work’, based on occupation and activity patterns at work. Multivariate models were conducted to examine the odds of being obese (&gt; 30 body-mass index) and risk of obesity in the two occupational groups based on energy balance factors (diet and physical activity). Models were adjusted for major confounders (smoking, education, income, number of children).There was no significant difference in the prevalence of obesity between groups (20.3% less sedentary vs 22.7% sedentary work, p = 0.11) at baseline. Being in the highest total energy intake tertile, saturated fat intake &gt; 35g/d and drinking 3 or more sugar-sweetened beverages per week increased the odds of being obese in both groups. But to a higher extent in ‘less sedentary work’ (OR 2.11 95%CI 1.41–3.19; OR 3.04 95%CI 2.09–4.45; 2.07 95%CI 1.45–2.97, respectively). High physical activity (&gt; 1000MET.min/week) was consistently associated with lower odds of being obese (OR 0.64 95%CI 0.43–0.97 ‘less sedentary’; OR 0.58 95%CI 0.36–0.93 ‘sedentary work’) but lower incidence of obesity only in ‘less sedentary work’ group (IRR 0.52 95%CI 0.30–0.88, absolute risk 14%). High sugar-sweetened beverages increased the incidence of obesity only in this group (IRR 1.72 95%CI 1.08–2.73, absolute risk 23%). Having a sedentary work per se did not play a major role in obesity prevalence and risk in women. Instead, high saturated fat and SSB intake, and physical inactivity remained the major contributors to obesity prevalence and risk, particularly for those in less sedentary jobs.

Selênio plasmático e sua relação com parâmetros de risco cardiovascular em mulheres obesas

O presente estudo tem por objetivo avaliar a relação entre a concentração plasmática de selênio e o risco cardiovascular em mulheres obesas. Trata-se de um estudo caso-controle, envolvendo 67 mulheres, com idade entre 20 e 50 anos, sendo distribuídas em dois grupos: grupo controle (mulheres eutróficas, n=42) e grupo caso (mulheres obesas n=25). Foram analisados selênio plasmático e perfil lipídico (colesterol total, triglicerídeos, HDL-colesterol, LDL-colesterol e VLDL-colesterol). Os dados foram analisados no programa estatístico SPSS for Windows 22.0. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal do Piauí, sob número de parecer 2.014.100. Quanto aos resultados, observou-se concentrações menores de selênio plasmático para o grupo composto pelas obesas, com diferença estatística significativa entre os grupos (p&lt;0,001). Paralelamente, encontrou-se concentrações maiores de colesterol total, HDL-colesterol, LDL-colesterol e índices de Castelli I e II entre as mulheres obesas, em comparação com as eutróficas, com diferença estatística significativa (p&lt;0,05). Para o resultado da análise de correlação entre as variáveis, verificou-se que houve correlação moderada negativa entre o selênio plasmático, colesterol total e LDL-colesterol (p&lt;0,05). Diante dos resultados obtidos, o estudo mostra a provável influência do selênio sobre parâmetros do perfil lipídico e, consequentemente, na redução do risco cardiovascular, a exemplo da relação inversa evidenciada entre a concentração plasmática do mineral, colesterol total e LDL-colesterol.

Endothelial function following interval exercise plus low-calorie diet treatment in obese females.

We determined if interval exercise plus a low‐calorie diet (LCD + INT) increases endothelial function more than an energy‐matched LCD. Obese women (47.2 ± 2.6y, 37.5 ± 1.3kg/m2) were randomized to 13 days of a LCD (n = 12; mixed meals of ~ 1200kcal/d) or LCD + INT (n = 13; 12 supervised 60‐min INT bouts of 3 min at 90% and 50% HRpeak). LCD + INT subjects received 350kcal postexercise to equate energy availability with LCD. Fitness (VO2peak) and body composition (BodPod) were determined and a 120 min, 75 g oral glucose tolerance test was performed to examine fasting and postprandial flow‐mediated dilation (FMD, endothelial function), respiratory exchange ratio (RER) via indirect calorimetry as well as glucose and insulin incremental area under the curve (iAUC120min). LCD + INT increased VO2peak (P = 0.02) compared with LCD, and both treatments decreased fat mass (P < 0.001) and insulin iAUC120min (P = 0.03). There was no overall treatment effect on fasting or iAUC120min FMD. However, in participants who increased fasting endothelial function after each treatment (Δ > 50%; LCD n = 5, LCD + INT n = 7), LCD + INT increased fasted (P = 0.005) and decreased iAUC120min (P = 0.003) FMD compared with LCD. Enhanced fitness correlated with increased fasting FMD (r = 0.43, P = 0.03) and diminished FMD iAUC120min (r = −0.44, P = 0.03). Decreased FMD iAUC120min correlated with reduced glucose iAUC120min (r = 0.64, P = 0.001) as well as increased 60‐min RER (r = −0.42, P = 0.04). Low baseline fasting and iAUC120min FMD was also linked to enhanced fasting and iAUC120min FMD post‐treatment (r = −0.71, P < 0.001; r = −0.89, P < 0.001, respectively). In conclusion, increasing fitness via INT may increase the effect of LCD on lowering cardiovascular disease risk in obese women.

Association of Exposure to Artificial Light at Night While Sleeping With Risk of Obesity in Women

Short sleep has been associated with obesity, but to date the association between exposure to artificial light at night (ALAN) while sleeping and obesity is unknown. To determine whether ALAN exposure while sleeping is associated with the prevalence and risk of obesity. This baseline and prospective analysis included women aged 35 to 74 years enrolled in the Sister Study in all 50 US states and Puerto Rico from July 2003 through March 2009. Follow-up was completed on August 14, 2015. A total of 43 722 women with no history of cancer or cardiovascular disease who were not shift workers, daytime sleepers, or pregnant at baseline were included in the analysis. Data were analyzed from September 1, 2017, through December 31, 2018. Artificial light at night while sleeping reported at enrollment, categorized as no light, small nightlight in the room, light outside the room, and light or television in the room. Prevalent obesity at baseline was based on measured general obesity (body mass index [BMI] ≥30.0) and central obesity (waist circumference [WC] ≥88 cm, waist-to-hip ratio [WHR] ≥0.85, or waist-to-height ratio [WHtR]≥0.5). To evaluate incident overweight and obesity, self-reported BMI at enrollment was compared with self-reported BMI at follow-up (mean [SD] follow-up, 5.7 [1.0] years). Generalized log-linear models with robust error variance were used to estimate multivariable-adjusted prevalence ratios (PRs) and relative risks (RRs) with 95% CIs for prevalent and incident obesity. Among the population of 43 722 women (mean [SD] age, 55.4 [8.9] years), having any ALAN exposure while sleeping was positively associated with a higher prevalence of obesity at baseline, as measured using BMI (PR, 1.03; 95% CI, 1.02-1.03), WC (PR, 1.12; 95% CI, 1.09-1.16), WHR (PR, 1.04; 95% CI, 1.00-1.08), and WHtR (PR, 1.07; 95% CI, 1.04-1.09), after adjusting for confounding factors, with P < .001 for trend for each measure. Having any ALAN exposure while sleeping was also associated with incident obesity (RR, 1.19; 95% CI, 1.06-1.34). Compared with no ALAN, sleeping with a television or a light on in the room was associated with gaining 5 kg or more (RR, 1.17; 95% CI, 1.08-1.27; P < .001 for trend), a BMI increase of 10% or more (RR, 1.13; 95% CI, 1.02-1.26; P = .04 for trend), incident overweight (RR, 1.22; 95% CI,1.06-1.40; P = .03 for trend), and incident obesity (RR, 1.33; 95% CI, 1.13-1.57; P < .001 for trend). Results were supported by sensitivity analyses and additional multivariable analyses including potential mediators such as sleep duration and quality, diet, and physical activity. These results suggest that exposure to ALAN while sleeping may be a risk factor for weight gain and development of overweight or obesity. Further prospective and interventional studies could help elucidate this association and clarify whether lowering exposure to ALAN while sleeping can promote obesity prevention.

Estrogen on the breast Yin or Yan?

The normal breast and most of breast cancers are influenced by hormones. Estradiol is responsible of the rapid proliferation of the breast at puberty. Breast cancers belong to different histological types defined by their content in hormone receptors (estradiol and progesterone receptors (ER,PR)), the amplification of HER2 or the lack of these markers. The prognosis of these types is different the best one beeing the ER+,PR+ breast cancers (luminal A type), the worse the triple negative ones, devoided of ER, PR and HER2. In preclinical models, transfection of ER into breast cancer celles ER-rescue a better diferentiated state. Combined menopause hormonal treatment (MHT) is associated with a higher risk fo breast cancer than the estrogen alone. There are no randomised head to head studies in post menopausal women with the two types of treatment. However all the studies reported a different level of risk in women using estrogen alone and a combined MHT. In the randomized trial from the WHI, in women hysterectomized, conjugated estrogen were associated with a decreased risk of breast cancer and deaths. This is not what was seen in a large cohort study (The Nurses’) where an increase at long term (>15 years of use) was observed or in most of observational studies with estradiol. However at short term the risk is negligeable. The difference in the risks observed in the WHI and other studies can be attributed to the difference in characteristics of the populations. In the WHI, obesity concerned 40% of the women whereas in the Nurses’, women were much leaner. One of the benefit from estrogen is to decrease insulinresistance and could explain a decrease in the risk in obese women. Furthermore conjugated estrogens contain hundreds or derivatives estrogen agonist and antagonists and thus the resultant effect on breast cancer can vary from estradiol treatment. Maybe another factor is the age of the women included in the WHI, which were in majority far from menopause. The different hypothesis to explain the results of the WHI will be discussed.

Cardiovascular risk in obese women with polycystic ovary syndrome using Framingham scoring system

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Obesity risk in women of childbearing age in New Zealand: a nationally representative cross-sectional study.

To investigate risk factors for women with obesity of childbearing age. A cross-sectional survey of New Zealand women (15-49years) with measured height and weight was used [unweighted (n = 3625) and weighted analytical sample (n = 1,098,372)] alongside sociodemographic-, behavioural- and environmental-level predictors. Multilevel logistic regression weighted for non-response of height and weight data was used. Meeting physical activity guidelines (AOR (adjusted odds ratio) 0.66, 95% CI 0.54-0.80), Asian (AOR 0.15, 95% CI 0.10-0.23) and European/other ethnicity (AOR 0.46, 95% CI 0.36-0.58) and an increased availability of public greenspace (Q4 AOR 0.55, 95% CI 0.41-0.75) were related to decreased obesity risk. Older age (45-49years AOR 3.01, 95% CI 2.17-4.16), Pacific ethnicity (AOR 2.81, 95% CI 1.87-4.22), residing in deprived areas (AOR 1.65, 95% CI 1.16-2.35) or secondary urban areas (AOR 1.49, 95% CI 1.03-2.18) were related to increased obesity risk. When examined by rural/urban classification, private greenspace was only related to increased obesity risk in main urban areas. This study highlights factors including but not limited to public greenspace, which inform obesity interventions for women of childbearing age in New Zealand.

Abstract P250: Sex-Related Differences in the Associations of Variability in Body Mass Index and Metabolic Health With Incidence of Obesity and Metabolically Unhealthy Status: The Framingham Offspring Study

Introduction: Higher variability of body mass index (BMI) is associated with both cardiometabolic and cardiovascular disease in high-risk individuals. It is unclear, however if variability of BMI impacts metabolic health or obesity risk in healthy adults and if any potential associations vary for women vs. men. Methods: We classified Framingham Offspring cohort participants (n=3,961, mean age 50.8 years, 53.8% women) according to their obesity (BMI ≥30 kg/m 2 ) and metabolic health status (&lt;2 non-obesity NCEP ATPIII conditions) and followed them prospectively 1987 to 2014. BMI and metabolic syndrome (MetS)-associated measures in the top quintile of the variance independent of the mean were classified as being variable. ‘Variable metabolic health’ (VMH) was defined as ≥2 ‘variable’ non-obesity MetS components. We estimated sex-specific incident rate ratios (IRRs) and 95% confidence intervals (95% CIs) for the associations of time-varying obesity, metabolic health status, and variability of BMI and metabolic health with the incidence of obesity and metabolically unhealthy state using Cox proportional hazards regression for interval-censored outcomes with age as the time scale. Results: On follow-up, 567 participants (313 women) developed new-onset obesity over 9,434 person-periods, and 759 individuals (437 women) developed a metabolically unhealthy state over 5,754 person-periods). After adjustment for covariates, being metabolically unhealthy was associated with a greater risk of new-onset obesity among women (153%, 95% CI 96-229%) compared with men (33%, 95% CI: 1, 79%; p sex- difference =0.005). Similarly, BMI variability was associated with a higher risk of becoming metabolically unhealthy in women (134%, 95% CI: 76, 212%) compared with men (-11%, 95% CI: -49, 53% (p sex-difference =0.0007). Among participants without obesity, BMI variability was associated with a greater risk of incident obesity in women (275%, 95% CI: 185, 393%) compared with men (33%, 95% CI: -22, 129% p sex- difference =0.005). Obesity was positively associated with greater risk of incident unhealthy metabolic state in women (157%, 95% CI: 93, 342%) compared to men (16%, 95% CI: -17, 62%; p sex-difference =0.006). Metabolic health did not alter the risk of either outcome among metabolically healthy or unhealthy individuals. Conclusions: Our longitudinal observations in a community-based sample suggest sex-related differences in the associations of variability of BMI and metabolic health on obesity and cardiometabolic risk. Additional investigations are warranted to replicate our findings and elucidate the biological basis for these sex-related differences. .

Double Discourse: Qualitative Perspectives on Breast Screening Participation among Obese Women and Their Health Care Providers.

Obesity in Australia is rising rapidly, and is a major public health concern. Obesity increases the risk of breast cancer and worsens associated outcomes, yet breast screening participation rates in Australia are suboptimal and can be lower in higher risk, obese women. This study qualitatively explored barriers to breast screening participation in obese women in Australia. In-depth interviews (n = 29), were conducted with obese women (body mass index ≥ 30) and key health providers. A disconnect between providers’ and women’s perceptions was found. For women, low knowledge around a heightened need to screen existed, they also reported limited desire to prioritize personal health needs, reluctance to screen due to poor body image and prior negative mammographic experiences due to issues with weight. Providers perceived few issues in screening obese women beyond equipment limitations, and health and safety issues. Overall, weight was a taboo topic among our interviewees, indicating that a lack of discourse around this issue may be putting obese women at increased risk of breast cancer morbidity and mortality. Consideration of breast screening policy in obese women is warranted. Targeted health promotion on increased breast cancer risk in obese women is required as is a need to address body image issues and encourage screening participation.

The effects of elastic resistance band training and green coffee bean extract supplement on novel combined indices of cardiometabolic risk in obese women.

The main purpose of this study was to investigate the effects of elastic resistance band training (ERBT) and green coffee bean extract (GCBE) supplement on novel cardiometabolic indices in obese women. To this end, a total number of 60 obese women aged 30-50 years with a body mass index of > 30 kg/m2 were selected for inclusion in this study and then they were randomly assigned to one of the following four groups: placebo (n = 15), GCBE supplement (n = 15), GCBE supplement + ERBT (n = 15), and placebo + ERBT (n = 15). Each commercially prepared GCBE supplement capsule used in this study contained 500 mg of GCBE supplement and it was also claimed by the manufacturer to have 50% chlorogenic acid (CGA) (250 mg). The participants in the placebo + ERBT and GCBE supplement + ERBT groups attended an 8-week ERBT program, 3 sessions / week, and 60 min each session. In the GCBE supplement + ERBT group, Framingham risk score (P = 0.018), atherogenic index of plasma (P = 0.003), and metabolic syndrome severity score (P = 0.001) significantly decreased. Taken together, the results of the present study supported the importance of supplemental and resistance-type training in improving obesity and novel cardiometabolic risk scores, despite the fact that longer nutritional and exercise interventions could enhance some cardiometabolic risk scores in obese women.

Influence of food preparation behaviors on 5-year weight change and obesity risk in a French prospective cohort

BackgroundFood preparation behaviors may markedly determine dietary intake and consequently influence weight status. However, the few available studies have found equivocal results. No study has prospectively investigated the association between food preparation behaviors and weight change over time. We estimated the associations of food preparation behaviors with the 5-year relative weight change and the risk of developing obesity in 12,851 French adults participating in the NutriNet-Santé cohort study. The mediating effect of dietary intake was also addressed.MethodsFrequency and time for meal preparation, cooking skills, preparation from scratch, kitchen equipment, cooking enjoyment, willingness to cook better/more frequently and dietary intake were assessed at baseline using web-based questionnaire and 24 h records, respectively. Self-reported anthropometric data were collected using questionnaire, at baseline and after 5 years of follow-up. Associations of such behaviors with 5-year relative weight change and the mediation analyses were assessed through multivariate linear regression models, and obesity risk was analyzed with logistic regression, stratified by sex and adjusted for age, household composition, education, occupation, income, physical activity, smoking and history of dieting.ResultsIn women, preparation from scratch was prospectively associated with a decreased risk of obesity over the 5-year follow-up (OR = 1.32 (1.08; 2.32)) after adjustment. After including dietary mediating factors, the association between preparation from scratch and obesity risk in women did not remain significant (P = 0.08). This association appeared to be partly mediated by dietary factors with a difference of 59% of the estimate, in the group with the low score, between the adjusted model and those with mediators (OR = 1.13 (0.71; 1.77)). Regarding 5-year relative weight change, after adjustment for confounding factors, all associations between indicators of food preparation behaviors and weight change became non significant.ConclusionsIn the context from reduced time spent preparing meals that could have an impact on dietary quality and health in industrialized countries, our prospective study does not show effect of food preparation behaviors on 5-year relative weight change and obesity risk, except for preparation from scratch on obesity risk in women. Our study provides useful information about the long term implications of food preparation behaviors on health and should be corroborated by future studies, particularly on the effect of food preparation behaviors on chronic diseases such as incident diabetes, hypertension or cardiovascular diseases, compared with other determinants.Trial registrationNCT03335644 on ClinicalTrials.gov

Cesarean Risk in Obese Women at Term: A Retrospective Cohort Analysis

(Aust N Z J Obstet Gynaecol. 2017;57(4):440–445) Obesity in pregnancy is a growing issue and has been associated with increased risk of maternal and fetal complications such as gestational diabetes and hypertensive disorders of pregnancy. While increased fetal surveillance during such pregnancies has been recommended, there is little information concerning the induction of labor (IOL) in pregnant obese women. This retrospective study aimed to compare the impact of IOL and expectant management on neonatal and maternal outcomes, hypothesizing that term IOL was not associated with an increased risk of cesarean delivery.

In women with PCOS, waist circumference is a better surrogate of glucose and lipid metabolism than disease status per se.

Cardiometabolic abnormalities are recognized in polycystic ovary syndrome (PCOS). However, over-emphasis on PCOS as a risk factor potentially results in over-investigation and treatment of some women with and under-recognition of cardiometabolic risk in obese women without PCOS. Our objective was to explore the association between waist circumference (WC) and indices of glucose and lipid metabolism in women with and without PCOS. (i) An exploratory cross-sectional study investigating association of potential cardiometabolic risk markers (PCOS status, anthropometric measures, hsCRP, HOMA-IR, SHBG, testosterone) with indices of glucose (frequently sampled intravenous glucose tolerance test) and lipid metabolism (postprandial studies and lipoprotein particle size) in 61 women with (n=29) and without (n=32) PCOS; (ii) a cross-sectional study in 103 PCOS women and 102 BMI-matched controls to explore if between-group differences in indices of lipid and glucose metabolism persist after adjusting for WC. NIH criteria were used for PCOS diagnosis. Study 1: Univariate correlations and stepwise regression modelling identified waist circumference (WC), as a better surrogate than PCOS status, independently predicting multiple variables of glucose and lipid metabolism. Study 2: Fasting insulin and triglyceride, hsCRP and insulin resistance (according to HOMA-IR and SiM [Avignon index]) were greater, while fasting HDL was lower in women with PCOS compared to BMI-matched women without PCOS. None of these differences persisted when a subset of 80 women with PCOS was compared with 80 women without PCOS, pair-matched for WC. Some cardiometabolic abnormalities in PCOS are related to central obesity, and following adjustment for WC does not differ from normal subjects. Waist circumference measurement has potential to take precedence over PCOS status as part of the assessment of cardiometabolic risk in reproductive-age women.

Balanced high fat diet reduces cardiovascular risk in obese women although changes in adipose tissue, lipoproteins, and insulin resistance differ by race

BackgroundWe previously reported that consuming a balanced high fat diet (BHFD) wherein total saturated fat was reduced and total unsaturated fat increased by proportionately balancing the type of fat (1/3 saturated, 1/3 monounsaturated, 1/3 polyunsaturated) led to significant improvements in inflammatory burden, blood pressure, and vascular function in obese premenopausal European American (EA) and African American (AA) women. ObjectiveHere we compared changes in adipose tissue, lipoproteins, insulin resistance, and cardiovascular risk between EA and AA women. MethodsDietary intakes, plasma fatty acids, lipids, apolipoproteins, lipoproteins, HOMA-IR and ASCVD risk was measured in 144 women who consumed BHFD for 16 weeks. Generalized linear modeling was performed while controlling for change in body weight. ResultsEA women had greater reductions in visceral adipose tissue. Only EA women had significant reductions in fasting insulin levels (↓24.8%) and HOMA-IR (↓29%) scores. In EA women, the most significant improvements occurred in VLDL particle size (↑), apolipoprotein B levels (↑), serum TG (↓), number of plasma LDL particles (↓), and serum LDL-cholesterol (↓). In AA women, significant improvements occurred in HDL particle size (↑), number of large HDL particles (↑), and apolipoprotein AI levels (↑). Consequently, both groups had improved ASCVD risk scores (↓5.5%). ConclusionsConsuming the balanced high fat diet led to significant reduction in cardiovascular risk factors in both groups. However, the pattern of response to BHFD differed with EA women responding more in components of the apolipoprotein B pathway versus AA women responding more in components of the apolipoprotein AI pathway.